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  • 101. Jaarsma, T
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Heart failure management programmes in Europe: a first overview.2006Conference paper (Other academic)
  • 102. Jaarsma, T
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Similarities and differences between Dutch and Swedish heart failure patients in regard to sexual problems.2006Conference paper (Other academic)
  • 103. Jaarsma, T
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    The European Heart Failure Self-Care Behaviour Scale: data from clinical and research populations.2006Conference paper (Other academic)
  • 104. 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)
  • 105. Jaarsma, T
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Mårtensson, J
    The European Heart Failure Self-Care Behaviour Scale: development and revision.2000Conference paper (Other academic)
  • 106. Jaarsma, T
    et al.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    De Geest, S
    Fridlund, B
    Heikkila, J
    Mårtensson, J
    Moons, P
    Scholte op Reimer, W
    Smith, K
    Stewart, S
    Thompson, DR
    Heart failure management programmes in Europé2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 3, p. 197-205Article in journal (Refereed)
    Abstract [en]

    Background: The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe. Method: A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes, and a survey to describe the content in countries where at least 30% of the hospitals had a programme. Results: Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding. Conclusion: Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries. © 2006 European Society of Cardiology.

  • 107.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. University of Groningen, The Netherlands .
    Brons, Maaike
    University of Groningen, The Netherlands .
    Kraai, Imke
    University of Groningen, The Netherlands .
    Luttik, Marie Louise
    University of Groningen, The Netherlands .
    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.
    Components of heart failure management in home care: a literature review2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 3, p. 230-241Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Patients with heart failure (HF) need long-term and complex care delivered by healthcare professionals in primary and secondary care. Although guidelines on optimal HF care exist, no specific description of components that are applied for optimal HF care at home exist. The objective of this review was to describe which components of HF (home) care are found in research studies addressing homecare interventions in the HF population.

    METHODS: The Pubmed, Embase, Cinahl, and Cochrane databases were searched using HF-, homecare services-, and clinical trial-related search terms.

    RESULTS: The literature search identified 703 potentially relevant publications, out of which 70 articles were included. All articles described interventions with two or more of the following components: multidisciplinary team, continuity of care and care plans, optimized treatment according to guidelines, educational and counselling of patients and caregivers, and increased accessibility to care. Most studies (n=65, 93%) tested interventions with three components or more and 20 studies (29%) used interventions including all five components.

    CONCLUSIONS: There a several studies on HF care at home, testing interventions with a variety in number of components. Comparing the results to current standards, aspects such as collaboration between primary care and hospital care, titration of medication, and patient education can be improved.

  • 108.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Mary Mackillop Institute, Australian Catholic University, Melbourne, Australia. Tiny.jaarsma@liu.se.
    Cameron, Jan
    Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia; Australian Centre for Heart Health, Royal Melbourne Hospital, Parkville, Australia.
    Riegel, Barbara
    Mary Mackillop Institute, Australian Catholic University, Melbourne, Australia; University of Pennsylvania School of Nursing, Philadelphia, PA, 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. Program in Nursing Science, University of California Irvine, Irvine, CA, USA.
    Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update2017In: Current Heart Failure Reports, ISSN 1546-9530, E-ISSN 1546-9549, Vol. 14, no 2, p. 71-77Article, review/survey (Refereed)
    Abstract [en]

    As described in the theory of self-care in chronic illness, there is a wide range of factors that can influence self-care behavior. The purpose of this paper is to summarize the recent heart failure literature on these related factors in order to provide an overview on which factors might be suitable to be considered to make self-care interventions more successful.

  • 109.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Deaton, Christi
    Central Manchester University Hospital NHS Fdn Trust, England .
    Fitzsimmons, Donna
    Belfast Health and Social Care Trust, North Ireland University of Ulster, North Ireland .
    Fridlund, Bengt
    Jonköping University, Sweden .
    Hardig, Bjarne M.
    Physiocontrol Sweden Jolife AB, Sweden Lund University, Sweden .
    Mahrer-Imhof, Romy
    Zurich University of Appl Science, Switzerland .
    Moons, Philip
    University of Leuven, Belgium Copenhagen University Hospital, Denmark .
    Noureddine, Samar
    Amer University of Beirut, Lebanon .
    O'Donnell, Sharon
    University of Dublin, Ireland .
    Pedersen, Susanne S.
    Tilburg University, Netherlands Erasmus MC, Netherlands University of Southern Denmark, Denmark Odense University Hospital, Denmark .
    Stewart, Simon
    Baker IDI Heart and Diabet Institute, Australia .
    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.
    Thompson, David R.
    Australian Catholic University, Australia .
    Tokem, Yasemin
    Izmir Katip Celebi University, Turkey .
    Kjellstrom, Barbro
    Karolinska Institute, Sweden .
    Research in cardiovascular care: A position statement of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 1Article in journal (Refereed)
    Abstract [en]

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined with the increasing opportunities and challenges in multidisciplinary research, the Science Committee of the Council on Cardiovascular Nursing and Allied Professionals (CCNAP) recognised the need for a position statement to guide researchers, policymakers and funding bodies to contribute to the advancement of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given.n/a

  • 110.
    Jaarsma, Tiny
    et al.
    University of Groningen.
    Franzen Arestedt, Kristofer
    University of Kalmar.
    Martensson, Jan
    Jonköping University.
    Dracup, Kathleen
    University of California.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument2009In: EUROPEAN JOURNAL OF HEART FAILURE, ISSN 1388-9842, Vol. 11, no 1, p. 99-105Article in journal (Refereed)
    Abstract [en]

    Aims Improved self-care is the goat of many heart failure (HF) management programmes. The 12-item European Heart Failure Self-Care Behaviour Scale (EHFScB scale) was developed and tested to measure patient self-care behaviours. It is now available in 14 languages. The aim of this study was to further determine reliability and validity of the EHFScB scale.

    Methods and results Data from 2592 HF patients (mean age 73 years, 63% mate) from six countries were analysed. Internal consistency was determined by Cronbachs alpha. Validity was established by (1) interviews with HF experts and with HF patients; (2) item analysis; (3) confirmatory factor analysis; and (4) analysing the relationship between the EHFScB scale and scales measuring quality of life and adherence. Internal consistency of the 12-item scale was 0.77 (0.71-0.85). After factor analyses and critical evaluation of both psychometric properties and content of separate items, a nine-item version was further evaluated. The reliability estimates for the total nine-item scale (EHFScB-9) was satisfactory (0.80) and Cronbachs alpha varied between 0.68 and 0.87 in the different countries. One reliable subscale was defined (consulting behaviour) with a Cronbachs alpha of 0.85. The EHFScB-9 measures a different construct than quality of life (r = 0.18) and adherence (r = 0.37).

    Conclusion The 12-item EHFScB scale was revised into the nine-item EHFScB-9, which can be used as an internally consistent and valid instrument to measure HF-related self-care behaviour.

  • 111.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    n/a.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Thompson, David R.
    n/a.
    The European Journal of Cardiovascular Nursing endorses the CONSORT statement and extension.2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, p. 235-236Article in journal (Other academic)
  • 112.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. 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 Centre, Department of Cardiology.
    Ågren, Susanna
    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.
    Quality of life and symptoms of depression in advanced heartfailure patients and their partners2010In: Current Opinion in Supportive and Palliative Care, ISSN 1751-4266, Vol. 4, no 4, p. 233-237Article in journal (Refereed)
    Abstract [en]

    Purpose of review: To provide an overview of factors related to quality of life and symptoms of depression in heart failure patients and their partners. Furthermore, to give an overview of interventions that can be effective in improving their quality of life and decrease depressive symptoms.Recent findings: Quality of life of patients with heart failure and their partners is poor compared with their age-matched peers from the general population and also compared with patients suffering from other chronic diseases. Furthermore, many heart failure patients are depressed. Depressive symptoms of patients and of their partners seem to be interrelated, making interventions complicated but needed.Although the number of studies that specifically target improvement of quality of life and depression in heart failure patients and their partners is still small, several interventions are known to improve quality of life, and these could be implemented in daily care.Summary: This review considers demographic and clinical factors that are related to quality of life and depressive symptoms and addresses interventions that can contribute to improvement of quality of life of heart failure patients and their partners and decrease depressive symptoms.Education on self-care management and physical exercise are important elements of disease management programs. A multidisciplinary care approach including optimizing medical therapy and optimal symptom management is advised, focusing both on the patient and the caregiver. Treatment and care should not only focus on heart failure, but also address the consequences of co-morbidities and the side-effects of therapies.

  • 113.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Klompstra, Leonie
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Ben Gal, Tuvia
    Rabin Medical Centre, Israel; Tel Aviv University, Israel.
    Boyne, Josiane
    Maastricht University, Netherlands.
    Vellone, Ercole
    University of Roma Tor Vergata, Italy.
    Bäck, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Dickstein, Kenneth
    University of Bergen, Norway.
    Fridlund, Bengt
    Jonköping University, Sweden.
    Hoes, Arno
    University of Medical Centre Utrecht, Netherlands.
    Piepoli, Massimo F.
    AUSL Piacenza, Italy; Fdn Toscana G Monasterio, Italy.
    Chiala, Oronzo
    University of Roma Tor Vergata, Italy.
    Martensson, Jan
    Jonköping 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.
    Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: the rationale, design and methodology of the HF-Wii study; a multicentre randomized controlled trial2015In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 17, no 7, p. 743-748Article in journal (Refereed)
    Abstract [en]

    Aims

    Exercise is known to be beneficial for patients with heart failure (HF), and these patients should therefore be routinely advised to exercise and to be or to become physically active. Despite the beneficial effects of exercise such as improved functional capacity and favourable clinical outcomes, the level of daily physical activity in most patients with HF is low. Exergaming may be a promising new approach to increase the physical activity of patients with HF at home. The aim of this study is to determine the effectiveness of the structured introduction and access to a Wii game computer in patients with HF to improve exercise capacity and level of daily physical activity, to decrease healthcare resource use, and to improve self-care and health-related quality of life.

    Methods and results

    A multicentre randomized controlled study with two treatment groups will include 600 patients with HF. In each centre, patients will be randomized to either motivational support only (control) or structured access to a Wii game computer (Wii). Patients in the control group will receive advice on physical activity and will be contacted by four telephone calls. Patients in the Wii group also will receive advice on physical activity along with a Wii game computer, with instructions and training. The primary endpoint will be exercise capacity at 3months as measured by the 6min walk test. Secondary endpoints include exercise capacity at 6 and 12 months, level of daily physical activity, muscle function, health-related quality of life, and hospitalization or death during the 12 months follow-up.

    Conclusion

    The HF-Wii study is a randomized study that will evaluate the effect of exergaming in patients with HF. The findings can be useful to healthcare professionals and improve our understanding of the potential role of exergaming in the treatment and management of patients with HF.

    Trial registration

    NCT01785121

  • 114.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Klompstra, Leonie
    Linköping University, Department of Social and Welfare Studies, 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.
    The rise of activity monitoring2019In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 26, no 4, p. 380-381Article in journal (Other academic)
    Abstract [en]

    n/a

  • 115.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Larsen, Torben
    University of Southern Denmark, Odense.
    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.
    Practical guide on home health in heart failure patients2013In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 13, no 4Article in journal (Refereed)
    Abstract [en]

    Introduction: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. less thanbrgreater than less thanbrgreater thanMethod: We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. less thanbrgreater than less thanbrgreater thanResults: In integrated home care for heart failure patients, it is advised to consider the following components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. less thanbrgreater than less thanbrgreater thanDiscussion: We summarised the state of the art of home-based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers.

  • 116.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic University, Australia.
    Riegel, Barbara
    Australian Catholic University, Australia; University of Penn, PA 19104 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. University of Calif Irvine, CA 92717 USA.
    Reporting on Self-care in Research Studies Guidance to Improve Knowledge Building2017In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 32, no 4, p. 315-316Article in journal (Other academic)
    Abstract [en]

    n/a

  • 117.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Riegel, Barbara
    University of Pennsylvania School of Nursing, USA.
    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.
    Self-care behaviours in heart failure: international similarities and differences2012Conference paper (Other academic)
  • 118.
    Jaarsma, Tiny
    et al.
    University Hospital Groningen, The Netherlands.
    Stewart, Simon
    De Geest, Sabina
    University of Basel, Switzerland).
    Fridlund, Bengt
    Högskolan i Halmstad.
    Heikkilä, Johanna
    Mårtensson, Jan
    Moons, Philip
    Scholte op Reimer, Wilma
    Smith, Karen
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Thompson, David R
    A survey of coronary risk factors and B-type natriuretic peptide concentrations in cardiac nurses from Europe: do nurses still practice what they preach?2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 1, p. 3-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: From a previous survey of cardiac nurses attending a scientific conference, we learned that these nurses adopted a healthier lifestyle than the general population. AIMS: The aim of this study was to determine the overall profile of cardiac risk factors in a similar cohort and determine whether cardiac nurses continue to 'practice what they preach' in this regard. Secondly, we examined the practical value of screening a large cohort of individuals within a short time frame (total of 8 hours screening time) and determined the range of BNP concentrations within a 'healthy' cohort. METHODS: Data on CHD risk factors were collected with a short self-report questionnaire. The sample consisted of 122 cardiac nurses from 19 countries attending a European cardiac nursing conference held in Stockholm. A venous blood sample was collected into a tube containing potassium ETDA. B-type natriuretic peptide was measured on-site with the use of a portable fluorescence immunoassay kit. RESULTS: Most participants were female (89%). Participants ranged in age from 23 to 60 years with a mean age of 41 (S.D. 9.4). Eleven percent - all female - reported they were current smokers, 27% (34) had a BMI >25 and 27% of the sample stated they did not exercise regularly. Almost half (48%) of the sample reported a family history of CHD. As expected, all BNP-values were within the normal range. There were significant differences in BNP on the basis of sex (P<0.05) and age (P<0.05) and a trend towards increasing BNP concentrations with progressively higher BMI scores (P=0.06). CONCLUSION: This study reconfirms the likelihood that many cardiac nurses heed their own advice on lifestyle modification to reduce cardiovascular risk and therefore provide a good role model for the promotion of primary and secondary prevention initiatives.

  • 119.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Arts and 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.
    20 Things You Didn't Know About European Cardiac Nurses2014In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, no 4, p. 291-292Article in journal (Other academic)
  • 120.
    Jaarsma, Tiny
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Cardiovascular Nursing: More than being nice2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 5, p. 315-315Article in journal (Other academic)
  • 121.
    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, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Heart Failure Clinics Are Still Useful (More Than Ever?)2014In: Canadian Journal of Cardiology, ISSN 0828-282X, E-ISSN 1916-7075, Vol. 30, no 3, p. 272-275Article in journal (Refereed)
    Abstract [en]

    Heart failure (HF) clinics have had an important role in optimal HF management and the effectiveness of these clinics has been studied intensively. A HF clinic is one of the various ways to organize a HF disease management program. There is good evidence that HF disease management can improve outcomes in HF patients, but it is not clear what the optimal components of these programs are and what the relative effectiveness of a HF clinic is compared with other forms of HF management. After initial positive reports on the effect of HF clinics, these clinics were implemented in many countries, although in different formats and of varying quality. In this article we describe the initial need for HF clinics, reflect on their development over time, and discuss the role of HF clinics in context of the current need for HF disease management.

  • 122.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Med Ctr Utrecht, Netherlands.
    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.
    We told you so: knowledge is not enough to improve heart failure self-care behaviour2019In: ESC Heart Failure, E-ISSN 2055-5822Article in journal (Refereed)
    Abstract [en]

    n/a

  • 123.
    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, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ben Gal, Tuvia
    Rabin Medical Centre, Israel.
    Cameron, Jan
    Australian Catholic University, Australia.
    Driscoll, Andrea
    Deakin University, Australia.
    Duengen, Hans-Dirk
    Charite, Germany.
    Inkrot, Simone
    Charite, Germany.
    Huang, Tsuey-Yuan
    Chang Gung University of Science and Technology, Taiwan.
    Ngoc Huyen, Nguyen
    University of Tokyo, Japan.
    Kato, Naoko
    University of Tokyo, Japan.
    Koeberich, Stefan
    University of Heart Centre Freiburg Bad Krozingen, Germany.
    Lupon, Josep
    Hospital University of Germans Trios and Pujol, Spain.
    Moser, Debra K.
    University of Kentucky, KY USA.
    Pulignano, Giovanni
    S Camillo Forlanini Hospital, Italy.
    Rejane Rabelo, Eneida
    University of Federal Rio Grande do Sul, Brazil.
    Suwanno, Jom
    Walailak University, Thailand.
    Thompson, David R.
    Australian Catholic University, Australia.
    Vellone, Ercole
    Tor Vergata University, Rome, Italy.
    Alvaro, Rosaria
    Tor Vergata University, Rome, Italy.
    Yu, Doris
    Chinese University of Hong Kong, Hong Kong.
    Riegel, Barbara
    University of Penn, USA.
    Comparison of self-care behaviors of heart failure patients in 15 countries worldwide2013In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 1, p. 114-120Article in journal (Refereed)
    Abstract [en]

    Objective

    Clinicians worldwide seek to educate and support heart failure patients to engage in self-care. We aimed to describe self-care behaviors of patients from 15 countries across three continents.

    Methods

    Data on self-care were pooled from 5964 heart failure patients from the United States, Europe, Australasia and South America. Data on self-care were collected with the Self-care of Heart Failure Index or the European Heart Failure Self-care Behavior Scale.

    Results

    In all the samples, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 samples, more than 50% of the patients reported low exercise levels. In 16 samples, less than half of the patients weighed themselves regularly, with large differences among the countries. Self-care with regard to receiving an annual flu shot and following a low sodium diet varied most across the countries.

    Conclusion

    Self-care behaviors are sub-optimal in heart failure patients and need to be improved worldwide.

    Practice implications

    Interventions that focus on specific self-care behaviors may be more effective than general educational programs. Changes in some health care systems and national policies are needed to support patients with heart failure to increase their self-care behavior.

  • 124.
    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)
  • 125.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Fridlund, B
    Jonköping University.
    De Geest, S
    Katholieke University Leuven.
    Martensson, J
    Unit Research and Dev Primary Care, Jonköping, Sweden .
    Moons, P
    Katholieke University Leuven.
    M Norekval, T
    Haukeland Hospital.
    Smith, K
    Ninewells Hospital.
    Steinke, E
    Wichita State University.
    R Thompson, D
    University of Leicester.
    Sexual counselling of cardiac patients: Nurses perception of practice, responsibility and confidence2010In: EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, ISSN 1474-5151, Vol. 9, no 1, p. 24-29Article in journal (Refereed)
    Abstract [en]

    Background: Cardiac patients may experience problems with sexual activity as a result of their disease, medications or anxiety and nurses play an important role in sexual counselling. We studied the practice, responsibility and confidence of cardiac nurses in the sexual counselling of these patients. Method: An adapted version of the nurses survey of sexual counselling of MI patients was administered during a scientific meeting of the Council on Cardiovascular Nursing and Allied Professionals within the European Society of Cardiology. Results: Most of the 157 cardiovascular nurses (87%) who completed the survey felt responsible to discuss sexual concerns with their clients, especially when patients initiated a discussion. However in practice, most respondents rarely addressed sexual issues. The items that nurses reported to counsel patients were closely related to the cardiac disease, symptoms and medications and seldom more sensitive subjects (e.g. foreplay, positions). Nurses estimated that their patients could be upset (67%), embarrassed (72%) or anxious (68%) if they were asked about sexual concerns. One-fifth of the nurses felt they had insufficient knowledge and 40% sometimes hesitated to discuss sexual concerns with clients because they might not know how to answer questions. Additional education on sexuality was significantly related to being more comfortable and active in sexual counselling. Conclusion: Although cardiac nurses feel responsible and not anxious discussing patients sexual concerns, these issues are not often discussed in daily practice. Nurses might need more knowledge and specific practical training in providing information on sexual concerns and sexual counselling to cardiac patients.

  • 126.
    Jaarsma, Tiny
    et al.
    University Hospital Groningen.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Mårtensson, J
    Ryhov County Hospital Jönköping.
    Dracup, K
    UCSF School of Nursing San Francisco.
    Development and testing of the European Heart Failure Self-Care Behaviour Scale2003In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 5, no 3, p. 363-370Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Improvement of self-care behaviour is an aim of several non-pharmacological nurse-led management programmes for patients with heart failure. These programmes are often evaluated based on their effects on readmission, costs and quality of life. It is, however, also important to know how patients changed their self-care behaviour as a result of such a programme. Therefore a comprehensive, reliable and valid measure of the self-care behaviour of HF patients is needed. OBJECTIVES: To develop a scale measuring the behaviour that heart failure patients perform to maintain life, healthy functioning, and well-being. METHOD: The European Heart Failure Self-Care Behaviour Scale (EHFScBS) was developed in three phases: (1) concept analysis and first construction; (2) revision of items and response and scoring format; and (3) testing of the new scale for validity and reliability. RESULTS: The European Heart Failure Self-Care Behaviour Scale is a 12-item, self-administered questionnaire that covers items concerning self-care behaviour of patients with heart failure. Face-validity and concurrent validity was established and the internal consistency of the scale was tested using pooled data of 442 patients from two centres in Sweden, three in the Netherlands and one in Italy. Cronbachs's alpha was 0.81. CONCLUSION: The instrument is a valid, reliable and practical scale to measure the self-reported self-care behaviour of heart failure patients. It is ready to use by investigators evaluating the outcome of heart failure management programmes that target changes in patients' self-care practices.

  • 127.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, 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 Centre, Department of Cardiology UHL.
    Thompson, David R.
    Australian Catholic University, Australia .
    What’s going on at age 11: development of the European Journal of Cardiovascular Nursing2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 1, p. 7-8Article in journal (Other academic)
  • 128.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    van der Wal, Martje
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. University Medical Centre Groningen, University of Groningen, The Netherlands.
    Hjelmfors, Lisa
    Linköping University, Department of Social and Welfare Studies, 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.
    Talking about palliative care in heart failure2018In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 20, no 9, p. 1348-1349Article in journal (Other academic)
    Abstract [en]

    This article refers to Which patients with heart failure should receive specialist palliative care? by R.T. Campbell et al., published in this issue on pages 1338-1347.

  • 129.
    Johansson, Ingela
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Blixt, F
    Andersson, F
    Strömberg, Anna
    Driving restrictions and implantable cardioverter defibrillator - the patient perspective2009Conference paper (Refereed)
  • 130.
    Johansson, Ingela
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Fluur, Christina
    Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bolse, Kärstin
    Högskolan i Halmstad.
    Patients' experiences of the ICD from a life perspective, with focus on end-of-life issues2012Conference paper (Other academic)
  • 131.
    Johansson, Ingela
    et al.
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping. 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.
    Experiences of Driving and Driving Restrictions in Recipients with an Implantable Cardioverter Defibrillator - The Patient Perspective2010In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 26, no 5, p. E1-E10Article in journal (Refereed)
    Abstract [en]

    Background and Objectives: The implantable cardioverter defibrillator (ICD) is a lifesaving device for treating patients who have experienced (secondary prevention), or are likely to experience (primary prevention), sudden cardiac death due to ventricular arrhythmias. Individuals with an ICD are prohibited from driving for a restricted period after the implantation and after recurrence of a ventricular arrhythmia, which may affect the ICD recipient in daily life. The aim of this study was therefore to describe how ICD recipients perceive driving and the driving restriction.

     

    Methods: Fourteen men and 6 women, aged 43 to 82 years, with driving restrictions due to both secondary and primary ICD indications, were interviewed. Data were analyzed using phenomenography.

     

    Results: The analysis resulted in the main category, the individual's unique relationship to driving, based on the categories: (1) achieving adherence on driving restrictions, (2) emotional influence of driving restriction, and (3) altered views on driving. The information was sometimes conceived as insufficient and unclear, and the willingness to accept the restriction differed. The ICD recipients perceived a loss of independence and changed self-image. Some patients had changed their driving behavior because of uncertainty of their driving abilities or fear of having arrhythmias/shocks while driving. They had different views on their future driving.

     

    Conclusions: Handling driving restrictions after ICD implantation and shocks is a complex and delicate issue in clinical practice and should be addressed in a dialogue with the ICD recipient. More individualized and structured information and support should be given according to the ICD recipients' experiences and needs.

  • 132.
    Johansson, Ingela
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ambulance use in patients with acute myocardial infarction2004In: Journal of Cardiovascular Nursing, ISSN 0889-4655, Vol. 19, no 1, p. 5-12Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the choice of transportation mode to hospital in patients experiencing acute myocardial infarction.

    Method: A descriptive survey study at the Coronary Care Unit of one Swedish University Hospital. The study was carried out between July 2000 and March 2001.

    Results: The study population consisted of 114 consecutive patients with acute myocardial infarction. Thirty-two percent stated that they did not know the importance of a short delay when experiencing an acute myocardial infarction. Only 60% called the emergency service number, 112. Patients calling for an ambulance differed from those who did not in several aspects. Medical characteristics associated with ambulance use in a univariate analysis were ST-elevation myocardial infarction and prior history of myocardial infarction. There were no differences regarding gender or age. When looking at the patients' symptom-experience, patients with vertigo or nausea and severe pain chose an ambulance for transport to the hospital. The only significant reasons for not choosing an ambulance were cramping pain and the patient perceiving the symptoms not to be serious. In a multivariate analysis, ST-elevation (OR = 0.30, P = .04), unbearable symptoms (OR = 0.20, P = .03), and nausea (OR = .33, P = .04) appeared as independent predictors of ambulance use and cramping pain (OR = 5.17, P = .01) for not using an ambulance.

    Conclusions: Patients with acute myocardial infarction view the ambulance as an option for transportation to hospital only if they feel really sick. For that reason, it needs to be made well known to the public that ambulances are not only a mode of transport, but also provide diagnostics and treatment.

  • 133.
    Johansson, Ingela
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Factors related to delay times in patients with suspected acute myocardial infarction2004In: Heart & Lung: The Journal of Acute and Critical Care, ISSN 0147-9563, Vol. 33, no 5, p. 291-300Article in journal (Refereed)
    Abstract [en]

    Objective

    The study’s objective was to describe symptoms, symptom management, and patient delay times in patients seeking treatment for suspected acute myocardial infarction (AMI), and to find explanatory factors influencing the decision time.

    Method

    This is a descriptive survey study including 403 Swedish patients with a median age of 64 years with suspected AMI.

    Results

    Altogether, 84% of the patients suspected that the symptoms emanated from the heart. Despite this fact, 59% delayed going to the hospital more than 1 hour after the onset of symptoms. In the multiple regression analysis, a “dull pain,” the patients’ belief that it was nothing serious, and contact with the general practitioner were associated with prolonged delay. The decision to contact the emergency service shortened the delay time.

    Conclusions

    The patient’s subjective feeling of the severity of symptoms is an important predictor for delay times. There is still a need for public awareness of the appropriate responses to AMI symptoms, that is, to call for an ambulance instead of contacting the general practitioner.

  • 134.
    Johansson, Ingela
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Manageability, vulnerability and interaction: A qualitative analysis of acute myocardial infarction patients' conceptions of the event2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 3, p. 184-191Article in journal (Refereed)
    Abstract [en]

    Background: Delay in seeking care remains a problem for many patients with myocardial infarction. There is a great deal of knowledge available about clinical factors contributing to this delay, while studies focusing on the patients' own experiences are few. Aim: Describe variations in how individuals perceived suffering symptoms of an acute myocardial infarction. Design: A qualitative method using phenomenographic design was applied. Interviews were conducted with 15 strategically selected patients with myocardial infarction. Findings: Eight sub-categories in the pre-hospital phase were summarised into three categories: manageability, vulnerability, and interaction. To manage their situation, patients expressed a need to understand it and to have a similar situation to compare with. They also described coping with the arising threat to their lives by self-medication or denying their symptoms. Patients expressed vulnerability, with feelings of anxiety, both as triggers and barriers to seeking medical care. In interaction with others, psychosocial support and guidance from the environment, was fundamental in helping the patients to manage the situation. Conclusions: There were large variations in myocardial infarction patients' conceptions of the event. To improve disease management in the pre-hospital phase, the awareness of this large variation in conceptions about suffering symptoms of an myocardial infarction could be used in the dialogue between patients and health care professionals, in cardiac prevention programmes, as well as in health care education. © 2006 European Society of Cardiology.

  • 135.
    Johansson, Ingela
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Manageability, vulnerability and interaction: A qualitative analysis of AMI patients´conceptions of the event2006In: NSFS landsgruppe av Kardiologiske sykepleiere,2006, 2006Conference paper (Other academic)
  • 136.
    Johansson, Ingela
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Cardiology . Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Spouses conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction - A qualitative analysis2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 3, p. 182-188Article in journal (Refereed)
    Abstract [en]

    Background: Delay from onset of acute myocardial infarction symptoms to the delivery of medical care is a major determinant of prognosis. Although studies have explored patient reasons for delay, there are only limited data concerning experiences of the spouse.

    Aim: Was to describe spouses conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction.

    Method: A phenomenographic approach was applied. Fifteen spouses were interviewed <48 h after the partners hospital admittance.

    Findings: Two categories with underlying sub-categories conceptualised the spouses experiences. The category being resourceful contained: sharing the experience, having knowledge, understanding the severity, being rational, and consulting others. The category respecting independence contained: accepting the need for control, marital roles and experiences, restraining emotions, and seeking agreement.

    Conclusion: Our findings suggest that spouses have a strong influence on the course of events. When accepting the partners need for control through following earlier marital roles and experiences, restraining own emotions and seeking agreement, this seemed to contribute to delay. However, when the spouse was resourceful by sharing the experience, having knowledge, understanding the severity, being rational and consulting others when needed, this seemed to have a positive influence on the pre-hospital time.

  • 137.
    Johansson, Ingela
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Spouses´conceptions of their partners suffering an AMI: A qualitative analysis.2006In: NSFS landsgruppe av Kardiologiske sykepleiere,2006, 2006Conference paper (Other academic)
  • 138.
    Johansson, Peter
    et al.
    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.
    van der Wal, Martje H. L.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. University of Groningen, Netherlands.
    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.
    Waldréus, Nana
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Södertälje Sjukhus, Sweden.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Fluid restriction in patients with heart failure: how should we think?2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 5, p. 301-304Article in journal (Refereed)
    Abstract [en]

    Background/aim: Fluid restriction has long been considered one of the cornerstones in self-care management of patients with heart failure. The aim of this discussion paper is to discuss fluid restriction in heart failure and propose advice about fluid intake in heart failure patients. Results: Although there have been seven randomised studies on fluid restriction in heart failure patients, the effect of fluid restriction on its own were only evaluated in two studies. In both studies, a stringent fluid restriction compared to a liberal fluid intake was not more beneficial with regard to clinical stability or body weight. In the other studies fluid restriction was part of a larger study intervention including, for example, individualised dietary recommendations and follow-up by telephone. Thus, the effect of fluid restriction on its own has been poorly evaluated. Conclusion: Fluid restriction should not be recommended to all heart failure patients. However, temporary fluid restriction can be considered in decompensated heart failure and/or patients with hyponatremia. Tailored fluid restriction based on body weight (30 ml/kg per day) seems to be most reasonable. To increase adherence to temporary fluid restriction, education, support and planned evaluations can be recommended.

  • 139.
    Jonkman, Nini H.
    et al.
    University of Medical Centre Utrecht, Netherlands.
    Westland, Heleen
    University of Medical Centre Utrecht, Netherlands.
    Groenwold, Rolf H. H.
    University of Medical Centre Utrecht, Netherlands.
    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.
    Anguita, Manuel
    Hospital Reina Sofia, Spain.
    Blue, Lynda
    British Heart Fdn, Scotland.
    Bruggink-Andre de la Porte, Pieta W. F.
    Deventer Hospital, Netherlands.
    Dewalt, Darren A.
    University of N Carolina, NC USA.
    Hebert, Paul L.
    University of Washington, WA 98195 USA.
    Heisler, Michele
    University of Michigan, MI 48109 USA.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Kempen, Gertrudis I. J. M.
    Maastricht University, Netherlands.
    Leventhal, Marcia E.
    University of Basel, Switzerland.
    Lok, Dirk J. A.
    Deventer Hospital, Netherlands.
    Martensson, Jan
    Jönköping University, Sweden.
    Muniz, Javier
    University of A Coruna, Spain; INIBIC, Spain; Institute Salud Carlos III, Spain.
    Otsu, Haruka
    Hirosaki University, Japan.
    Peters-Klimm, Frank
    University of Heidelberg Hospital, Germany.
    Rich, Michael W.
    Washington University, MO 63110 USA.
    Riegel, Barbara
    University of Penn, PA 19104 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.
    Tsuyuki, Ross T.
    University of Alberta, Canada.
    Trappenburg, Jaap C. A.
    University of Medical Centre Utrecht, Netherlands.
    Schuurmans, Marieke J.
    University of Medical Centre Utrecht, Netherlands.
    Hoes, Arno W.
    University of Medical Centre Utrecht, Netherlands.
    What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis2016In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 22, no 11, p. 861-871Article in journal (Refereed)
    Abstract [en]

    Background: To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and Results: Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97-0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96-0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92-0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics. Conclusion: No specific program characteristics were consistently associated with better effects of self management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients.

  • 140.
    Jonkman, Nini H.
    et al.
    University of Medical Centre Utrecht, Netherlands.
    Westland, Heleen
    University of Medical Centre Utrecht, Netherlands.
    Groenwold, Rolf H. H.
    University of Medical Centre Utrecht, Netherlands.
    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.
    Atienza, Felipe
    Hospital Gen University of Gregorio Maranon, Spain.
    Blue, Lynda
    British Heart Fdn, Scotland.
    Bruggink-Andre de la Porte, Pieta W. F.
    Deventer Hospital, Netherlands.
    DeWalt, Darren A.
    University of N Carolina, NC USA.
    Hebert, Paul L.
    Heisler, Michele
    University of Washington, WA 98195 USA.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Kempen, Gertrudis I. J. M.
    Maastricht University, Netherlands.
    Leventhal, Marcia E.
    University of Basel, Switzerland.
    Lok, Dirk J. A.
    Deventer Hospital, Netherlands.
    Martensson, Jan
    Jonköping University, Sweden.
    Muniz, Javier
    University of A Coruna, Spain; INIBIC, Spain.
    Otsu, Haruka
    Hirosaki University, Japan.
    Peters-Klimm, Frank
    University of Heidelberg Hospital, Germany.
    Rich, Michael W.
    Washington University, MO 63110 USA.
    Riegel, Barbara
    University of Penn, PA 19104 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.
    Tsuyuki, Ross T.
    University of Alberta, Canada.
    van Veldhuisen, Dirk J.
    University of Medical Centre Groningen, Netherlands.
    Trappenburg, Jaap C. A.
    University of Medical Centre Utrecht, Netherlands.
    Schuurmans, Marieke J.
    University of Medical Centre Utrecht, Netherlands.
    Hoes, Arno W.
    University of Medical Centre Utrecht, Netherlands.
    Do Self-Management Interventions Work in Patients With Heart Failure? An Individual Patient Data Meta-Analysis2016In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 133, no 12, p. 1189-1198Article in journal (Refereed)
    Abstract [en]

    Background- Self-management interventions are widely implemented in the care for patients with heart failure (HF). However, trials show inconsistent results, and whether specific patient groups respond differently is unknown. This individual patient data meta-analysis assessed the effectiveness of self-management interventions in patients with HF and whether subgroups of patients respond differently. Methods and Results- A systematic literature search identified randomized trials of self-management interventions. Data from 20 studies, representing 5624 patients, were included and analyzed with the use of mixed-effects models and Cox proportional-hazard models, including interaction terms. Self-management interventions reduced the risk of time to the combined end point of HF-related hospitalization or all-cause death (hazard ratio, 0.80; 95% confidence interval [CI], 0.71-0.89), time to HF-related hospitalization (hazard ratio, 0.80; 95% CI, 0.69-0.92), and improved 12-month HF-related quality of life (standardized mean difference, 0.15; 95% CI, 0.00-0.30). Subgroup analysis revealed a protective effect of self-management on the number of HF-related hospital days in patients &lt; 65 years of age (mean, 0.70 versus 5.35 days; interaction P=0.03). Patients without depression did not show an effect of self-management on survival (hazard ratio for all-cause mortality, 0.86; 95% CI, 0.69-1.06), whereas in patients with moderate/severe depression, self-management reduced survival (hazard ratio, 1.39; 95% CI, 1.06-1.83, interaction P=0.01). Conclusions- This study shows that self-management interventions had a beneficial effect on time to HF-related hospitalization or all-cause death and HF-related hospitalization alone and elicited a small increase in HF-related quality of life. The findings do not endorse limiting self-management interventions to subgroups of patients with HF, but increased mortality in depressed patients warrants caution in applying self-management strategies in these patients.

  • 141.
    Khatib, Rani
    et al.
    Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK / Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
    Lee, Geraldine A.
    Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, London, UK.
    Marques-Sule, Elena
    Department of Physiotherapy, University of Valencia, Valencia, Spain.
    Arnesdatter Hopstock, Laila
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    O'Donnell, Sharon
    School of nursing and Midfwifery, 24 D’Olier St, University of Dublin, Trinity College, Dublin 2, Ireland.
    Svavarsdóttir, Margrét Hrönn
    School of Health Science, Department of Nursing, University of Akureyri, Solborg V/Nordurslod, Akureyri, Iceland.
    Andreae, Christina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Vellone, Ercole
    Department of Biomedicine and Prevention, University of Rome ‘Tor Vergata’, Via Montpellier, Rome, Italy.
    Goossens, Eva
    Academic Center for Nursing and Midwifery, Departement of Public Health and Primary Care, KU Leuven, Leuven, Belgium / Research Foundation Flanders (FWO), Brussels, Belgium.
    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.
    Kjellström, Barbro
    Department of Medicine, Cardiology Unit, Karolinska Institute, Stockholm, Sweden.
    Jaarsma, Tiny
    Department of Nursing Science Julius Center, University Medical Center 100, CG Utrecht, the Netherlands.
    Stewart, Chloe
    Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
    Evaluating the extent of patient-centred care in a selection of ESC guidelines2019In: European Heart Journal - Quality of Care and Clinical Outcomes, ISSN 2058-5225, E-ISSN 2058-1742, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Patient-centred care (PCC) is the cornerstone for healthcare professionals to promote high quality care for patients with cardiovascular conditions. It is defined as ‘Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’. PCC can improve patient outcomes and allow patients and healthcare professionals to manage care collaboratively using best available evidence. However, there is no clear understanding how extensively guidelines incorporate PCC recommendations. The aim of the study was to evaluate the incorporation of PCC into a selection of guidelines published by the European Society of Cardiology (ESC).Using a narrative literature review and expert consensus, the Science Committee within the Association of Cardiovascular Nursing and Allied Professions (ACNAP) developed a checklist to determine PCC incorporation in clinical guidelines. Nine ESC guidelines were reviewed, with committee members independently evaluating five PCC aspects: patient voice and involvement, multidisciplinary involvement, holistic care recommendations, flexibility to meet patients’ needs, and provision of patient tools. The level of congruence in item ratings by experts was then compared. The incorporation of PCC using these respective five categories, ranged from 4% (patient tools) to 53% in the ‘multidisciplinary involvement’ category.Overall, the inclusion of PCC was low, indicating that patient perspectives and needs were less likely to be taken into account when developing, endorsing, or formulating recommendations. Future development of guidelines should ensure better incorporation of patients’ perspective, in particular, and other PCC aspects highlighted in this study.

  • 142.
    Kjellström, Barbro
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Lee, Geraldine
    Kings Coll London, England.
    Khatib, Rani
    Leeds Teaching Hospital NHS Trust, England.
    Mahrer-Imhof, Romy
    Zurich University of Appl Science, Switzerland.
    Moons, Philip
    Katholieke University of Leuven, Belgium; University of Gothenburg, Sweden.
    Noureddine, Samar
    Amer University of Beirut, Lebanon.
    ODonnell, Sharon
    University of Dublin Trinity Coll, Ireland.
    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.
    Svavarsdottir, Margret H.
    University of Akureyri, Iceland; Norwegian University of Science and Technology, Norway.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic University, Australia.
    The Science Committee of the Council of Cardiovascular Nursing and Allied Professions: Moving forward2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 476-477Article in journal (Other academic)
    Abstract [en]

    n/a

  • 143.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    An in-depth, longitudinal examination of the daily physical activity of a patient with heart failure using a Nintendo Wii at home: a case report2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 6, p. 599-602Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore the influence of the Nintendo Wii on the daily physical activity of a patient with chronic heart failure at home.

    METHODS: A 74-year-old Swedish patient with heart failure had access to a Nintendo Wii at home for 12 weeks. Exercise motivation, exercise self-efficacy and exercise capacity were assessed before and after the intervention. Data on perceived physical effort, global well-being and expended energy were collected every day during the intervention.

    RESULTS: During the 12 weeks of access to the Nintendo Wii, daily physical activity increased by 200% on weekdays and 57% on weekends, compared with baseline. The patient’s exercise motivation and exercise self-efficacy increased during the study, whereas perceived physical effort and global well-being did not change. The patient had no difficulties in using the system and did not suffer any major harm.

    DISCUSSION: The results of this case study suggest that providing patients with heart failure access to a Nintendo Wii is a promising and safe intervention. The energy expended by the patient per day increased, as did exercise capacity. Playing the Nintendo Wii did not increase the perceived physical effort, but increased motivation to exercise and decreased barriers to exercising.

  • 144.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    Exergaming to increase the exercise capacity and daily physical activity in heart failure patients: a pilot study2014In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, no 119Article in journal (Refereed)
    Abstract [en]

    Background

    Regular daily physical activity is recognised as important in heart failure (HF) patients, but adherence to physical activity is low (<50%). To improve adherence to exercise in HF patients, alternative approaches to motivate and increase self-efficacy to exercise are needed. Therefore, we have studied a new phenomenon: exergames (games to improve physical exercise). The aims of the study were to assess the influence of the exergame platform Nintendo Wii on exercise capacity and daily physical activity in heart failure patients, to study factors related to exercise capacity and daily physical activity, and to assess patients’ adherence to exergaming.

    Methods

    A 12-week pilot study with a pretest-posttest design was conducted. The intervention consisted of an instruction on how to use the Wii and 12 weeks’ access to Wii at home. The main variables tested were exercise capacity (measured with a six-minute walking test), daily physical activity (measured with an activity monitor), and time exergaming (daily self-report with a diary). Bivariate correlations were used to assess associations between symptom experience, self-efficacy, motivation, anxiety, and depression.

    Results

    In total, 32 heart failure patients were included. More than half of the patients (53%) significantly increased their exercise capacity after 12 weeks. No significant difference was found in daily physical activity between baseline and 12 weeks. Lower NYHA class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The daily mean time spent exergaming was 28 minutes, and having grandchildren and being male were related to more time spent exergaming.

    Conclusion

    Exergaming has the potential to increase exercise capacity in elderly, chronically ill cardiac patients. Although the daily physical activity did not change over time, exergaming was feasible for heart failure patients and might be a rehabilitation option for patients with heart failure

  • 145.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences2015In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 9, p. 1603-1610Article in journal (Refereed)
    Abstract [en]

    Background: Adherence to recommendations for physical activity is low in both male and female patients with heart failure (HF). Men are more physically active than women. In order to successfully promote physical activity, it is therefore essential to explore how much and why HF patients are physically active and if this is related to sex. The aim of this study was therefore to evaluate physical activity in HF patients, to describe the factors related to physical activity, and to examine potential barriers and motivations to physical activity with special focus on sex differences. Methods: The study had a cross-sectional survey design. HF patients living at home received a questionnaire during May-July 2014, with questions on physical activity (from the Short Form-International Physical Activity Questionnaire), and potential barriers and motivations to physical activity. Results: A total of 154 HF patients, 27% women, with a mean age of 70 +/- 10 were included. In total, 23% of the patients reported a high level of physical activity, 46% a moderate level, and 34% a low level. Higher education, self-efficacy, and motivation were significantly associated with a higher amount of physical activity. Symptoms or severity of the disease were not related to physical activity. All the potential barriers to exercise were reported to be of importance. Psychological motivations were most frequently rated as being the most important motivation (41%) to be physically active. Physical motivations (33%) and social motivations were rated as the least important ones (22%). Women had significantly higher total motivation to be physically active. These differences were found in social, physical, and psychological motivations. Discussion: One-third of the HF patients had a low level of physical activity in their daily life. Severity of the disease or symptoms were not related, whereas level of education, exercise self-efficacy, and motivation were important factors to take into account when advising a HF patient about physical activity. Women reported higher motivation to be physically active than men, but there was no difference in the reported level of physical activity.

  • 146.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    Using virtual reality to increase exercise capacity of heart failure patients2013Conference paper (Other academic)
    Abstract [en]

    Purpose Exercise is an important self-care behaviour and is related to decreased mortality in heart failure (HF). There are several barriers for HF patients to start exercising in conventional ways (rehabilitation center, fitness club).Virtual reality might be a solution to increase exercise at home. The Wii, a video game console made by Nintendo, uses virtual reality to increases the possibilities to exercise. The aim of this study was to assess change in exercise capacity in HF patients using the Wii game console at home for 12 weeks and examine factors related to this change.

    Methods The Wii was installed in the home of 32 HF patients (age 64 ± 14 years, 10 female, 68% NYHA II) for a period of 12 weeks. At baseline and at 12 weeks the patients performed the 6-minute walking test (6MWT) to assess physical capacity and completed a questionnaire concerning exercise self-efficacy and exercise motivation. Patients also completed a diary about the amount of minutes playing on the Wii, HF symptoms and perceived exertion.

    Results At baseline patients walked on the 6MWT a mean distance of 500 (±93) meters and at 12 weeks this had increased to 521 (±101) meters. More than half of the patients (n=17) had a clinically significant improvement of 30 meters or more and 9 patients (28%) decreased the amount of meters walked. One patient (3%) increased in the amount of meters but less than 30 meters. Patients who increased the amount of meters during 6MWT had a significant lower NYHA class. No associations were found between change in meter walked and the amount of minutes played on the Wii, the perceived exertion, or HF symptoms

    Conclusion Virtual reality in the rehabilitation of HF patients is a new innovative method to increase activity. More than half of the patients in this pilot study achieved a clinically relevant increase in exercise capacity due to access to the Wii at home for 12 weeks. Patients with a lower functional class at baseline seemed to benefit the most using the Wii.

  • 147.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    Muhic, Almira
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Cabanes, R
    Gastelurrutia, B
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Cabanes, R
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Rodrigues, R
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Gonzales, B
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Lupon, J
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Bayes-Genis, A
    Germans Trias i Pujol University Hospital, Unitat d’Insuficiència Cardíaca, Badalona, Spain.
    Physical activity in daily life in heart failure patients living in two European countries, Volume 17, Issue Supplement S12015Conference paper (Other academic)
    Abstract [en]

    Aims: 

    Exercise is recognized as important in patients with heart failure (HF). It is unclear if there are differences in physical activity between European Countries, therefore the aims of this study were to

    -Assess physical activity levels in HF patients,

    -Describe the different types of physical activity of HF patients 

    -Explore differences between patients from Spain and Sweden 

    Method: The short International Physical Activity Questionnaire (sIPAQ) was used to assess the level of physical activity during the previous week. The sIPAQ contains seven items to identify the frequency and duration of light, moderate, and vigorous PA, as well as inactivity during the past week. Data was collected during April-July 2014 in Swedish and Spanish HF patients. Differences were analysed using Pearson’s chi-square or Mann-Whitney U test.

    Results: 

    Population:

    • 548 Spanish and 154 Swedish HF patients
    • 29% female, mean age 69±12 years, 75% NYHA class II/19% NYHA III
    • No differences were found in gender, age NYHA class between the two countries 

    Patients in Sweden compared to Spanish patients:

    • Had a higher mean physical activity level
    • Did more vigorous activities, like lifting, digging, aerobics, or fast bicycling
    • Did more moderate activities like carrying light loads, bicycling at a regular pace, or doubles tennis.
    • Did less walking (walking at work and at home, walking to travel from place to place, and any other walking that might be done solely for recreation, sport, exercise, or leisure) 

    Conclusions: 

    Despite that most of the patients were in NYHA class II and not symptomatic even at moderate to high level of activity, one third of them had a low physical activity level in their daily life.

    We found differences in the kind of physical activities between Spain and Sweden, which could be due to cultural and regional differences. Specific differences and consequences need to be further explored.

  • 148.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, 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.
    van der Wal, Martje H. L.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Groningen, Netherlands.
    Seasonal variation in physical activity in patients with heart failure2019In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 48, no 5, p. 381-385Article in journal (Refereed)
    Abstract [en]

    Background and objectives: Physical activity is important for all heart failure (HF) patients to improve quality of life and physical function. Since adherence to physical activity is low and could differ between seasons, it is essential to explore factors related to change that may depend on seasonal changes. The purpose of this study was to describe the seasonal differences in physical activity and assess factors that influence these differences in a country with markedly different winter-to-summer weather conditions (in temperature, hours of daylight and snow fall). Methods: The study had a cross-sectional survey design. Outpatients with HF completed a questionnaire on physical activity, motivation and self-efficacy to exercise and I-IF symptom severity in the summer and the winter in a northern hemisphere country. We used analysis of variance to evaluate seasonal differences in physical activity, motivation, self-efficacy and HF symptom severity. Results: Eighty-seven patients with HF (29% women, mean age 70 +/- 9 years) were included and 35% performed less physical activity (METs) in the winter, compared to the summer. Increased symptom severity during the winter was associated with lower activity levels. Conclusion: One-third of the patients performed less physical activity during the winter compared to the summer, and this was associated with symptom severity. Decreased physical activity was not related with motivation and self-efficacy. This study emphasises the need for personalised physical activity programmes that also assess symptom severity and change in symptom severity depending between seasons. (C) 2019 The Authors. Published by Elsevier Inc.

  • 149.
    Klompstra, Leonie
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. 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.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Turollo, Andrea
    Fondazione Ospedale San Camillo, I.R.C.C.S., Venice.
    Using a virtual reality application to improve physical activity in heart failure patients2012Conference paper (Other academic)
    Abstract [en]

    Introduction: A virtual reality application might be a promising tool to increase exercise in the homes of patients with Heart failure (HF). However, the feasibility to use an exergame for elderly heart failure patients, from patient and provider perspective is currently not known. The aim is to assess the feasibility to increase daily activity in HF patients using the Wii game console.

    Method: A descriptive study design will be used. Nintendo Wii sport will be used by 40 patients with HF. Intervention: Nintendo Wii sport will be installed in the home of 10 heart failure patients for a period of 3 months. A personalized exercise plan will be made with the patient for 10 weeks by a physiotherapist or nurse. An instructor will help the patient to install and set up the program, to make a training plan and to help the patient to use the system.

    Data collection: At baseline, at 3 and 6 months data will be collected on self care behavior, heart failure knowledge, exercise self-efficacy, exercise motivation and depression and anxiety. During the use of the Wii computer patients fill in a diary which contains questions about heart failure symptom monitoring, global well-being, perceived exertion and daily activity. At 3 and 6 months a qualitative interview will be conducted to assess the feasibility of using the Wii computer. Patients will also use activity monitors (SenseWear and Direct Life) to assess the total daily activity. Actual use, problems and questions to the instructor will also be assessed.

    Results: The first patients are recruited for the study and data are planned to be available during the conference

    Conclusion: This study will provide insight on the feasibly to apply virtual reality application in HF patients to increase their physical activity in their home.

  • 150.
    Lainscak, Mitja
    et al.
    University Clin Resp and Allerg Disease Golnik.
    Blue, Lynda
    British Heart Foundation.
    Clark, Andrew L
    University of Hull.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Dickstein, Kenneth
    Stavanger University Hospital.
    Ekman, Inger
    Gothenburg University.
    McDonagh, Theresa
    Royal Brompton Hospital.
    J McMurray, John
    University of Glasgow.
    Ryder, Mary
    Heart Failure Unit, St Vincents Healthcare Grp.
    Stewart, Simon
    Heart and Diabet Institute, Melbourne.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology2011In: EUROPEAN JOURNAL OF HEART FAILURE, ISSN 1388-9842, Vol. 13, no 2, p. 115-126Article in journal (Refereed)
    Abstract [en]

    Guidelines on heart failure (HF) stress the importance of lifestyle advice, although there is little evidence that such recommendations improve symptoms or prognosis. Patients experience symptoms of different intensities which impair their daily activities and reduce the quality-of-life. To cope with their clinical condition, many patients seek advice about lifestyle and self-management strategies when in contact with medical care providers, particularly specialized HF services. Self-care management is an important part of HF treatment, thus health professionals working with patients with HF have recognized the need for more specific recommendations on lifestyle advice. The present paper summarizes the available evidence, promotes self-care management, and aims to provide practical advice for health professionals delivering care to HF patients. It also defines avenues of research to optimize self-care strategies in a number of key areas to derive further benefits.

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