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  • 1.
    Ahlander, Britt-Marie
    et al.
    Ryhov County Hospital, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Engvall, Jan
    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 Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Maret, Eva
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Ericsson, Elisabeth
    University of Örebro, Sweden.
    Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 6, p. 1368-1380Article in journal (Refereed)
    Abstract [en]

    Aim. To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire. Background. Questionnaires measuring patients anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed. Design. Psychometric cross-sectional study with test-retest design. Methods. A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imaging-scanners. The sample was recruited between October 2012-October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbachs alpha. Criterion-related validity, known-group validity and test-retest was calculated. Results. Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbachs alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale. Conclusion. Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.

  • 2.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine
    Sweden Lorraine Evangelista, RN, Prof, University of California, Irvine, CA, USA.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    The associations between physical activity and appetite in patients with heart failure – a prospective observational study2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Physical activity and appetite both play a crucial role for health outcomes and quality of life in patients with heart failure. Nevertheless, both of these key functions are frequently decreased in patients with heart failure. Whilst most attention focuses independently on the physical activity levels, the associations with appetite has been insufficiently investigated. The aim was therefore to explore the associations between physical activity and appetite in community dwelling heart failure patients.

    Methods: This prospective observational study consisted of 186 patients with symptomatic heart failure of whom 56 (30%) were women and 130 (70%) were men. Mean age was 70.7 (SD=11 years), the majority had NYHA-class II, 114 (63%). Objective and subjective methods were used to measure physical activity include a wearable actigraph (SenceWear) for 4 days and six minutes’ walk test. The actigraph calculate total energy expenditure, active energy expenditure, number of steps and METs daily average index. Patients also stated their physical activity level on a numeric rating scale. A self-reported questionnaire, the Council on Nutrition Appetite Questionnaire was used to assess appetite. Simple linear regression was conducted to explore the associations between physical activity and appetite at baseline and at 18-month follow-up.

    Results: In general, the levels of physical activity in this sample was low and appetite was poor. There was a significant association between objective physical activity measures and appetite at baseline ranging between (p=<0.001-0.041). The number of steps and walking distance had the strongest association, each explaining 6% and 7% of the total variance in appetite. At the 18-month follow-up, all objective and subjective physical activity measures were associated with appetite (p=0.001-0.035) with the number of steps being most strongly associated (p=<0.001) explaining 14% of the total variation in appetite.

    Conclusions: Patients with heart failure who are more physically active experiences better appetite. These findings underscore the importance of placing greater attention on both physical activity and appetite in clinical practice as these factors has implications for patient’s health outcomes. Further longitudinally oriented studies are needed to determine whether there is a causal relationship between physical activity and appetite in heart failure populations.

    Keywords: Appetite, Heart Failure, Physical activity

  • 3.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    The assosciation between depressive symptoms and appetite among patients with chronic heart failure2012Conference paper (Other academic)
  • 4.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Chung, Misook
    College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
    Lennie, Terry
    College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Depressive symptoms as a moderator and mediator of the relationship between physical activity, appetite and perceived health among patients with heart failure2015Conference paper (Other academic)
    Abstract [en]

    Purpose: Depressive symptoms have been shown to directly influence perceived health among persons with heart failure (HF). Decreased physical activity and appetite may also be predictive of poor perceived health.The purposes of this study were to determine whether appetite and physical activity predicted perceived health, and to determine whether depressive symptoms mediated or moderated their relationship with perceived health.

    Methods: A total of 184 patients with mild to severe HF were included. Appetite, depressive symptoms and perceived health were measured by self-report questionnaires (Council on Nutrition Appetite Questionnaire, Patient Health Questionnaire and EuroQol 5D index). Physical activity was measured by SenceWearTM for 6 days. A separate series of multiple linear regression analyses were run to determine whether depressive symptoms mediated or moderated the relationship between physical activity and perceived health, and between appetite and perceived health.

    Results: Higher physical activity predicted better perceived health (ß=0.202, p=.006) but the strength of the association decreased (ß=0.13, p=.048) when depressive symptoms were included in the model. There was a significant mediation effect for depressive symptoms on perceived health (sobel=2.03, p=.041) (Fig 1). Appetite was a significant predictor of perceived health. Examination of this association among those with and without depressive symptoms, however showed positive association between appetite and perceived health remained only for patients without depressive symptoms demonstrating a moderating effect (p<.001) (Fig 2).

    Conclusion: Identifying and treating depression simultaneously while addressing appetite and physical activity may be key to improving perceived health among persons with HF.

  • 5.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hjelm, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Factors influencing nutritional status in chronic heart failure2011Conference paper (Refereed)
  • 6.
    Andreae, Christina
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Uppsala University, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sawatzky, Richard
    Trinity Western University, Canada; Centre Health Evaluat and Outcome Science, Canada.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Correction: Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure (vol 21, pg 954, 2015)2016In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 22, no 3, p. 245-245Article in journal (Other academic)
    Abstract [en]

    n/a

  • 7.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sawatzky, Richard
    Trinity Western University, Canada; Providence Health Care Research Institute, Canada.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure2015In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 21, no 12, p. 954-958Article in journal (Refereed)
    Abstract [en]

    Background: Decreased appetite in heart failure (HF) may lead to undemutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HE Methods and Results: A total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II-IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ. Conclusions: CNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF.

  • 8.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Caring for appetite among patients with chronic heart failure - the extent of appetite and associated factors in outpatient clinic settings2013Conference paper (Refereed)
  • 9.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Factors associated with appetite among patients with symptomatic heart failure2014Conference paper (Other academic)
  • 10.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Årestedt, Kristofer
    Institutionen för hälso- och vårdvetenskap, Linnéuniversitetet, Kalmar, Sweden.
    Predictors for appetite among patients with chronic heart failure2013Conference paper (Other academic)
  • 11.
    Andreae, Christina
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Uppsala University, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Prevalence and associated factors for decreased appetite among patients with stable heart failure2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1703-1712Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesTo explore the prevalence of decreased appetite and factors associated with appetite among patients with stable heart failure. BackgroundDecreased appetite is an important factor for the development of undernutrition among patients with heart failure, but there are knowledge gaps about prevalence and the factors related to appetite in this patient group. DesignObservational, cross-sectional study. MethodsA total of 186 patients with mild to severe heart failure were consecutively recruited from three heart failure outpatient clinics. Data were obtained from medical records (heart failure diagnosis, comorbidity and medical treatment) and self-rated questionnaires (demographics, appetite, self-perceived health, symptoms of depression and sleep). Blood samples were taken to determine myocardial stress and nutrition status. Heart failure symptoms and cognitive function were assessed by clinical examinations. The Council on Nutrition Appetite Questionnaire was used to assess self-reported appetite. Bivariate correlations and multivariate linear regression analyses were conducted to explore factors associated with appetite. ResultsSeventy-one patients (38%) experienced a loss of appetite with a significant risk of developing weight loss. The final multiple regression model showed that age, symptoms of depression, insomnia, cognitive function and pharmacological treatment were associated with appetite, explaining 27% of the total variance. ConclusionIn this cross-sectional study, a large share of patients with heart failure was affected by decreased appetite, associated with demographic, psychosocial and medical factors. Relevance to clinical practiceLoss of appetite is a prevalent problem among patients with heart failure that may lead to undernutrition. Health care professionals should routinely assess appetite and discuss patients experiences of appetite, nutrition intake and body weight and give appropriate nutritional advice with respect to individual needs.

  • 12.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine L
    Sue and Bill Gross School of Nursing, University of California, Irvine, CA,.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Physical activity and appetite in patients with stable heart failure – A cross sectional study2017Conference paper (Refereed)
  • 13.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine
    Sue and Bill Gross School of Nursing, University of California, Irvine, CA.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sedentary lifestyle is associated with poor appetite in patients with heart failure.2017Conference paper (Refereed)
  • 14.
    Berg, Katarina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Kjellgren, Karin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, p. 1630-1638Article in journal (Refereed)
    Abstract [en]

    Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patient’s own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.

    Objectives: To explore day surgery patients’ perceptions of postoperative recovery.

    Design: A qualitative design with a phenomenographic approach was used.

    Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face-to-face at the patients’ homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.

    Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implied changes in ordinary life with varying levels of support. The organization at the day surgery unit, with its advantages and disadvantages, was perceived as having an impact on the subsequent recovery trajectory. The results are demonstrated in three descriptive categories: ‘Conditions for recovery at home’, The rollback to ordinary life’ and ‘Being a cog in a flow of care’.

    Conclusions: Postoperative recovery following day surgery implies, from the patients’ perspective, a migration from being a recipient of care at the day surgery unit to playing an active role, with extensive responsibility at home. To manage self-care confidently, postdischarge patients require knowledge and understanding of what constitutes the normal range in recovery following their specific surgical procedure.

  • 15.
    Berg, Katarina
    et al.
    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.
    Nilsson, Ulrica
    Örebro University Hospital.
    Franzén Årestedt, Kristofer
    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.
    Psychometric evaluation of the post-discharge surgical recovery scale2010In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, no 4, p. 794-801Article in journal (Refereed)
    Abstract [en]

    Rationale, aim and objectives Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post-discharge surgical recovery (PSR) scale, an instrument to monitor the patients recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness. Methods Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbachs alpha. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self-rated health was assessed using Pearsons correlation coefficient. Patients ability to work and their self-rated health on postoperative day 14 were used as external indicators of change. Results Six items showed floor or ceiling effects. Cronbachs coefficient alpha was 0.90 and the average inter-item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one-factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non-improved patients varied (AUC 0.58-0.81). There was a strong correlation between change scores in PSR and health (0.63). Conclusions The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.

  • 16.
    Berg, Katarina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kjellgren, Karin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Postoperative recovery and its association with health-related quality of life among day surgery patientsManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Day surgery holds advantages for both the patient and the health care organization. However, recovery beyond the first postoperative week and following different types of surgery has not been explored to any greater degree. The current aims were to prospectively describe postoperative recovery and health-related quality of life among different groups of day surgery patients and to explore the association between postoperative recovery and health-related quality of life 30 days after discharge. A consecutive sample of 607 adult day surgery patients undergoing orthopaedic, gynaecological or general surgery was included. Postoperative recovery was assessed on days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale and the Quality of Recovery-23 scale. The EQ-5D was used to assess health-related quality of life preoperatively and 30 days following discharge. A repeated measure ANOVA was conducted to evaluate postoperative recovery from day 1 to day 14 and between different surgical groups. Hierarchical multiple linear regression models were used to explore the association between postoperative recovery and health-related quality of life.

    Results: Postoperative recovery improved from day 1 to 14 in all surgical groups (p<0.001). The orthopaedic patients had lower postoperative recovery on day 14 compared to the general and the gynaecological patients (p<0.001). Health-related quality of life was lower among orthopaedic patients (p<0.001), even if significant improvements over time were seen in all groups. Recovery on day 7 was associated with health-related quality of life 30 days after the day surgery (p<0.05).

    Conclusion: Particularly orthopaedic day surgical patients seem to favour a closer follow-up in order to support recovery and thereby also positively influence health-related quality of life.

  • 17.
    Berg, Katarina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kjellgren, Karin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Postoperative recovery and its association with health-related quality of life among day surgery patients2012In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 11, no 24Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Day surgery holds advantages for both the patient and the health care organization. However, recovery beyond the first Postoperative week and following different types of surgery has not been explored to any greater degree. The current aims were to prospectively describe Postoperative recovery and health-related quality of life among different groups of day surgery patients and to explore the association between Postoperative recovery and healthrelated quality of life 30 days after discharge.

    METHODS: A consecutive sample of 607 adult day surgery patients undergoing orthopaedic, gynaecological or general surgery was included. Postoperative recovery was assessed on days 1, 7 and 14 using the Swedish Post-discharge Surgery recovery scale and the quality of recovery-23 scale. The EQ-5D was used to assess health-related quality of life preoperatively and 30 days following discharge. A repeated measure ANOVA was conducted to evaluate Postoperative recovery from day 1 to day 14 and between different surgical groups. Hierarchical multiple linear regression models were used to explore the association between Postoperative recovery and health-related quality of life.

    RESULTS: Postoperative recovery improved from day 1 to 14 in all surgical groups (p<0.001). The orthopaedic patients had lower Postoperative recovery on day 14 compared to the general and the gynaecological patients (p<0.001). health-related quality of life was lower among orthopaedic patients (p<0.001), even if significant improvements over time were seen in all groups. recovery on day 7 was associated with health-related quality of life 30 days after the day surgery (p<0.05).

    CONCLUSION: Particularly orthopaedic day surgical patients seem to favour a closer follow-up in order to support recovery and thereby also positively influence health-related quality of life.

  • 18.
    Bergman, Eva
    et al.
    County Hospital Ryhov, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Jonköping University, Sweden .
    Karlsson, Jan-Erik
    County Hospital Ryhov, Sweden .
    Malm, Dan
    County Hospital Ryhov, Sweden .
    The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction: a long-term follow-up study2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 3, p. 276-283Article in journal (Refereed)
    Abstract [en]

    Background: After being through a myocardial infarction (MI), a severe recovery period ensues for the patient. Longterm follow-ups are helpful, but what this should include differs between patients. Today there is no established approach to identify needs for support after an MI. Aim: The aim was to describe sense of coherence (SOC) over time in relation to sex, as well as further SOC in relation to quality of life (QoL) and treatment satisfaction in patients with an MI. Methods. This study had an observational and longitudinal design and followed 18 women and 60 men with an acute MI for 49-67 months after the onset of MI. Instruments used were the SOC-13 and the Seattle Angina Questionnaire. Results: Women scored lower SOC than men. A main effect of time was shown for comprehensibility which increased significantly from baseline to the long-term follow-up. Women increased from a lower level to an equal level as men at the long-term follow-up. The total SOC was significantly associated with QoL and treatment satisfaction. Conclusion: High comprehensibility and high SOC give the patient a better basis to handle life after MI. Thus, healthcare professionals should keep in mind that SOC and especially comprehensibility have meaning for the patients ability to handle her or his recovery. Healthcare professionals need to together with the patient identify and work with lifestyle factors that contribute to increased comprehensibility about the disease, which gives the patient the foundation to preserve and promote her or his health both in the short and long term.

  • 19.
    Broström, Anders
    et al.
    Omvårdnad, Högskolan i Jönköping.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences.
    The side-effects to CPAP treatment inventory: the development and initial validation of a new tool for the measurement of side-effects to CPAP treatment2010In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 19, no 4, p. 603-611Article in journal (Refereed)
    Abstract [en]

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side-effects are common. No validated self-rating scale measuring side-effects to CPAP treatment exists today. The aim was to develop the side-effects to CPAP treatment inventory (SECI), and investigate the validity and reliability of the instrument among patients with OSAS. SECI was developed on the basis of: (1) in-depth interviews with 23 patients; (2) examination of the scientific literature and (3) consensus agreement of a multi-professional expert panel. This yielded 15 different types of side-effects related to CPAP treatment. Each side-effect has three sub-questions (scales): perceived frequency (a) and magnitude (b) of the side-effect, as well as its perceived impact on CPAP use (c). A cross-sectional descriptive design was used. A total of 329 patients with OSAS with an average use of CPAP treatment for 39 months (2 weeks to 182 months) were recruited. Data were collected with SECI, and obtained from medical records (clinical variables and data related to CPAP treatment). Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation). A logical two-factor solution, the device subscale and symptom subscale, emerged across all three scales. The symptom subscale describing physical and psychological side-effects and the device subscale described mask and device-related side-effects. Internal consistency reliability of the three scales was good (Cronbach’s α = 0.74–0.86) and acceptable for the subscales (Cronbach’s α = 0.62–0.86). The satisfactory measurement properties of this new instrument are promising and indicate that SECI can be used to measure side-effects to CPAP treatment.

  • 20.
    Broström, Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Gardner, Benjamin
    University College London, UK.
    Johansson, Peter
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Fridlund, Bengt
    Jönköping University, Sweden.
    Arestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University & Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm.
    Validation of the CPAP Habit Index-5: A Tool to Understand Adherence to CPAP Treatment in Patients with Obstructive Sleep Apnea.2014In: Sleep Disorders, ISSN 2090-3545, E-ISSN 2090-3553, Vol. 2014, p. 1-9, article id 929057Article in journal (Refereed)
    Abstract [en]

    Long-term adherence to continuous positive airway pressure (CPAP) is low among patients with obstructive sleep apnea (OSA). The potential role of "habit" in sustaining adherence to CPAP use has not been studied. This study aimed to establish the relevance of habit to CPAP adherence, via validation of an adaptation of the Self-Report Habit Index (the CPAP Habit Index-5; CHI-5). Analyses focused on the homogeneity, reliability, and factor structure of the CHI-5 and, in line with theoretical predictions, its utility as a predictor of long-term CPAP adherence in middle-aged patients with OSA. A prospective longitudinal design was used. 117 patients with objectively verified OSA intended for CPAP treatment were recruited. Data was collected via clinical examinations, respiratory recordings, questionnaires, and CPAP devices at baseline, 2 weeks, 6 months, and 12 months. The CHI-5 showed satisfactory homogeneity interitem correlations (0.42-0.93), item-total correlations (0.58-0.91), and reliability ( α = 0.92). CHI-5 data at 6 months showed a one-factor solution and predicted 63% of variance in total CPAP use hours after 12 months. Based on the satisfactory measurement properties and the high amount of CPAP use variance it explained, the CHI-5 can be seen as a useful tool in clinical practice.

  • 21.
    Broström, Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sunnergren, Ola
    Ryhov County Hospital, Jönköping, Sweden.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, Peter
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences.
    Riegel, Barbara
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. University of Pennsylvania School of Nursing, Philadelphia, USA.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Factors associated with undiagnosed obstructive sleep apnoea in hypertensive primary care patients2012In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 30, no 2, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Objective. In hypertensive primary care patients below 65 years of age, (i) to describe the occurrence of undiagnosed obstructive sleep apnoea (OSA), and (ii) to identify the determinants of moderate/severe OSA. Design. Cross-sectional. Setting. Four primary care health centres in Sweden. Patients. 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed and treated hypertension (BP andgt; 140/90). Main outcome measures. Occurrence of OSA as measured by the apnoea hypopnoea index (AHI). Results. Mild (AHI 5-14.9/h) and moderate/severe (AHI andgt; 15/h) OSA were seen among 29% and 30% of the patients, respectively. Comparing those without OSA with those with mild or moderate/severe OSA, no differences were found in blood pressure, pharmacological treatment (anti-hypertensive, anti-depressive, and hypnotics), sleep, insomnia symptoms, daytime sleepiness, or depressive symptoms. Obesity (BMI andgt; 30 kg/m(2)) was seen in 30% and 68% of the patients with mild and moderate/severe OSA, respectively. Male gender, BMI andgt; 30 kg/m(2), snoring, witnessed apnoeas, and sleep duration andgt; 8 hours were determinants of obstructive sleep apnoea. Conclusion. Previously undiagnosed OSA is common among patients with hypertension in primary care. Obesity, snoring, witnessed apnoeas, long sleep duration, and male gender were the best predictors of OSA, even in the absence of daytime sleepiness and depressive symptoms.

  • 22.
    Broström, Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Neurophysiology UHL.
    Franzén Årestedt, Kristofer
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    The attitudes to CPAP treatment inventory: development and initial validation of a new tool for measuring attitudes to CPAP treatment2011In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 20, no 3, p. 460-471Article in journal (Refereed)
    Abstract [en]

    ontinuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but low adherence rates are common. The aim was to develop the attitudes to CPAP treatment inventory (ACTI), and to investigate the validity and reliability of the instrument among patients with OSAS. ACTI was developed on the basis of: (i) in-depth interviews with 23 patients; (ii) examination of the scientific literature; and (iii) consensus agreement of a multi-professional expert panel. This yielded five different types of attitudes to CPAP treatment. A prospective longitudinal design was used. Two-hundred and eighty-nine patients with OSAS were recruited at three different CPAP centres. Data were collected with ACTI and obtained from medical records. The homogeneity and internal consistency reliability were satisfactorily reflected by the item-total correlations (0.59-0.81) and Cronbachs alpha (0.89), respectively. Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation; PCF). The PCF based on baseline data resulted in a one single-factor solution explaining 69% of the total variance. A confirmatory factor analysis was performed 2 weeks after CPAP initiation, resulting in the same factor solution. No indication of uniform differential item functioning was found. The predictive validity was tested with receiver operating characteristic analyses, and a cut-off of 10 on the ACTI gave a sensitivity of 93% and a specificity of 44% for CPAP termination within 6 months. The satisfactory measurement properties of this new pragmatic instrument are promising and indicate that ACTI can be useful in clinical practice to reliably measure attitudes to CPAP treatment.

  • 23.
    Ekback, Maria
    et al.
    University of Örebro, Sweden .
    Benzein, Eva
    Linnaeus University, Sweden .
    Lindberg, Magnus
    University of Örebro, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden .
    The Swedish version of the multidimensional scale of perceived social support (MSPSS) - a psychometric evaluation study in women with hirsutism and nursing students2013In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11Article in journal (Refereed)
    Abstract [en]

    Background

    The Multidimensional Scale of Perceived Social Support (MSPSS) is a short instrument, developed to assess perceived social support. The original English version has been widely used. The original scale has demonstrated satisfactory psychometric properties in different settings, but no validated Swedish version has been available. The aim was therefore to translate, adapt and psychometrically evaluate the Multidimensional Scale of Perceived Social Support for use in a Swedish context.

    Method

    In total 281 participants accepted to join the study, a main sample of 127 women with hirsutism and a reference sample of 154 nursing students. The MSPSS was translated and culturally adapted according to the rigorous official process approved by WHO. The psychometric evaluation included item analysis, evaluation of factor structure, known-group validity, internal consistency and reproducibility.

    Results

    The original three-factor structure was reproduced in the main sample of women with hirsutism. An equivalent factor structure was demonstrated in a cross-validation, based on the reference sample of nursing students. Known-group validity was supported and internal consistency was good for all scales (α = 0.91-0.95). The test-retest showed acceptable to very good reproducibility for the items (κw = 0.58-0.85) and the scales (ICC = 0.89-0.92; CCC = 0.89-0.92).

    Conclusion

    The Swedish version of the MSPSS is a multidimensional scale with sound psychometric properties in the present study sample. The simple and short format makes it a useful tool for measuring perceived social support.

  • 24.
    Eriksson, Kerstin
    et al.
    Jonköping University, Sweden Ryhov County Hospital, Sweden .
    Wikstrom, Lotta
    Jonköping University, Sweden Ryhov County Hospital, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Jonköping University, Sweden .
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Numeric rating scale: patients perceptions of its use in postoperative pain assessments2014In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 27, no 1, p. 41-46Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of this study was to describe how patients perceive the use of the numeric rating scale in postoperative pain assessments. Background: There are recommendations to use a pain scale to follow patients postoperative pain. Most patients prefer the NRS but there is a discrepancy between patients and healthcare professionals how to interpret the ratings from the pain assessments. Methods: A descriptive design with a phenomenographic approach was used. Semi structured interviews were held with 25 patients. Results: Three description categories emerged that illustrate patients perceptions; use of the NRS facilitated communication of pain, it put demands on healthcare professionals and care routines and it contained interpretation difficulties. Conclusion: The NRS has a place in pain management according to the patients but there is a need for a dialogue to give the patients the opportunity to describe their pain and set a common goal.

  • 25.
    Eriksson, Kerstin
    et al.
    Jonköping University, Sweden; Ryhov County Hospital, Sweden.
    Wikström, Lotta
    Jonköping University, Sweden; Ryhov County Hospital, Sweden.
    Fridlund, Bengt
    Jonköping University, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonköping University, Sweden.
    Patients experiences and actions when describing pain after surgery - A critical incident technique analysis2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 56, p. 27-36Article in journal (Refereed)
    Abstract [en]

    Background: Postoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients experiences and actions could help healthcare professionals to improve pain management and could increase patients participation in pain assessments. Objective: The aim of this study was, through an examination of critical incidents, to describe patients experiences and actions when needing to describe pain after surgery. Methods: An explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. Findings: Pain experiences were described according to two main areas: "Patients resources when in need of pain assessment" and "Ward resources for performing pain assessments". Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients ability to describe pain. Two main areas regarding actions emerged: "Patients used active strategies when needing to describe pain" and "Patients used passive strategies when needing to describe pain". Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals large work load. (C) 2015 Elsevier Ltd. All rights reserved.

  • 26.
    Franzén Årestedt, Kristofer
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Andreae, Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Initial psychometric evaluation of the council of nutrition apetite queestionnaire (QNAC)2012Conference paper (Other academic)
  • 27.
    Franzén Årestedt, Kristofer
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Design and methodology of the NutriHeart study: an interdisciplinary approach to investigate nutrition and cardiac cachexia in patients with chronic heart failure.2009In: 9th Annual Spring Meeting on Cardiovascular Nursing, CCNAP., 2009Conference paper (Refereed)
  • 28.
    Franzén Årestedt, Kristofer
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Flemme, Inger
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Psychometric properties of the Swedish version of the Control Attitude Sclae for patients with heart disease and their family members2010Conference paper (Refereed)
  • 29.
    Henriksson, Anette
    et al.
    University of Örebro, Sweden .
    Arestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden .
    Benzein, Eva
    Linnaeus University, Sweden .
    Ternestedt, Britt-Marie
    Ersta Skondal University of Coll, Sweden .
    Andershed, Birgitta
    Ersta Skondal University of Coll, Sweden .
    Effects of a support group programme for patients with life-threatening illness during ongoing palliative care2013In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, no 3, p. 257-264Article in journal (Refereed)
    Abstract [en]

    Background: Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Several studies show that family members report a lack of preparation, knowledge and the ability to handle the caregiver role, and a need for information and psychosocial support. less thanbrgreater than less thanbrgreater thanAim: The aim was to investigate the effects of a support group programme for family members of patients with life-threatening illness during ongoing palliative care. less thanbrgreater than less thanbrgreater thanDesign: A prospective quasi-experimental design, including an intervention group and a comparison group, was used. less thanbrgreater than less thanbrgreater thanSettings/participants: A support group programme was offered to family members during ongoing palliative care at three intervention settings: two specialist palliative care units and one haematology unit. A fourth setting, a specialist palliative care unit, was used for comparisons. less thanbrgreater than less thanbrgreater thanResults: Family members taking part in the support group programme significantly increased their perceptions of preparedness for caregiving, competence for caregiving, and rewards of caregiving. Hope, anxiety, depression symptoms and health showed no significant changes. less thanbrgreater than less thanbrgreater thanConclusions: The intervention, including a support group programme delivered to family members of patients with life-threatening illness during ongoing palliative care, proved to be effective in certain domains of caregiving. No negative outcomes were detected. The results indicate that this intervention could be implemented and delivered to family members during ongoing palliative care.

  • 30.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Dalens Hospital, Sweden; Karolinska Institute, Sweden.
    Carlander, Ida
    Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Karolinska Institute, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Linnaeus University, Sweden.
    Factors associated with feelings of reward during ongoing family palliative caregiving2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 505-512Article in journal (Refereed)
    Abstract [en]

    Objective: Of the few studies that have paid attention to feelings of reward in family palliative caregiving, most are retrospective and examine the experiences of bereaved family caregivers. Although feeling rewarded has been described as an influence that may facilitate the way family caregivers handle the caregiving situation, no study has sought to identify the factors associated with feelings of reward while providing ongoing family palliative care. The aim of this study, therefore, was to identify influential factors in feelings of reward experienced by family palliative caregivers. Method: Our study had a correlational cross-sectional design. Family caregivers (n = 125) of patients receiving specialized palliative care were consecutively recruited from four settings. These caregivers answered a questionnaire that included the Rewards of Caregiving Scale (RCS). This questionnaire included questions about demographic background and scales to measure preparedness for caregiving, feelings of hope, perceived health, and symptoms of anxiety and depression. Correlation and regression analyses were conducted to identify factors associated with rewards. Results: The results demonstrated that the more prepared caregivers with higher levels of hope felt more rewarded, while caregivers with higher levels of anxiety and those in a spousal relationship with the patient felt less rewarded by caregiving. Significance of results: It seems reasonable that feeling rewarded can be a significant contributor to the overall experience of providing ongoing palliative care. The situation of family caregivers has been shown to be multifaceted and complex, and such covariant factors as preparedness, anxiety, hope, and being in a spousal relationship with the patient to influence this experience.

  • 31.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Collage, Sweden; Ersta Hospital, Sweden; Dalens Hospital, Sweden; Karolinska Institute, Sweden.
    Carlander, Ida
    Ersta Skondal University of Collage, Sweden; Karolinska Institute, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Ersta Skondal University of Collage, Sweden; Ersta Hospital, Sweden; Linnaeus University, Sweden.
    Feelings of rewards among family caregivers during ongoing palliative care2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 6, p. 1509-1517Article in journal (Refereed)
    Abstract [en]

    Objectives: Palliative family caregivers appear to experience the rewards of caregiving concurrent with burdens and negative feelings. Relatively few studies have attended to the positive and rewarding aspects in palliative family caregiving. In addition, most studies on rewards are retrospective and examine the experiences of bereaved family caregivers. The present study aimed at describing feelings of reward among family caregivers during ongoing palliative care. A further aim was to compare the experience of rewards in relation to sex and age. Methods: The sample consisted of 125 family caregivers and took place in three specialist palliative care units and one hematology unit. Participants answered a questionnaire including demographic background questions and the Rewards of Caregiving Scale (RCS). Descriptive statistics were employed to describe characteristics of the participants and the level of rewards. A Mann-Whitney U test was used to compare differences between groups of different sex and age. Results: Palliative family caregivers reported general high levels of reward. The greatest source of rewards involved feelings of being helpful to patients. This was closely followed by giving something to patients that brought them happiness and being there for them. The smallest sources of rewards were related to personal growth, self-satisfaction, and personal meaning. There was also an association between rewards and age but not between men and women. Significance of results: Family caregivers experienced the rewards of caregiving during ongoing palliative care despite their unique and stressful situation. Feelings of reward seem to be about handling a situation in a satisfying way, feeling competent and confident to take care of the patient and thereby feeling proud. Support could preferably be designed to improve a family caregivers ability to care and to facilitate the positive aspects and rewards of caregiving and focus on strengths and resources.

  • 32.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Coll, Sweden Ersta Hospital, Sweden Dalens Hospital, Sweden Karolinska Institute, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: A correlational, cross-sectional study2013In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, no 7, p. 639-646Article in journal (Refereed)
    Abstract [en]

    less thansec id="section1-0269216313486954"greater than Background: Family caregivers in palliative care often report feeling insufficiently prepared to handle the caregiver role. Preparedness has been confirmed as a variable that may actually protect family caregiver well-being. Preparedness refers to how ready family caregivers perceive they are for the tasks and demands in the caregiving role. less thansec id="section2-0269216313486954"greater than Aim: The aim of this study was to explore factors associated with preparedness and to further investigate whether preparedness is associated with caregiver outcomes. less thansec id="section3-0269216313486954"greater than Design: This was a correlational study using a cross-sectional design. less thansec id="section4-0269216313486954"greater than Setting/participants: The study took place in three specialist palliative care units and one haematology unit. A total of 125 family caregivers of patients with life-threatening illness participated. less thansec id="section5-0269216313486954"greater than Result: Preparedness was significantly associated with higher levels of hope and reward and with a lower level of anxiety. In contrast, preparedness was not associated with depression or health. Being female and cohabiting with the patient were significantly associated with a higher level of preparedness. The relationship to the patient was significantly associated with preparedness, while social support, place of care, time since diagnosis and age of the patients showed no association. less thansec id="section6-0269216313486954"greater than Conclusion: Feelings of preparedness seem to be important for how family caregivers experience the unique situation when caring for a patient who is severely ill and close to death. Our findings support the inclusion of preparedness in support models for family caregivers in palliative care. Psycho-educational interventions could preferably be designed aiming to increase family caregivers preparedness to care, including practical care, communication and emotional support.

  • 33.
    Henriksson, Annette
    et al.
    University of Örebro, Sweden .
    Andershed, Birgitta
    Ersta Skondal University of Coll, Sweden Gjovik University, Norway .
    Benzein, Eva
    Ersta Skondal University of Coll, Sweden Linneaus University, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Adaptation and psychometric evaluation of the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in a sample of Swedish family members of patients with life-threatening illness2012In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 26, no 7, p. 930-938Article in journal (Refereed)
    Abstract [en]

    Background: Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. less thanbrgreater than less thanbrgreater thanAim: This study aimed to translate, adapt and psychometrically evaluate the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in Swedish family members of patients with life threatening illness. less thanbrgreater than less thanbrgreater thanDesign: Correlational. less thanbrgreater than less thanbrgreater thanSetting/participants: The study took place in four settings including advanced palliative care. The scales were tested in a sample of 125 family members of persons with life-threatening illness. All three scales were tested in relation to distribution of item and scale scores, missing data patterns, dimensionality, convergent validity and reliability. less thanbrgreater than less thanbrgreater thanResults: The results in this study indicate that the Swedish versions of The Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale are valid, reliable and user-friendly scales. Confirmatory factor analysis showed that the scales were unidimensional and all demonstrated Cronbachs alpha values of andgt;= 0.9. less thanbrgreater than less thanbrgreater thanConclusions: As a result of this study it is anticipated that the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale could provide a basis for collaborative research between different countries and make international studies more comparable and generalizable despite differences in language and culture.

  • 34.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonköping University, Sweden.
    Riegel, Barbara
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    The association between cognitive function and self-care in patients with chronic heart failure2015In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 44, no 4, p. 113-119Article in journal (Refereed)
    Abstract [en]

    Aim: To test the relationship between cognitive function and self-care in patients with heart failure after adjusting for the contribution of age, education, functional status, myocardial stress, sleep and depression. Further, the relationship between cognitive function and self-care was explored with depression and sleep as moderators.

    Background: Self-care can significantly impact functional capacity, well-being, morbidity, and prognosis in patients with heart failure (HF). However, self-care requires the cognitive ability to learn, perceive, interpret and respond. The influence of demographics and clinical symptoms on the relationship between cognition and self-care needs to be further understood.

    Design: Descriptive, cross-sectional study.

    Methods: The study included 142 patients with chronic HF (68% male, median age 72 years, 61% in NYHA II). Self-care was measured with the European Heart Failure Self-Care Behavior Scale. Cognitive function was evaluated with neuropsychological tests measuring global cognitive dysfunction, psychomotor speed, executive function, visual-spatial perception/construct, spatial performance, semantic and episodic memory.

    Findings: Psychomotor function (speed and attention) measured with the Trail Making A was the only dimension of cognitive function significantly associated with self-care. Neither depressive symptoms, nor sleep disturbances  moderated the relation between cognitive function and selfcare.

    Conclusion: Deficits in psychomotor speed have implications for how patients should be educated and supported to perform self-care. A decrease in sustained attention and ability to carry out more than one task at a same time could lead to difficulties in self-care. Screening for psychomotor speed is therefore advocated for patients with HF.

  • 35.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Jönköping University .
    Association between sleep-disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure2013In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 15, no 5, p. 496-504Article in journal (Refereed)
    Abstract [en]

    Aims Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction.

    Methods and results In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea–hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition.

    Conclusion The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.

  • 36.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Hälsohögskolan i Jönköping.
    Effects of sleep disordered breathing, insomnia and excessive daytime sleepiness on cognitive function among patients with heart failure2012Conference paper (Other academic)
  • 37.
    Holm, Maja
    et al.
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden.
    Carlander, Ida
    Ersta Skondal University of Coll, Sweden; Karolinska Institute, Sweden.
    Furst, Carl-Johan
    Lund University, Sweden; Lund University, Sweden.
    Wengstrom, Yvonne
    Karolinska Institute, Sweden; University of Örebro, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden.
    Ohlen, Joakim
    Ersta Skondal University of Coll, Sweden; University of Gothenburg, Sweden; University of Gothenburg, Sweden.
    Henriksson, Anette
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden; Ersta Skondal University of Coll, Sweden; Dalen Hospital, Sweden.
    Delivering and participating in a psycho-educational intervention for family caregivers during palliative home care: a qualitative study from the perspectives of health professionals and family caregivers2015In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 14, no 16Article in journal (Refereed)
    Abstract [en]

    Background: Family caregivers in palliative care have a need for knowledge and support from health professionals, resulting in the need for educational and supportive interventions. However, research has mainly focused on the experiences of family caregivers taking part in interventions. To gain an increased understanding of complex interventions, it is necessary to integrate the perspectives of health professionals and family caregivers. Hence, the aim of this study is to explore the perspectives of health professionals and family caregivers of delivering and participating in a psycho-educational intervention in palliative home care. Methods: A psycho-educational intervention was designed for family caregivers based on a theoretical framework describing family caregivers need for knowing, being and doing. The intervention was delivered over three sessions, each of which included a presentation by healthcare professionals from an intervention manual. An interpretive descriptive design was chosen and data were collected through focus group discussions with health professionals and individual interviews with family caregivers. Data were analysed using framework analysis. Results: From the perspectives of both health professionals and family caregivers, the delivering and participating in the intervention was a positive experience. Although the content was not always adjusted to the family caregivers individual situation, it was perceived as valuable. Consistently, the intervention was regarded as something that could make family caregivers better prepared for caregiving. Health professionals found that the work with the intervention demanded time and engagement from them and that the manual needed to be adjusted to suit group characteristics, but the experience of delivering the intervention was still something that gave them satisfaction and contributed to them finding insights into their work. Conclusions: The theoretical framework used in this study seems appropriate to use for the design of interventions to support family caregivers. In the perspectives of health professionals and family caregivers, the psycho-educational intervention had important benefits and there was congruence between the two groups in that it provided reward and support. In order for health professionals to carry out psycho-educational interventions, they may be in need of support and supervision as well as securing appropriate time and resources in their everyday work.

  • 38.
    Israelsson, Johan
    et al.
    Kalmar County Hospital, Sweden; Linnaeus University, Sweden.
    Persson, Carina
    Linnaeus University, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Årested, Kristofer Franzén
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Is there a difference in survival between men and women suffering in-hospital cardiac arrest?2014In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, no 6, p. 510-515Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival. Background: Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted. Methods: This registry study included 286 CAs. To investigate if sex was associated with survival, logistic regression analyses were performed. Results: The proportion of CA with a resuscitation attempt compared to CA without resuscitation was higher among men. There were no associations between sex and survival when controlling for previously known predictors and interaction effects. Conclusions: Sex does not appear to be a predictor for survival among patients suffering CA where resuscitation is attempted. The difference regarding proportion of resuscitation attempts requires more attention. It is important to consider possible interaction effects when studying the sex perspective.

  • 39. Jaarsma, T
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, K
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    the 9-item European Heart Failure Self-Care Behavior Scale tested with data from 6 countries2008Conference paper (Other academic)
  • 40.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jönköping University, Sweden .
    Kärner, Anita
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Mårtensson, Jan
    Jönköping University, Sweden .
    Moons, Philip
    Katholieke University of Leuven, Belgium .
    Thylén, Ingela
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Thompson, David R
    Australian Catholic University, Australia .
    A good manuscript review for the European Journal of Cardiovascular Nursing2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 2, p. 102-103Article in journal (Other academic)
  • 41.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Agren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Franzén Årested, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Long term follow up after an integrated educational and psychosocial intervention in patient-partner dyads affected by heart failure.2014Conference paper (Refereed)
  • 42.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Factors influencing caregiver burden in partners of patients with heart failure, a long term follow up2013Conference paper (Other academic)
  • 43.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Long term follow up after an integrated educational and psychosocial intervention in patient-partner dyads affected by heart failure2012Conference paper (Other academic)
  • 44.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Long term follow up after an integrated educational and psychosocial intervention in patient-partner dyads affected by heart failure2012Conference paper (Other academic)
  • 45.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden; Ersta Skondal University of Collage, Sweden; Ersta Hospital, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 9, p. e0138058-Article in journal (Refereed)
    Abstract [en]

    Background To date, contemporary heart failure care remains patient-focused, but awareness of the partners and families situation is increasing. Randomized studies have mainly evaluated the short-term effects of dyadic interventions. Therefore, the aim of this study was to determine the 24-month effects of an intervention with psych-educational support in dyads of heart failure patients and their partners. Methods This study used a randomized study design and 155 patient-partner dyads were enrolled. The intervention included a nurse-led program of three sessions addressing psychoeducational support. Results The intervention did not have any effect on health, depressive symptoms or perceived control among the patient-partner dyads after 24 months. Furthermore, time to first event did not differ significantly between the intervention group and the control patients. Conclusion This study may be regarded as a first step in trying to understand dyads need for supportive care. Individualized and more targeted interventions seem necessary to achieve a higher impact on dyad outcomes.

  • 46.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Årested, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    A long-term follow up of experiences of and factors influencing caregiver burden in partners of patients with heart failure2013Conference paper (Other academic)
  • 47.
    Liljeroos, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Long term effects of an integrated educational and psychosocial intervention in partners to patients affected by heart failure2014Conference paper (Other academic)
  • 48.
    Lin, Chung-Ying
    et al.
    Hong Kong Univ Sci and Technol, Peoples R China.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran; Jonkoping Univ, Sweden.
    Brostrom, Anders
    Jonkoping Univ, Sweden.
    Fridlund, Bengt
    Jonkoping Univ, Sweden.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus Univ, Sweden.
    Strömberg, Anna
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. ACU, Australia.
    Martensson, Jan
    Jonkoping Univ, Sweden.
    Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients2018In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 3, p. 281-288Article in journal (Refereed)
    Abstract [en]

    Background: The 9-item European Heart Failure Self-Care Behavior scale (EHFScB-9) is a self-reported questionnaire commonly used to capture the self-care behavior of people with heart failure (HF). Objective: The aim of this study was to investigate the EHFScB-9s factorial structure and categorical functioning of the response scale and differential item functioning (DIF) across subpopulations in Iran. Methods: Patients with HF (n = 380; 60.5% male; mean [SD] age, 61.7 [9.1] years) participated in this study. The median (interquartile range) of the duration of their HF was 6.0 (2.4-8.8) months. Most of the participants were in New York Heart Association classification II (NYHA II, 61.8%); few of them had left ventricular ejection fraction assessment (11.3%). All participants completed the EHFScB-9. Confirmatory factor analysis was used to test the factorial structure of the EHFScB-9; Rasch analysis was used to analyze categorical functioning and DIF items across 2 characteristics (gender and NYHA). Results: The 2-factor structure ("adherence to regimen" and "consulting behavior") of the EHFSCB-9 was confirmed, and the unidimensionality of each factor was found. Categorical functioning was supported for all items. No items displayed substantial DIF across gender (DIF contrast, -0.25-0.31). Except for item 3 ("Contact doctor or nurse if legstfeet are swollen"; DIF contrast, -0.69), no items displayed substantial DIF across NYHA classes (DIF contrast, -0.40 to 0.47). Conclusions: Despite the DIF displayed in 1 item across the NYHA classes, the EHFScB-9 demonstrated sound psychometric properties in patients with HF.

  • 49.
    Näsström, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Idvall, Ewa
    Malmö University, Sweden; Skåne University Hospital, Sweden.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden; Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Patient participation in patients with heart failure receiving structured home care - a prospective longitudinal study2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, no 633Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care. Methods: The study had a prospective pre-post longitudinal design evaluating the influence of structured home care on participation in patients at four different home care units. Patient participation was measured using 3 scales and 1 single item. Self-care behavior, knowledge, symptoms of depression, socio-demographic and clinical characteristics were measured to explore factors associated with patient participation. Repeated measure ANOVA was used to describe change over time, and stepwise regression analyses were used to explore factors associated with patient participation. Results: One hundred patients receiving structured heart failure home care were included. Mean age was 82 years, 38 were women and 80 were in New York Heart Association functional class III. One aspect of participation, received information, showed a significant change over time and had increased at both six and twelve months. Better self-care behavior was associated with all four scales measuring different aspects of participation. Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation. Conclusion: Patients experienced a fairly high level of satisfaction with participation in care at baseline, and there was a significant improvement over time for participation with regard to received information after being admitted to structured home care. Higher level of patient participation was consistently associated with better self-care behavior. This study shows that patient participation may need to be further focused upon, and that the association with self-care may be interesting to target in future interventions.

  • 50.
    Palmetun Edback, Maria
    et al.
    University Hospital Örebro, Sweden; University of Örebro, Sweden; Örebro County Council, Sweden.
    Lindberg, Magnus
    University Hospital Örebro, Sweden; University of Örebro, Sweden.
    Benzein, Eva
    University of Örebro, Sweden; Linnaeus University, Sweden.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden; Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden.
    Social support: an important factor for quality of life in women with hirsutism2014In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 12, no 183Article in journal (Refereed)
    Abstract [en]

    Background: Women with hirsutism have reported imparied health and health-related quality of life (HRQoL). Social support is a factor that might increase HRQoL in chronic diseases, but little is known about this association among women with hirsutism. Aim: The aim of the study was to describe social support and explore its association with HRQoL among women with hirsutism. A further aim was to compare HRQoL in women with hirsutism with a Swedish normal population. Methods: A questionnaire including socio-demographic questions, Short-Form Health Survey (SF-36), the Multidimensional Scale of Perceived Social Support (MSPSS), and a self-estimation of hairiness using the Ferriman-Gallway scale (F-G scale) was answered by 127 women with hirsutism. Results: Multiple regression analyses showed significant associations between social support and all health dimensions in the SF-36, also after the model was adjusted for age, hairiness and body mass index. Compared to the normal Swedish population, women with hirsutism reported significantly lower HRQoL in all dimensions of the SF-36 (p less than 0.01). Conclusions: There is a significant positive association between social support and HRQoL, demonstrating its importance for the ability to adapt to problems associated with hirsutism. As women with hirsutism reported poorer HRQoL compared to the normal population, social support may be a factor to consider in clinical practice.

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