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  • 251.
    Hellström Ängerud, Karin
    et al.
    Institutionen för omvårdnad, Umeå Universitet.
    Ericsson, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Isaksson, R-M
    Norrbotten County Council, Department of Research, Luleå.
    Sederholm Lawesson, Sofia
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Swahn, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Differences in symptoms in relation to myocardial infarction.2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: In myocardial infarction (MI) rapid diagnosis and treatment is crucial for the prognosis. Previous research has found that symptom presentation influence pre hospital delay times but studies about differences in MI symptoms between patients with ST-elevation myocardial infarction (STEMI) and non ST-elevation myocardial infarction (NSTEMI) are sparse and inconclusive. To enhance the understanding of symptom presentation in regard to MI type, we aimed to describe symptoms in relation to MI type and to find predictors of STEMI versus NSTEMI in patients with MI.

    Methods: Patients with MI (n=694) from the SymTime study were included. SymTime was a multicentre cross-sectional study of symptoms and actions in the prehospital phase of MI and data were collected using a previously validated questionnaire administered to MI patients within 24 h of admission to hospital.

    Results: Patients with STEMI were younger, more often men and smokers. Patients with NSTEMI were more likely to have a history of hypertension, MI and stroke. Chest pain was the most common symptom in both groups. Pain, discomfort, or pressure located in the jaw or teeth, vertigo/pre-syncope, cold sweat and nausea/vomiting were significantly more frequent in patients with STEMI (Table 1). In a multivariate logistic regression model patients with STEMI were more likely to present with cold sweat (OR 4.13, 95% CI 2.71–6.29) jaw pain (OR 2.14, 95% CI 1.02–4.50), and nausea (OR 2.01, 95% CI 1.20–3.33), and less likely to have a history of stroke (OR 0.35, 95% CI 0.15–0.84), fluctuating symptoms (OR 0.54, 95% CI 0.36–0.83) and anxiety (OR 0.54, 95% CI 0.32–0.92) compared to patients with NSTEMI.

    Conclusion: Patients with STEMI differed significantly from those with NSTEMI regarding symptom presentation. This knowledge is important for health care personnel to recognize symptoms alarming for STEMI when evaluating patients with MI symptoms.

  • 252. Hellström-Ängerud, K
    et al.
    Eriksson, M
    Isaksson, R-M
    Swahn, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Logander, Elisabeth
    Lawesson, Sofia
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Symptoms in MI in patients wit and without diabetes: a survey report from the SymTime study group.2014Konferensbidrag (Refereegranskat)
  • 253.
    Hendriks, Jeroen
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Univ Adelaide, Australia.
    Gallagher, Celine
    Univ Adelaide, Australia.
    Middeldorp, Melissa E.
    Univ Adelaide, Australia.
    Sanders, Prashanthan
    Univ Adelaide, Australia.
    New approaches to detection of atrial fibrillation2018Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 104, nr 23, s. 1898-1899Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 254.
    Hendriks, Jeroen
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Univ Adelaide, Australia; Royal Adelaide Hosp, Australia.
    Heidbuchel, Hein
    Antwerp Univ, Belgium; Univ Hosp, Belgium; Hasselt Univ, Belgium.
    The management of atrial fibrillation: An integrated team approach - insights of the 2016 European Society of Cardiology guidelines for the management of atrial fibrillation for nurses and allied health professionals2019Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, nr 2, s. 88-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The 2016 European Society of Cardiology guidelines for the management of atrial fibrillation recommends integrated care in the treatment of atrial fibrillation and follows a patient-centred, multidisciplinary team approach. Nurses and allied health professionals have a significant role to play in the management of chronic conditions such as atrial fibrillation, which is underlined by this guideline and the integrated care approach. In this article, members of the task force writing committee highlight significant evidence from this particular guideline as well as clinical implications for nurses and allied health professionals in their daily work with atrial fibrillation patients and their caregivers.

  • 255.
    Hendriks, Jeroen M. L.
    et al.
    Maastricht University, Netherlands.
    Johansson, Peter
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Ulander, Martin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Neurofysiologiska kliniken US.
    Broström, Anders
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Neurofysiologiska kliniken US. Jönköping University, Sweden .
    Editorial Material: Sleep disordered breathing - A hidden co-morbidity in patients with atrial fibrillation? in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 13, issue 6, pp 480-4822014Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 6, s. 480-482Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 256.
    Hendriks, Jeroen
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. University of Adelaide, Australia.
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Johansson, Peter
    Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Editorial Material: E-health in patients with atrial fibrillation in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 15, issue 4, pp 200-2022016Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, nr 4, s. 200-202Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 257.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Dalens Hospital, Sweden; Karolinska Institute, Sweden.
    Carlander, Ida
    Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Karolinska Institute, Sweden.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Ersta Skondal University of Coll, Sweden; Ersta Hospital, Sweden; Linnaeus University, Sweden.
    Factors associated with feelings of reward during ongoing family palliative caregiving2015Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, nr 3, s. 505-512Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 258.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Collage, Sweden; Ersta Hospital, Sweden; Dalens Hospital, Sweden; Karolinska Institute, Sweden.
    Carlander, Ida
    Ersta Skondal University of Collage, Sweden; Karolinska Institute, Sweden.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Ersta Skondal University of Collage, Sweden; Ersta Hospital, Sweden; Linnaeus University, Sweden.
    Feelings of rewards among family caregivers during ongoing palliative care2015Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, nr 6, s. 1509-1517Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 259.
    Henriksson, Anette
    et al.
    Ersta Skondal University of Coll, Sweden Ersta Hospital, Sweden Dalens Hospital, Sweden Karolinska Institute, Sweden .
    Franzén Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: A correlational, cross-sectional study2013Ingår i: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, nr 7, s. 639-646Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 260.
    Hilcz, Rebecca
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Göransson, Rebecka
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Sjuksköterskans erfarenheter av bedsiderapportering: - En kvalitativ intervjustudie2017Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Bedsiderapportering är en metod där överrapporteringen sker inne hos personen som vårdas och dennes egna berättelser blir ett tillägg i rapporteringen. Bedsiderapportering ger en snabb och tydlig överblick av personens tillstånd och underlättar planeringen för sjuksköterskan. Överrapporteringsmetoden har bland annat resulterat i en ökad delaktighet och patientsäkerhet.

    Syfte: Syftet med studien var att beskriva sjuksköterskans erfarenheter av bedsiderapportering.

    Metod: En kvalitativ studie med induktiv ansats genomfördes, där datainsamlingen baserades på tolv semistrukturerade intervjuer med legitimerade sjuksköterskor. Det insamlade materialet analyserades baserat på Graneheim och Lundmans metod för innehållsanalys.

    Resultat: I resultatet identifierades 15 subkategorier vilka ledde fram till 5 kategorier som samtliga beskriver sjuksköterskans erfarenheter av bedsiderapportering. Kategorierna som identifierades var: Göra personen delaktig, Förutsättningar för patientsäkerhet, Ökade krav på sjuksköterskan, Sekretess samt Sjuksköterskans känslor och attityder.

    Konklusion: Bedsiderapportering anses främja en personcentrerad vård med ökad delaktighet samt en ökad patientsäkerhet. Sjuksköterskan behöver ta tillvara på de möjligheter som ges under rapporteringstillfället för att optimera överrapporteringen. Bedsiderapportering har utvecklingspotential och anses tillhöra framtidens vård där delaktighet och personcentrerad vård står i centrum.

    Nyckelord: Bedsiderapportering, delaktighet, patientsäkerhet, personcentrerad vård, överrapportering.

  • 261.
    Hill, Loreena
    et al.
    Queens Univ, North Ireland.
    McIlfatrick, Sonja
    Ulster Univ, North Ireland; All Ireland Inst Hosp and Palliat Care, Ireland.
    Taylor, Brian J.
    Ulster Univ, North Ireland.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Mary MacKillop Inst Hlth Res, Australia.
    Moser, Debra
    Univ Kentucky, KY USA; Univ Kentucky, KY USA.
    Slater, Paul
    Ulster Univ, North Ireland.
    McAloon, Toni
    Ulster Univ, North Ireland.
    Dixon, Lana
    Belfast Hlth and Social Care Trust, North Ireland.
    Donnelly, Patrick
    South Eastern Hlth and Social Care Trust, North Ireland.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Fitzsimons, Donna
    Queens Univ, North Ireland; All Ireland Inst Hosp and Palliat Care, Ireland.
    Patient and Professional Factors That Impact the Perceived Likelihood and Confidence of Healthcare Professionals to Discuss Implantable Cardioverter Defibrillator Deactivation in Advanced Heart Failure Results From an International Factorial Survey2018Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, nr 6, s. 527-535Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Rate of implantable cardioverter defibrillator (ICD) implantations is increasing in patients with advanced heart failure. Despite clear guideline recommendations, discussions addressing deactivation occur infrequently. Aim: The aim of this article is to explore patient and professional factors that impact perceived likelihood and confidence of healthcare professionals to discuss ICD deactivation. Methods and Results: Between 2015 and 2016, an international sample of 262 healthcare professionals (65% nursing, 24% medical) completed an online factorial survey, encompassing a demographic questionnaire and clinical vignettes. Each vignette had 9 randomly manipulated and embedded patient-related factors, considered as independent variables, providing 1572 unique vignettes for analysis. These factors were determined through synthesis of a systematic literature review, a retrospective case note review, and a qualitative exploratory study. Results showed that most healthcare professionals agreed that deactivation discussions should be initiated by a cardiologist (95%, n = 255) or a specialist nurse (81%, n = 215). In terms of experience, 84% of cardiologists (n = 53) but only 30% of nurses (n = 50) had previously been involved in a deactivation decision. Healthcare professionals valued patient involvement in deactivation decisions; however, only 50% (n = 130) actively involved family members. Five of 9 clinical factors were associated with an increased likelihood to discuss deactivation including advanced age, severe heart failure, presence of malignancy, receipt of multiple ICD shocks, and more than 3 hospital admissions during the previous year. Furthermore, nationality and discipline significantly influenced likelihood and confidence in decision making. Conclusions: Guidelines recommend that healthcare professionals discuss ICD deactivation; however, practice is suboptimal with multifactorial factors impacting on decision making. The role and responsibility of nurses in discussing deactivation require clarity and improvement.

  • 262.
    Hjelm, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Cognitive function in elderly patients with chronic heart failure2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction

    Approximately 1-2% of the adult population in developed countries suffer from heart failure (HF), with the prevalence rising to more than 10% among patients 80 years of age or older. The HF syndrome is associated with elevated mortality and morbidity, and decreased quality of life. Cognitive dysfunction has been reported in patients suffering from a variety of cardiovascular disorders. However, few studies have systematically assessed cognitive performance in HF patients, its prevalence and other factors influencing cognition in HF patients. Further, it is of great interest to understand the relationship between self-care in HF and cognition. It may be important to screen for cognitive dysfunction as it may influence HF patients’ ability to perform self-care, e.g. make lifestyle changes, adhere to medical treatment and monitor, evaluate and treat symptoms of deterioration.

    Aim

    The overall aim of this thesis was to explore cognitive function in elderly patients with chronic heart failure with focus on prevalence, risk factors, sleep and self-care.

    Design and method

    This thesis is based on four quantitative studies. The data from study I and II were collected in a prospective longitudinal design, including Swedish same-sex twin pairs born in 1913 or earlier in Sweden. The study was conducted 1991-2002 and a total of 702 individuals aged 80 and older were included.

    Study III and IV had a cross- sectional design and included stable HF patients, median 72 years of age, living in the community in the south of Sweden. Data were collected between 2009 and 2012. Study III included a total of 137 patients and Study IV included 142 patients.

    Results

    Study I found that  octogenarians with HF had significantly poorer spatial performance and episodic memory, and that the episodic memory declined more over time compared to a non-HF population of the same ages.

    Study II showed that octogenarians with HF had a significantly higher prevalence of vascular dementia, 16% vs. 6%, and all types of dementia, 40% vs. 30%, than those not diagnosed with HF. Factors related to dementia in individuals with HF were depression, hypertension and increased levels of homocysteine. Diabetes was associated with an increased risk for vascular dementia.

    In study III we found that  HF patients with sleep disordered breathing (SDB) (apnoea-hypopnoea index >15) had significantly higher saturation time < 90%, more difficulties maintaining sleep and lower levels of daytime sleepiness compared to those in the non-SDB group. Cognitive function did not differ between the SDB and the non-SDB-group. Only insomnia was associated with a decreased global cognititive function measured with the Mini Mental State Examination instrument.

    Finally, in study IV, the relationship between self-care and different dimensions of cognitive function was explored. Psycho- and visuomotor function (speed and attention) was the only dimension of cognitive function associated with self-care.

    Conclusion

    Octogenarians suffering from HF have a decreased performance in spatial and episodic memory and they also have a higher risk for developing dementia. Cognitive dysfunction as well as higher prevalence of dementia can contribute to decreased adherence to prescribed therapy and self-care management, and lead to other socio-behavioural problems.  

    Self-care was found to be associated with psychomotor speed. This may influence sustained attention negatively and the ability to carry out more than one task at the same time. This may lead to decreased attention for receiving and understanding information on self-care.

    Delarbeten
    1. The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older
    Öppna denna publikation i ny flik eller fönster >>The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older
    Visa övriga...
    2012 (Engelska)Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 7-8, s. 994-1003Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aim.  The aim of this study was to examine the relationship between heart failure and specific cognitive abilities in octogenarians with regard to level and change over time.

    Background.  Cognitive impairment is influenced by many factors, and the impact of heart failure is debated. Intact cognitive ability is crucial for successful self-care in patients with heart failure. Middle-aged patients with heart failure seem to have an increased risk of cognitive impairment. No studies have examined the association between heart failure and longitudinal cognitive changes in octogenarians (individuals 80 years and older).

    Design.  A prospective longitudinal design.

    Methods.  Cognitive tests were carried out five times (1991–2002) in 702 octogenarians from the Swedish Twin Registry, including same-sex twin pairs. The test battery included the measurement of processing speed, visuospatial ability, short-term, episodic and semantic memory. Latent growth curve modelling was employed to measure change and performance over time and compares the group diagnosed with heart failure to individuals without a heart failure diagnosis.

    Results.  At baseline, the participants’ mean age was 83·5 years, 67% were women and 13% suffered from heart failure. Individuals diagnosed with heart failure scored significantly lower in spatial abilities and episodic memory than participants not diagnosed with heart failure. Moreover, measures of episodic memory declined more over time in individuals diagnosed with heart failure. There were no significant differences between the groups in other cognitive tests.

    Conclusion.  Spatial problems and episodic memory have implications for everyday life. This might contribute to decreased adherence to prescribed therapy and self-care management and lead to socio-behavioural problems because of an impaired capacity to drive, read and write.

    Relevance to clinical practice.  Nurses should take into account in their assessment that cognitive impairment may restrain elderly heart failure patient’s ability to make decisions and perform self-care actions. Patient education strategies should also be adapted to cognitive ability.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2012
    Nyckelord
    chronic heart failure, cognitive dysfunction, episodic memory, heart failure, neuropsychological testing, octogenarians, patient education, self-care, spatial abilities
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-74495 (URN)10.1111/j.1365-2702.2011.03817.x (DOI)000301427600012 ()21883570 (PubMedID)
    Anmärkning

    funding agencies|Health Research Council in the South-East of Sweden||Faculty of Health Science at LinkopingUniversity||US National Institute on Aging of the National Institutes of Health| NIA:AG08861 |Swedish Council for Working Life and Social Research||Adlerbertska Foundation||Hjalmar Svensson Foundation||Knut and Alice Wallenberg Foundation||Wennergren Foundations||Wilhelm and Martina Lundgrens Foundation||Department of Medical Epidemiology and Biostatistics||Karolinska Institute, Stockholm, Institute of Gerontology, School of Health Sciences, Jonkoping||

    Tillgänglig från: 2012-01-30 Skapad: 2012-01-30 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    2. Factors Associated With Increased Risk for Dementia in Individuals Age 80 Years or Older With Congestive Heart Failure
    Öppna denna publikation i ny flik eller fönster >>Factors Associated With Increased Risk for Dementia in Individuals Age 80 Years or Older With Congestive Heart Failure
    Visa övriga...
    2014 (Engelska)Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, nr 1, s. 82-90Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND AND RESEARCH OBJECTIVE:: An increasing body of evidence shows that individuals diagnosed with congestive heart failure (CHF) are at a higher risk for dementia. However, the prevalence rate of dementia among persons with CHF in very old individuals has not been previously reported, and little is known about the comorbidities that place old persons with CHF at a higher risk for dementia. The aim of this study was to compare the prevalence of dementia in individuals 80 years or older who have CHF with that in individuals without CHF and to identify factors related to dementia in individuals diagnosed with CHF.

    METHODS:: A total of 702 participants from a Swedish population-based longitudinal study (Octogenerian Twin) were included. The group consisted of same-sex twin pairs, age 80 years or older, and 138 participants had CHF. Dementia was diagnosed according to criteria in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Generalized estimating equations including gender, age and educational level, waist circumference, diabetes, hypertension, smoking, depression, and blood values were used in a case-control analysis.

    RESULTS:: Individuals with CHF had a significantly higher prevalence of vascular dementia, 16% vs 6% (P < 0.001), and of all types of dementia, 40% vs 30% (P < 0.01), than those not diagnosed with CHF. The generalized estimating equation models showed that depression, hypertension, and/or increased levels of homocysteine were all associated with a higher risk for dementia in individuals with CHF. Diabetes was specifically associated with an increased risk for vascular dementia.

    CONCLUSIONS:: The prevalence of dementia was higher among individuals with CHF than in those without CHF. Diabetes, depression, and hypertension in patients with CHF require special attention from healthcare professionals because these conditions are associated with an elevated risk for dementia. Higher levels of homocysteine were also found to be a marker of dementia in patients with CHF. Further research is needed to identify the factors related to dementia in individuals 80 years or older diagnosed with CHF.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-96804 (URN)10.1097/JCN.0b013e318275543d (DOI)000328934000013 ()23369853 (PubMedID)
    Tillgänglig från: 2013-08-27 Skapad: 2013-08-27 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
    3. Association between sleep-disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure
    Öppna denna publikation i ny flik eller fönster >>Association between sleep-disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure
    2013 (Engelska)Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 15, nr 5, s. 496-504Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

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

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

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

    Ort, förlag, år, upplaga, sidor
    Oxford University Press (OUP): Policy B, 2013
    Nyckelord
    Chronic heart failure, Cognitive dysfunction, Sleep-disordered breathing, Sleepwake pattern, Insomnia
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-93967 (URN)10.1093/eurjhf/hft014 (DOI)000318552200004 ()
    Anmärkning

    Funding Agencies|Research Council in South-East Sweden (FORSS)||Heart-Lung Foundation||Ostergotland County Council||Linkoping University||Linkoping University Hospital, Sweden||

    Tillgänglig från: 2013-06-13 Skapad: 2013-06-13 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
    4. The association between cognitive function and self-care in patients with chronic heart failure
    Öppna denna publikation i ny flik eller fönster >>The association between cognitive function and self-care in patients with chronic heart failure
    Visa övriga...
    2015 (Engelska)Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 44, nr 4, s. 113-119Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

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

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

    Design: Descriptive, cross-sectional study.

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

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

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

    Ort, förlag, år, upplaga, sidor
    New York: Elsevier, 2015
    Nyckelord
    Aging, Brain natriuretic peptides, Cognitive function, Depression, Heart failure, Nursing, Psychomotor speed, Patient education, Self-care, Sleep disordered breathing, Trail-making test
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-96805 (URN)10.1016/j.hrtlng.2014.12.003 (DOI)000351027400007 ()
    Tillgänglig från: 2013-08-27 Skapad: 2013-08-27 Senast uppdaterad: 2019-01-25Bibliografiskt granskad
  • 263.
    Hjelm, Carina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Andreae, Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Centre for Clinical Research Sörmland, Uppsala University, Sweden.
    Isaksson, Rose-Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    From insecurity to perceived control over the heart failure disease–A qualitative analysis2019Ingår i: Nursing & Care Open Access Journal, E-ISSN 2572-8474, Vol. 6, nr 3, s. 101-105Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: The objective in our study was to explore chronic heart failure patients’ perceived control over their heart disease.

    Background: Higher levels of perceived control over one’s chronic heart disease are associated with lower levels of psychological distress and a higher quality of life.

    Design: The study has an explorative and descriptive design using a directed manifest qualitative content analysis according to Marring.

    Methods: The analysis was based on nine interviews with four men and five women aged between 62-85 years, diagnosed with chronic heart failure. The study followed consolidated criteria for reporting qualitative research (COREQ).

    Results: Five categories emerged in the analysis, mirroring a step-by-step process. The first step, insecurity, was followed by evaluation, management and adjustment. The patients finally reached a higher level of perceived control over their lives in relation to their heart disease.

    Conclusions: Most of the patients stated that they could assess and manage symptoms and had adapted to their condition, which increased their level of perceived control.

    Relevance to clinical practice: These findings suggest that managing symptoms is important for strengthen the patients with chronic heart failure. The findings can help health care professionals in communication with the patient planning for self-care actions.

  • 264.
    Hjelm, Carina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Broström, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Neurofysiologiska kliniken US. Jönköping University.
    Dahl, Anna
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Boo
    Department of Psychology, University of Gothenburg, Sweden.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Factors Associated With Increased Risk for Dementia in Individuals Age 80 Years or Older With Congestive Heart Failure2014Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, nr 1, s. 82-90Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND RESEARCH OBJECTIVE:: An increasing body of evidence shows that individuals diagnosed with congestive heart failure (CHF) are at a higher risk for dementia. However, the prevalence rate of dementia among persons with CHF in very old individuals has not been previously reported, and little is known about the comorbidities that place old persons with CHF at a higher risk for dementia. The aim of this study was to compare the prevalence of dementia in individuals 80 years or older who have CHF with that in individuals without CHF and to identify factors related to dementia in individuals diagnosed with CHF.

    METHODS:: A total of 702 participants from a Swedish population-based longitudinal study (Octogenerian Twin) were included. The group consisted of same-sex twin pairs, age 80 years or older, and 138 participants had CHF. Dementia was diagnosed according to criteria in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Generalized estimating equations including gender, age and educational level, waist circumference, diabetes, hypertension, smoking, depression, and blood values were used in a case-control analysis.

    RESULTS:: Individuals with CHF had a significantly higher prevalence of vascular dementia, 16% vs 6% (P < 0.001), and of all types of dementia, 40% vs 30% (P < 0.01), than those not diagnosed with CHF. The generalized estimating equation models showed that depression, hypertension, and/or increased levels of homocysteine were all associated with a higher risk for dementia in individuals with CHF. Diabetes was specifically associated with an increased risk for vascular dementia.

    CONCLUSIONS:: The prevalence of dementia was higher among individuals with CHF than in those without CHF. Diabetes, depression, and hypertension in patients with CHF require special attention from healthcare professionals because these conditions are associated with an elevated risk for dementia. Higher levels of homocysteine were also found to be a marker of dementia in patients with CHF. Further research is needed to identify the factors related to dementia in individuals 80 years or older diagnosed with CHF.

  • 265.
    Hjelm, Carina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Broström, Anders
    Region Östergötland, Sinnescentrum, Neurofysiologiska kliniken US. Jonköping University, Sweden.
    Riegel, Barbara
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    The association between cognitive function and self-care in patients with chronic heart failure2015Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 44, nr 4, s. 113-119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

    Design: Descriptive, cross-sectional study.

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

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

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

  • 266.
    Hjelm, Eva
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Hartwig, Kerstin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Institutionen för vård och välfärd. Linköpings universitet, Tekniska högskolan.
    Berterö, Carina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    An inevitable journey by train: Nurses' narratives about palliative care2007Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 9, nr 4, s. 206-211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this article is to explore the meaning of palliative care in the context of the caring relationship described by nurses providing such care in the home. Eleven nurses were interviewed, and the transcripts were analyzed using the hermeneutic narrativism method. The study found that the nurses'' narrative account of a caring relationship can be represented by a metaphor: an inevitable journey by train, characterized by the three themes of transit points, time, and guidance. Each journey passes through the same four points in chronological order. Time always moves forward, but the duration of the journey can be either long or short. Having more time creates better conditions for developing a caring relationship. The nurse provides guidance through a journey that she has made before, although each journey is unique. A caring relationship signifies commitment and involvement. © 2007 Lippincott Williams & Wilkins, Inc.

  • 267.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Dissimilarities in Social Support as  Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden2014Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 3, s. 211-222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Diabetes (DM) requires self-care that is demanding and may cause stress. Social support canbuffer effects of stress. No previous study has been found comparing perceptions of foreign-bornpersons with DM, concerning the content of and need for social support with a population of origin.The aim was to compare the meaning of support and its impact on the life situation in Swedishandforeign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74persons; 34 foreign- and 40 Swedish-born, aged 32 - 80 years, diagnosed with type 2 DM, was included.The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixedmethods were used and data were collected by qualitative interviews and quantitative data collectedby the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured byNSSQ, no significant differences were found according to gender but foreign-born men scoredlower than Swedish, especially in emotional support and aid. The main findings showed that respondents,irrespective of origin, described the meaning of the concept of support mainly as informationsupport in learning to manage DM. However, foreign-born persons also focused onmedical support with regular follow-ups while Swedes emphasized the need for emotional support.Foreign- and Swedish-born persons are in general more similar than dissimilar in describingthe meaning, need and impact of support. Irrespective of origin they want to learn to manage theirdisease and thus desire and need regular follow-up and information immediately from being diagnosed.Further studies are needed as the study is based on a limited sample.

  • 268.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Kärner, Anita
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Tingström, Pia
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Problem-based learning used in the context of cardiac rehabilitation: different scenes and different roles2014Ingår i: Studies in Continuing Education, ISSN 0158-037X, E-ISSN 1470-126X, Vol. 36, nr 2, s. 218-232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Several studies show that how patients have difficulties in changing lifestyle even though such changes are essential because they are suffering from a life-threatening disease. Coronary artery disease (CAD) patients met 13 times during a year and used problem-based learning (PBL) to improve their empowerment and self-efficacy in making lifestyle changes. District nurses functioned as tutors, helping patients to formulate issues and to state self-care goals. To identify and describe the enactment of PBL, an ethnographic approach was used, including, for example, participant observations and interviews, all derived from six sessions of the education programme. Five different enactments were found, metaphorically expressed as: ‘The study circle’, ‘The classroom’, ‘The expert consultation’, ‘The therapy session’ and ‘The coffee party’. The education programme did not always function as it was supposed to according to the model, but perhaps this should not be seen as a failure of the pedagogical intervention since these enactments as a whole seem to be a way for the patients to be able to make healthy lifestyle changes. The metaphors can broaden the understanding of what can happen when implementing problem-based learning in health care practice.

  • 269.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Sandgren, Anna
    Linneaus Univ, Sweden.
    Strömberg, Anna
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Mårtensson, Jan
    Jonkoping Univ, Sweden.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    I was told that I would not die from heart failure2018Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 41, s. 41-45Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim and objectives: To describe patients experiences of communication about their heart failure prognosis and explore how these experiences affected their preferences for future communication about the prognosis. Background: Professionals need to discuss about the heart failure prognosis with patients in order to improve their understanding of their illness and address palliative care needs. Methods: An inductive and exploratory design was used. A total of 24 patients (75% men, 52-87 years of age) in New York Heart Association class I-III from primary outpatient care participated in focus group-, or individual semi-structured interviews. Thematic analysis was used to identify and interpret patterns in the data. Findings: Two overarching themes, "The message sent" and "Hoping for the best or preparing for the worst", each with three sub-themes, were discovered during the thematic analysis. Many patients described that professionals had not provided them with any prognosis information at all. Other patients described professional information about prognosis that was given in an either very optimistic or very negative way. However, patients also described situations where professionals had given information in a way that they thought was perfect for them to handle, and in accordance with their preferences. Conclusion: This study shows that patients have different experiences and preferences for communication about prognosis and uses different approaches in order to cope living with a chronic illness such as heart failure.

  • 270.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Mårtensson, Jan
    Hälsohögskolan, Jönköping, Sweden.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Communicating prognosis and end-of-life care to heart failure patients: a survey of heart failure nurses' perspectives2014Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 2, s. 152-161Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Many heart failure (HF) patients have palliative care needs, but communication about prognosis and end-of-life care is lacking. HF nurses can play an important role in such communication, but their views on this have rarely been sought.

    AIMS:

    This study aims to describe HF nurses' perspectives on, and daily practice regarding, discussing prognosis and end-of-life care with HF patients in outpatient care. It further aims to explore barriers, facilitators and related factors for discussing these issues.

    METHODS:

    A national survey including nurses from outpatient clinics and primary health care centres was performed. Data was collected using a questionnaire on communication with HF patients about prognosis and end-of-life care.

    RESULTS:

    In total, 111 (82%) of the HF nurses completed the questionnaire. Most of them reported that physicians should have the main responsibility for discussing prognosis (69%) and end-of-life care (67%). Most nurses felt knowledgeable to have these discussions, but 91% reported a need for further training in at least one of the areas. Barriers for communication about prognosis and end-of-life care included the unpredictable trajectory of HF, patients' comorbidities and the opinion that patients in NYHA class II-III are not in the end-of-life.

    CONCLUSION:

    Although HF nurses feel competent discussing prognosis and end-of-life care with the HF patient, they are hesitant to have these conversations. This might be partly explained by the fact that they consider the physician to be responsible for such conversations, and by perceived barriers to communication. This implies a need for clinical policy and education for HF nurses to expand their knowledge and awareness of the patients' possible needs for palliative care.

  • 271.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Sandgren, Anna
    Linnaeus Univ, Sweden.
    Martensson, Jan
    Jonkoping Univ, Sweden.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care2018Ingår i: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 17, artikel-id 85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention. Methods: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy. Results: Two communication tools were designed and evaluated; 1) a Question Prompt List (QPL) for patients and family members and 2) a communication course for professionals which was web -based with one face-to-face training day with simulation. Data on feasibility was collected with questionnaires that were developed for this study, from the 13 participants who completed the course (all nurses). They reported improved knowledge, confidence and skills to discuss the HF trajectory and end-of-life care. The QPL was evaluated to be a useful tool in communication with patients and family members. Conclusions: In a co-design process, future users identified the need for a QPL and a communication course. These communication tools can be used as a dual intervention to improve communication about the HF trajectory and end-of-life care. The QPL can help patients and families to ask questions about the HF trajectory and end-of-life care. The communication course can prepare the professionals to be knowledgeable, confident and skilled to discuss the questions in the QPL. Before the tools are ready for implementation in clinical practice, further studies testing the feasibility of the intervention are needed, including also patients and their families.

  • 272.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Karlsson, Katarina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Olsson, Louise
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Vic., Australia.
    Simulation to Teach Nursing Students About End-of-Life Care2016Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 18, nr 6, s. 512-518Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is minimal education on death and dying in undergraduate nursing programs, leaving the students unprepared to provide sufficient care to dying patients and their families. This article describes a teaching innovation on how end-of-life care simulation can provide a successful and appreciated learning situation for nursing students, teaching them communication skills in challenging situations. Modifications in the setup of the simulation might help the students to focus more on communication and existential issues instead of mostly practical ones.

  • 273.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    van der Wal, Martje H. L.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. University of Groningen, Netherlands.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Martensson, Jan
    Jonköping University, Sweden.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Patient-Nurse Communication about Prognosis and End-of-Life Care2015Ingår i: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 18, nr 10, s. 865-871Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although several studies advise that discussions about prognosis and end-of-life care should be held throughout the whole heart failure (HF) trajectory, data is lacking on the prevalence and practice of such discussions in HF care. Objective: The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education. Methods: This was a descriptive and comparative study. Participants were HF nurses from Swedish and Dutch HF outpatient clinics. Measurements were taken via a survey for both quantitative and qualitative data. Additional data was collected via open-ended questions and analyzed with content analysis. Results: Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. Prognosis and end-of-life care were among the least frequently discussed topics, whereas symptoms of HF was discussed most often. Prognosis was discussed with 687 patients (38%), and end-of-life care was discussed with 179 patients (10%). Prognosis and end-of-life care were discussed more frequently in The Netherlands than in Sweden (41% versus 34%, pless than0.001, 13% versus 4%, pless than0.001). The nurses did not always recognize prognosis and end-of-life care discussions as a part of their professional role. Conclusions: Currently, patient-nurse communication about prognosis and end-of-life care does not seem to be routine in patient education in HF clinics, and these discussions could be included more often. The reasons for nurses to discuss these topics were related to clinical routines, the patients situation, and professional responsibilities. To improve future care, communication with patients needs to be further developed.

  • 274.
    Hollman Frisman, Gunilla
    et al.
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Wåhlin, I
    FoU-enheten, Länssjukhuset i Kalmar, Sweden.
    Orwelius, L
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten.
    Ågren, Susanna
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Critical illness - health promoting conversation for families2016Konferensbidrag (Refereegranskat)
  • 275.
    Hollman Frisman, Gunilla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN.
    Wåhlin, Ingrid
    Intensive Care Department, Kalmar Hospital, Linnaeus University, Kalmar.
    Orwelius, Lotti
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Ågren, Susanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Health-promoting conversations: A novel approach to families experiencing critical illness in the ICU environment.2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 3-4, s. 631-639Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of this study was to identify and describe the outcomes of a nurse-led intervention, "Health-promoting conversations with families," regarding family functioning and well-being in families with a member who was critically ill.

    BACKGROUND: Families who have a critically ill family member in an intensive care unit face a demanding situation, threatening the normal functioning of the family. Yet, there is a knowledge gap regarding family members' well-being during and after critical illness.

    DESIGN: The study utilized a qualitative inductive-descriptive design.

    METHODS: Eight families participated in health-promoting conversations aimed to create a context for change related to the families' identified problems and resources. Fifteen qualitative interviews were conducted with 18 adults who participated in health-promoting conversations about a critical illness in the family. Eight participants were patients (6 men, 2 women) and 10 were family members (2 male partners, 5 female partners, 1 mother, 1 daughter, 1 female grandchild). The interviews were analyzed by conventional content analysis.

    RESULTS: Family members experienced strengthened togetherness, a caring attitude, and confirmation through health-promoting conversations. The caring and calming conversations were appreciated despite the reappearance of exhausting feelings. Working through the experience and being confirmed promoted family well-being.

    CONCLUSION: Health-promoting conversations were considered to be healing, as the family members take part in sharing each other's feelings, thoughts, and experiences with the critical illness.

    RELEVANCE TO CLINICAL PRACTICE: Health-promoting conversations could be a simple and effective nursing intervention for former intensive care patients and their families in any cultural context. This article is protected by copyright. All rights reserved.

  • 276.
    Hollman, G
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Ek, A-C
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Olsson, AG
    Livskvalitet vid blodfettscreening1999Konferensbidrag (Övrigt vetenskapligt)
  • 277.
    Hollman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Familjär hyperkolesterolemi. Optimal behandlingsstrategi och livskvalitet1999Konferensbidrag (Övrigt vetenskapligt)
  • 278.
    Hollman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Quality of life in family members in families with familial hypercholesterolemia2003Konferensbidrag (Övrigt vetenskapligt)
  • 279.
    Hollman, Gunilla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Knowing about the metabolic syndrome, does it influence life?2007Konferensbidrag (Refereegranskat)
  • 280.
    Hollman, Gunilla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Living with the metabolic syndrome2006Konferensbidrag (Refereegranskat)
  • 281.
    Hollman, Gunilla
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Ek, Anna-Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Livskvalitet vid genetiskt ökad sjukdomsrisk2003Konferensbidrag (Refereegranskat)
  • 282.
    Holm, Maja
    et al.
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden.
    Carlander, Ida
    Ersta Skondal University of Coll, Sweden; Karolinska Institute, Sweden.
    Furst, Carl-Johan
    Lund University, Sweden; Lund University, Sweden.
    Wengstrom, Yvonne
    Karolinska Institute, Sweden; University of Örebro, Sweden.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linnaeus University, Sweden.
    Ohlen, Joakim
    Ersta Skondal University of Coll, Sweden; University of Gothenburg, Sweden; University of Gothenburg, Sweden.
    Henriksson, Anette
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden; Ersta Skondal University of Coll, Sweden; Dalen Hospital, Sweden.
    Delivering and participating in a psycho-educational intervention for family caregivers during palliative home care: a qualitative study from the perspectives of health professionals and family caregivers2015Ingår i: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 14, nr 16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 283.
    Holm, Maja
    et al.
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linnaeus University, Sweden.
    Carlander, Ida
    Ersta Sköndal University of Coll, Sweden; Karolinska Institute, Sweden.
    Wengström, Yvonne
    Karolinska Institute, Sweden; University of Örebro, Sweden.
    Ohlen, Joakim
    Ersta Skondal University of Coll, Sweden; University of Gothenburg, Sweden.
    Alvariza, Anette
    Karolinska Institute, Sweden; Ersta Skondal University of Coll, Sweden; Ersta Skondal University of Coll, Sweden; Dalen Hospital, Sweden.
    Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care A Prospective Correlational Study2017Ingår i: CANCER NURSING, ISSN 0162-220X, Vol. 40, nr 1, s. 76-83Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness. Objective: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did. Intervention/Methods: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score amp;lt;= 0 vs amp;gt;= 1). Results: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression. Conclusions: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit. Implications for Practice: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.

  • 284.
    Holmqvist, Rolf
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Ström, Thomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Foldemo, Anniqa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    The effects of psychological treatment in primary care in Sweden—A practice-based study2014Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, nr 3, s. 204-212Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Practice-based studies have found substantial effects of psychological treatment in routine care, often equivalent between treatment methods. Factors that moderate treatment outcome may be important to assess.

    Aim: The purpose of this study was to evaluate treatment outcome in psychological treatment in primary care, and to compare outcome between the most frequently used methods. An additional aim was to study factors that might moderate outcome differences.

    Method: The Clinical Outcome in Routine Evaluation (CORE) system was used to evaluate psychological treatment at Swedish primary care centers. Treatment methods were coded by the therapists after treatment. Three major treatment orientations-directive (cognitive, behavioral and CBT), reflective (psychodynamic and relational) and supportive therapy were compared. Patient and therapist variables were studied as treatment moderating factors.

    Results: Analyses of 733 therapies, delivered by 70 therapists, showed good results in short psychological treatments (median session number = 6). Forty-three percent of the patients were remitted, 34% recovered. For patients receiving at least five sessions, the figures were 50% and 40%. Directive therapy and reflective therapy had comparable outcome, and better than supportive treatment. Patients in supportive therapy had higher age and received fewer therapy sessions. The patients' motivation, alliance capacity and reflective ability, as rated by the therapist after treatment, were lower for patients in supportive treatment.

    Conclusions: Psychological treatment in primary care obtains god results. Supportive therapy should be studied more systematically, particularly with regard to variables that may moderate treatment outcome.

     

  • 285.
    Hultcrantz, Elisabeth
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Ericsson, Elisabeth
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts2013Ingår i: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, nr 3, s. 184-191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Tonsil surgery has been performed for more than 3,000 years. During the 19th century when anesthesia became available, techniques were refined and the number of procedures performed increased. Repeated throat infections often causing big tonsils was the reason why parents asked for the procedure. During the preantibiotic era, scarlet fever was feared since potential heart or kidney complications were life-threatening. The technique used before 1900 was tonsillotomy since neither a fingernail, snare nor the later guillotine were used extracapsularly. Bleeding was small and the surgery ambulatory. Extracapsular tonsillectomy developed around the turn of the 20th century with the purpose of avoiding remnants the focal infection theory was prevailing. The whole tonsil was now extirpated with good visibility of the tonsillar area in a deeply anesthetized patient. During the first half of the 20th century, the two methods competed, but by 1950, total tonsillectomy had become the only correct tonsil surgery. The indication was still recurrent infections. The risk for serious bleeding increased; therefore large clinics arose where patients remained for at least a week after tonsillectomy. When oral penicillin for children became available during the 1960s, the threat of throat infection decreased and the number of tonsillectomies declined. The awareness of obstructive problems in children rose at the same time when obstructive sleep apnea syndrome became a disease for adults (1970s). Tonsillotomy was revived during the 1990s and is today used increasingly in many countries. The indication is mainly obstructive sleep apnea syndromeor sleep-disordered breathing, especially in small children. Total tonsillectomy is still preferred for recurrent infections, which include periodic fever/adenitis/pharyngitis/aphthous ulcer syndrome and recurrent peritonsillitis.

  • 286.
    Hultcrantz, Elisabeth
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Ericsson, Elisabeth
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Hemlin, Claes
    Öron näsa hals, Aleris Specialistvård Sabbatsberg, Stockholm, Sweden.
    Hessén-Söderman, Anne-Charlotte
    Öron näsa hals, Aleris Specialistvård Sabbatsberg, Stockholm, Sweden.
    Roos, Kristian
    Öron-näsa-halsmottagningen, Capio Lundby Närsjukhus, Göteborg, Sweden.
    Sunnergren, Ola
    Öron-näs-halsmottagningen, Ryhovs Länssjukhus, Jönköping, Sweden.
    Stalfors, Joacim
    Öron-näs-halsmottagningen, Sahlgrenska Universitetssjukhuset, Göteborg, Sweden.
    Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy2013Ingår i: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 270, nr 9, s. 2531-2536Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1–15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1–15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.

  • 287.
    Hultgren, Amanda
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Saeid, Fathi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Jag kan se att du lider: Sjuksköterskans bemötande av anhöriga som har förlorat en familjemedlem i plötslig död2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Sjuksköterskan är den person som är närmast patienten, och är den som oftast är med när en patient avlider. De anhöriga som lämnas kvar drabbas alltid av förlusten efter en död, och det är sjuksköterskans ansvar att sköta omvårdnaden av dessa anhöriga. I Sverige dör årligen cirka 90 000 personer, varav 11600 räknas som plötsliga dödsfall. När döden kommer plötsligt orsakar den ett enormt trauma som riskerar att inverka negativt på de efterlevandes hälsa, om de inte får rätt omhändertagande.

    Syfte: Syftet med studien var att identifiera och beskriva sjuksköterskans bemötande av anhöriga som förlorat en familjemedlem i plötslig död.

    Design: Allmän litteraturstudie med systematiskt tillvägagångssätt.

    Metod: Litteratur söktes i databaserna CINAHL, PubMed, PsychINFO, Scopus, Eric och Swemed+. Under sökningen användes svenska Mesh-termer, booleska söktermer, fri sökning och thesaurus-sökning. 16 artiklar kvalitetsgranskades, varav 13 artiklar gick vidare för analys. Av dessa var 12 av kvalitativ art, och en av kvantitativ.

    Resultat: Bemötandet av anhöriga innefattar många områden. Följande huvudkategorier identifierades: Egenvård, att skapa en relation, att ge utrymme, att delge, att vara professionell, samt att lämna situationen.

    Konklusion: Då en patient har avlidit är det viktigt att sjuksköterskan är kompetent att ta hand om de sörjande anhöriga. Sjuksköterskan behöver vara relationsfokuserad i sitt bemötande av dessa, för att kunna se deras behov och ge dem rätt omvårdnad. De anhöriga är i akut behov av information för att skapa sig en förståelse och acceptans för det plötsliga dödsfallet.

  • 288.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Ryhov Cty Council, Sweden.
    Bachrack Lindström, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Safipour, Jalal
    Linnaeus Univ, Sweden.
    Hadziabdic, Emina
    Linnaeus Univ, Sweden.
    Cultural awareness requires more than theoretical education2019Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 39, s. 73-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cultural awareness in healthcare providers is considered one of the most important factors in improving the efficiency and quality of care in a diverse population. Thus, education in cultural awareness needs to be an essential component in nursing education. This study, which uses a qualitative design, aimed to investigate cultural awareness in nursing students in Sweden. Focus groups were used to collect data from 12 students. Three categories were identified as follows after qualitative data analysis of the interviews: 1) desire to learn, 2) learning by doing and 3) caring beyond boundaries. The result clearly indicates that students are willing to learn more about how to care for people with different cultural backgrounds. However, this learning is not always available in official lecture-based education. In fact, most awareness about cultural aspects of healthcare is developed from practice and informal education. Finally, the result also revealed the importance of nurses being able to see the individual beyond the culture, and being aware of their own prejudice. In conclusion, education offers limited opportunities for nursing students to become culturally aware. Nursing education can be improved by strengthening both theoretical and practical tasks involving cultural awareness.

  • 289.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Ryhov County Council, Jönköping, Sweden.
    Wärdig, Rikard
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Rytterström, Patrik
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa.
    The borderline between life and death: Mental healthcare professionals' experience of why patients commit suicide during ongoing care2019Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, nr 9-10, s. 1623-1632Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore mental health professionals' experiences in regard to circumstances that cause the patient to take their own life during ongoing care.

    BACKGROUND: Suicide is a worldwide health problem, and of those who take their own life, nearly 20% have had contact with a psychiatric unit. Mental health professionals may have extended intuitive knowledge that has not been made visible. Mental health professionals' experiences can contribute knowledge that can complement suicide risk assessments and can be helpful in developing approaches and strategies where the hope is to identify and draw attention to people at risk of taking their own life.

    DESIGN: A reflective lifeworld research.

    METHODS: Twelve interviews with mental health professionals with experience of working in caring relationships with patients that had taken their life during the period of care. The study was performed in accordance with COREQ (see Supporting Information Data S1).

    RESULTS: Mental health professionals' experiences regarding circumstances that cause the patient to take their own life are related to the patient's life circumstances that led to a loss of dignity, and finally beyond retrieval. Mental health professionals share patients' struggle to choose between life and death, the darkness of their life and their hopeless situation. This shared experience also makes the mental health professionals wish to relieve patient's suffering but also gives them an understanding of why patients take their own life.

    CONCLUSIONS: The mental health professionals experience how the patient loses the possibility of living a worthwhile life, recognise darkness within the patient and see how the patient's life is fragile. Suicide described as logical and expected, based on their life and life circumstances, has not been found in previous research. Bearing this in mind, should psychiatric care focus on a proactive approach and act when these circumstances are identified?

    RELEVANCE TO CLINICAL PRACTICE: The Mental health professionals' tacit knowledge may be used to strengthen uncertain suicide assessments.

    Publikationen är tillgänglig i fulltext från 2019-12-27 08:59
  • 290.
    Humphrey, Louise
    et al.
    Adelphi Values, UK.
    Kulich, Karoly
    Novartis Pharma AG, Basel, Switzerland.
    Deschaseaux, Celine
    Novartis Pharma AG, Basel, Switzerland.
    Blackburn, Steven
    Adelphi Values, UK.
    Maguire, Laura
    Adelphi Values, UK.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    The Caregiver Burden Questionnaire for Heart Failure (CBQ-HF): face and content validity2013Ingår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, nr 1, s. 84-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    A new caregiver burden questionnaire for heart failure (CBQ-HF v1.0) was developed based on previously conducted qualitative interviews with HF caregivers and with input from HF clinical experts. Version 1.0 of the CBQ-HF included 41 items measuring the burden associated with caregiving in the following domains: physical, emotional/psychological, social, and impact on caregiver’s life. Following initial development, the next stage was to evaluate caregivers’ understanding of the questionnaire items and their conceptual relevance.

    Methods

    To evaluate the face and content validity of the new questionnaire, cognitive interviews were conducted with caregivers of heart failure patients. The cognitive interviews included a “think aloud” exercise as the patient completed the CBQ-HF, followed by more specific probing questions to better understand caregivers’ understanding, interpretation and the relevance of the instructions, items, response scales and recall period.

    Results

    Eighteen caregivers of heart failure patients were recruited. The mean age of the caregivers was 50 years (SD = 10.2). Eighty-three percent of caregivers were female and most commonly the patient was either a spouse (44%) or a parent (28%). Among the patients 55% were NYHA Class 2 and 45% were NYHA Class 3 or 4. The caregiver cognitive interviews demonstrated that the CBQ-HF was well understood, relevant and consistently interpreted. From the initial 41 item questionnaire, fifteen items were deleted due to conceptual overlap and/or item redundancy. The final 26-item CBQ-HF (v3.0) uses a 5-point Likert severity scale, assessing 4 domains of physical, emotional/psychological, social and lifestyle burdens using a 4-week recall period.

    Conclusions

    The CBQ-HF (v3.0) is a comprehensive and relevant measure of subjective caregiver burden with strong content validity. This study has established that the CBQ-HF (v3.0) has strong face and content validity and should be valuable as an outcomes measure to help understand and monitor the relationship between patient heart failure severity and caregiver burden. A Translatability AssessmentSM of the measure has since been performed confirming the cultural appropriateness of the measure and psychometric validation is planned for the future to further explore the reliability, and validity of the new questionnaire in a larger caregiver sample.

  • 291.
    Hägglund, Ewa
    et al.
    Karolinska Institute, Sweden.
    Hagerman, Inger
    Karolinska Institute, Sweden.
    Dencker, Kerstin
    Karolinska Institute, Sweden.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. University of Calif Irvine, CA 92717 USA.
    Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure: A randomized controlled study2017Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr 5, s. 381-389Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The aims of this study were to determine whether yoga and hydrotherapy training had an equal effect on the health-related quality of life in patients with heart failure and to compare the effects on exercise capacity, clinical outcomes, and symptoms of anxiety and depression between and within the two groups. Methods: The design was a randomized controlled non-inferiority study. A total of 40 patients, 30% women (meanSD age 64.98.9 years) with heart failure were randomized to an intervention of 12 weeks, either performing yoga or training with hydrotherapy for 45-60 minutes twice a week. Evaluation at baseline and after 12 weeks included self-reported health-related quality of life, a six-minute walk test, a sit-to-stand test, clinical variables, and symptoms of anxiety and depression. Results: Yoga and hydrotherapy had an equal impact on quality of life, exercise capacity, clinical outcomes, and symptoms of anxiety and depression. Within both groups, exercise capacity significantly improved (hydrotherapy p=0.02; yoga p=0.008) and symptoms of anxiety decreased (hydrotherapy p=0.03; yoga p=0.01). Patients in the yoga group significantly improved their health as rated by EQ-VAS (p=0.004) and disease-specific quality of life in the domains symptom frequency (p=0.03), self-efficacy (p=0.01), clinical summary as a combined measure of symptoms and social factors (p=0.05), and overall summary score (p=0.04). Symptoms of depression were decreased in this group (p=0.005). In the hydrotherapy group, lower limb muscle strength improved significantly (p=0.01). Conclusions: Yoga may be an alternative or complementary option to established forms of exercise training such as hydrotherapy for improvement in health-related quality of life and may decrease depressive symptoms in patients with heart failure.

  • 292.
    Hälleberg-Nyman, Maria
    et al.
    School of Health Sciences, Örebro University, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Forsman, Henrietta
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Wallin, Lars
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ostaszkiewicz, Joan
    Centre for Quality and Patient Safety Research, Barwon Partnership, School of Nursing and Midwifery, Deakin University, Melbourne, Australia.
    Hommel, Ami
    Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden; Department of Orthopaedics, Skaane University Hospital, Lund, Sweden.
    Eldh, Ann Catrine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Dalarna University, Sweden; Uppsala University, Sweden.
    Promoting evidence‐based urinary incontinence management in acute nursing and rehabilitation care: A process evaluation of an implementation intervention in the orthopaedic context2019Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 25, nr 2, s. 282-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale, aims, and objectives

    The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence‐based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence‐based practice for UI in patients aged 65 or older undergoing hip surgery.

    Methods

    A 3‐month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.

    Results

    Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence‐based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.

    Conclusion

    To promote evidence‐based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence‐based management of UI.

  • 293.
    Ibrahim, Farzana
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi.
    Sandström, Per A.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Björnsson, Bergthor
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Lindhoff Larsson, Anna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Drott, Jenny
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi.
    'I want to know why and need to be involved in my own care…': a qualitative interview study with liver, bile duct or pancreatic cancer patients about their experiences with involvement in care.2019Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 27, nr 7, s. 2561-2567Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    Patients’ involvement in their own care is important for those with upper abdominal tumours. Care is often conducted according to standardized fast-track care programs (FTCP), and a shorter hospital stay is one of the goals. However, there is no research providing an in-depth perspective on patients’ experiences of involvement in care. In this qualitative study, we explored experiences of involvement among patients who had surgery for upper abdominal tumours and were cared for according to an FTCP.

    Methods

    Qualitative in-depth face-to-face interviews about patient involvement in care were conducted with 20 patients who had surgery for the liver, bile duct, or pancreatic cancer using an open-interview guide.

    Results

    The most important findings are that customized information and active dialogue about care decisions stimulate patient involvement. We identified three themes from the analysed data: involvement depended on the quality of information, communication and involvement during the care period, and safety at discharge.

    Conclusions

    Individualized care and continuous information about treatment and care goals in the FTCP during the care process create trust between patients and healthcare professionals and increase patient experiences of involvement.

  • 294.
    Ingadottir, Brynja
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. University of Iceland, Reykjavik, Iceland.
    Blondal, Katrin
    University of Iceland, Reykjavik, Iceland.
    Jaarsma, Tiny
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Thylen, Ingela
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.2016Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 11, s. 2672-2683Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To explore the perceptions of surgical patients about traditional and novel methods to learn about post-operative pain management.Background: Patient education is an important part of post-operative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice.Design: A qualitative design with a vignette and semi-structured interviews used for data collection.Methods: A purposeful sample of 13 post-surgical patients, who had been discharged from hospital, was recruited during 2013 - 2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about post-operative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach.Findings: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualised the factors affecting patients' perceptions: 1) 'Trusting the source', sub-categorised into 'Being familiar with the method' and 'Having own prejudgments'; and 2) 'Being motivated to learn' sub-categorised into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'.Conclusion: In order to implement successfully novel educational methods into post-operative care, healthcare professionals need to be aware of the factors influencing patients' perceptions abouthow to learn, such as trust and motivation.

  • 295.
    Ingadottir, Brynja
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. National University Hospital of Iceland, Surgical Services, Reykjavik, Iceland, Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
    Blondal, Katrin
    Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
    Thue, David
    School of Computer Science, Reykjavik University, Reykjavik, Iceland.
    Zoega, Sigridur
    National University Hospital of Iceland, Surgical Services, Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland .
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study.2017Ingår i: JMIR Serious Games, E-ISSN 2291-9279, Vol. 5, nr 2, artikel-id e10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Postoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain.

    OBJECTIVE: The aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game.

    METHODS: A computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information.

    RESULTS: Theories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001).

    CONCLUSIONS: A computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game's usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required.

  • 296.
    Ingadottir, Brynja
    et al.
    Landspitali, Iceland.
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation2015Ingår i: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 9, s. 913-921Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To describe what knowledge heart failure patients expect to acquire in relation to their upcoming cardiac resynchronization therapy (CRT) device implantation, to describe their self-care and health complaints, and to explore the relationship between knowledge expectations and self-care, health complaints, and background factors. Patients and methods: Cross-sectional multicenter study with 104 patients scheduled for a first-time, elective CRT implantation in Swedish and Icelandic hospitals. Data were collected with the Knowledge Expectations of hospital patient Scale, European Heart Failure Self-care Behavior Scale, and Adjusted Postoperative Recovery Profile. Results: Patients expected most knowledge related to their disease and its treatment (median 4.0, interquartile range 0.13) and least on social issues (median 3.5, interquartile range 0.83). Their self-care was average (standardized mean 51.0 +/- 19.6) before the procedure. Patients had on average 8.2 (+/- 4.7) health complaints and rated fatigue and sexual problems as the most severe. Age was independently associated with knowledge expectations (Exp beta 0.049, P= 0.033). Conclusion: Heart failure patients waiting for a CRT device implantation have high expectations for multiple aspects of knowledge, including self-care issues, before their procedure. These expectations are similar to those of other surgical patients and they increase with age.

  • 297. Ingadóttir, B
    et al.
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Knowledge expectations of heart failure patients waiting for cardiac resynchronisation therapy implantation.2014Konferensbidrag (Refereegranskat)
  • 298.
    Ingadóttir, Brynja
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Learning as a patient: What and how individuals want to learn when preparing for surgery, and the potential use of serious games in their education2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: Surgical patients need knowledge to participate in their own care and to engage in self-care behaviour in the perioperative period which is important for their recovery. Patient education facilitates such knowledge acquisition and several methods can be used to facilitate it, for example, face-to-face education and brochures or using information technology such as website or computer games. Healthcare professionals have been slow to seize the possibilities that information technology has to offer within the field, including the use of serious games. To optimise patient education, the information is needed on the patients’ needs and preferences and what they think about the idea of using a serious game to learn about self-care.

    Aim: The overall aims of this thesis were to describe the knowledge expectations of surgical patients, to describe how surgical patients want to learn, and to explore the potential use of serious games in patient education.

    Methods: This thesis includes four studies that used both quantitative and qualitative data to describe aspects of patient learning in relation to surgery. Study I has a prospective and comparative design with survey data collected before surgery and before hospital discharge from 290 patients with osteoarthritis undergoing knee arthroplasty. Data was collected on fulfilment of knowledge expectations and related factors. Study II is a cross-­‐sectional study in 104 patients with heart failure who had been scheduled for cardiac resynchronisation therapy (CRT) device implantation. Data was collected on knowledge expectations and related factors. In Study III the perceptions of 13 surgical patients towards novel and traditional methods to learn about post-operative pain management are explored in a qualitative interview study using content analysis. Study IV describes the development and evaluation of a serious game to learn about pain management with the participation of 20 persons recruited from the public. The game was developed by an interdisciplinary team following a structured approach. Data on the efficacy and usability of the game was collected in one session with questionnaires, observations and interviews.

    Results: Participants reported high knowledge expectations. Knowledge expectations were highest within the bio-physiological knowledge dimension on disease, treatment and complications and the functional dimension on how daily activities are affected, both of which include items on self-care. Most participants wanted to know about the possible complications related to the surgery procedure. In none of the knowledge dimensions the expectations of participants were fulfilled. Participants received most knowledge on the physical and functional issues and received least on the financial and social aspects of their illness. The main predictor of fulfilment of knowledge expectations was having access to knowledge in the hospital from doctors and nurses. Trust in the information source and own motivation to learn shaped how the participants thought about different learning methods. Although the participants were open to using novel learning methods such as websites or games they were also doubtful about their use and called for advice by healthcare professionals. To develop a serious game with the goal to learn about pain management, theories of self-care and adult learning, evidence on the educational needs of patients about pain management and principles of gamification were found useful. The game character is a surgical patient just discharged home from hospital who needs to attend to daily activities while simultaneously managing post-operative pain with different strategies. Participants who evaluated a first version of the serious game improved their knowledge and described usability of the game as high. They were positive towards this new learning method and found it suitable for learning about pain management after surgery in spite of some technical obstacles.

    Conclusions: Surgical patients have high knowledge expectations about all aspects of their upcoming surgery and although they prefer direct communication with healthcare professionals as a source for knowledge they might be open to try using more novel methods such as games. Preliminary short-­‐term results demonstrate that a serious game can help individuals to learn about pain management, and has the potential to improve knowledge. A careful introduction, recommendation, and support from healthcare professionals is needed for implementation of such a novel method in patient education.

    Delarbeten
    1. The fulfilment of knowledge expectations during the perioperative period of patients undergoing knee arthroplasty - a Nordic perspective
    Öppna denna publikation i ny flik eller fönster >>The fulfilment of knowledge expectations during the perioperative period of patients undergoing knee arthroplasty - a Nordic perspective
    Visa övriga...
    2014 (Engelska)Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 19-20, s. 2896-2908Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the possible differences between knowledge expectations and received knowledge of patients undergoing elective knee arthroplasty in Iceland, Sweden and Finland and also to determine the relationship between such a difference and both background factors and patient satisfaction with care.

    BACKGROUND: Knee arthroplasty is a fast-growing and a successful treatment for patients with osteoarthritis. Patient education can improve surgery outcomes, but it remains unknown what knowledge patients expect to receive and actually acquire during the perioperative period and what factors are related to that experience.

    DESIGN: Descriptive, prospective survey.

    METHODS: In total, 290 patients answered questionnaires about their expectations (Knowledge Expectations of hospital patients - scale) before surgery and about received knowledge (Received Knowledge of hospital patients - scale) and satisfaction with hospital care (Patient Satisfaction Scale) at discharge. Sociodemographics, clinical information, accessibility to knowledge from healthcare providers (Access to Knowledge Scale), and preferences for information and behavioural control (Krantz Health Opinion Survey) were collected as background data.

    RESULTS: Patients` knowledge expectations were higher (mean 3·6, SD 0·4) than their perception of received knowledge (mean 3·0, SD 0·7). Multiple linear regression analysis showed that access to knowledge, information preferences and work experience within health- or social care explained 33% (R²) of the variation in the difference between received and expected knowledge. Patients reported high satisfaction with their care except regarding how their family was involved.

    CONCLUSION: Patients undergoing knee arthroplasty receive less knowledge than they expect, and individual factors and communication with healthcare providers during hospitalisation are related to their experience. The content of patient education and family involvement should be considered in future care.

    RELEVANCE TO CLINICAL PRACTICE: The results strengthen the knowledge base on the educational needs of knee arthroplasty patients and can be used to develop and test new interventions.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2014
    Nyckelord
    Knee arthroplasty, osteoarthritis, patient education, patient expectations, patient satisfaction, surgery
    Nationell ämneskategori
    Hälsovetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-105225 (URN)10.1111/jocn.12552 (DOI)000343857700020 ()24476393 (PubMedID)
    Projekt
    EEPO
    Tillgänglig från: 2014-03-13 Skapad: 2014-03-13 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
    2. Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation
    Öppna denna publikation i ny flik eller fönster >>Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation
    2015 (Engelska)Ingår i: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 9, s. 913-921Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose: To describe what knowledge heart failure patients expect to acquire in relation to their upcoming cardiac resynchronization therapy (CRT) device implantation, to describe their self-care and health complaints, and to explore the relationship between knowledge expectations and self-care, health complaints, and background factors. Patients and methods: Cross-sectional multicenter study with 104 patients scheduled for a first-time, elective CRT implantation in Swedish and Icelandic hospitals. Data were collected with the Knowledge Expectations of hospital patient Scale, European Heart Failure Self-care Behavior Scale, and Adjusted Postoperative Recovery Profile. Results: Patients expected most knowledge related to their disease and its treatment (median 4.0, interquartile range 0.13) and least on social issues (median 3.5, interquartile range 0.83). Their self-care was average (standardized mean 51.0 +/- 19.6) before the procedure. Patients had on average 8.2 (+/- 4.7) health complaints and rated fatigue and sexual problems as the most severe. Age was independently associated with knowledge expectations (Exp beta 0.049, P= 0.033). Conclusion: Heart failure patients waiting for a CRT device implantation have high expectations for multiple aspects of knowledge, including self-care issues, before their procedure. These expectations are similar to those of other surgical patients and they increase with age.

    Ort, förlag, år, upplaga, sidor
    Dove Medical Press, 2015
    Nyckelord
    cardiac devices; CRT treatment; patient education
    Nationell ämneskategori
    Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
    Identifikatorer
    urn:nbn:se:liu:diva-120368 (URN)10.2147/PPA.S83069 (DOI)000357535000001 ()26170641 (PubMedID)
    Anmärkning

    Funding Agencies|Landspitali University Hospital Research Fund, Landspitali - The National University Hospital of Iceland; Icelandic Nurses Association Research Fund; Ingibjorg Magnusdottir in Iceland; Medtronic-Vingmed AB; St. Jude Medical Sweden AB in Sweden

    Tillgänglig från: 2015-07-31 Skapad: 2015-07-31 Senast uppdaterad: 2019-06-27
    3. Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.
    Öppna denna publikation i ny flik eller fönster >>Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.
    2016 (Engelska)Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 11, s. 2672-2683Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aim: To explore the perceptions of surgical patients about traditional and novel methods to learn about post-operative pain management.Background: Patient education is an important part of post-operative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice.Design: A qualitative design with a vignette and semi-structured interviews used for data collection.Methods: A purposeful sample of 13 post-surgical patients, who had been discharged from hospital, was recruited during 2013 - 2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about post-operative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach.Findings: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualised the factors affecting patients' perceptions: 1) 'Trusting the source', sub-categorised into 'Being familiar with the method' and 'Having own prejudgments'; and 2) 'Being motivated to learn' sub-categorised into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'.Conclusion: In order to implement successfully novel educational methods into post-operative care, healthcare professionals need to be aware of the factors influencing patients' perceptions abouthow to learn, such as trust and motivation.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2016
    Nyckelord
    Content analysis; educational methods; nursing; patient education; patient learning; post-operative self-care; vignettes
    Nationell ämneskategori
    Omvårdnad
    Identifikatorer
    urn:nbn:se:liu:diva-129199 (URN)10.1111/jan.13021 (DOI)000386079500010 ()27205900 (PubMedID)
    Anmärkning

    Funding agencies: Landspitali University Hospital Research Fund; Icelandic Nurses Association Research Fund

    Tillgänglig från: 2016-06-13 Skapad: 2016-06-13 Senast uppdaterad: 2019-06-27
  • 299.
    Israelsson, Johan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Kalmar County Hospital, Sweden; Linnaeus University, Sweden.
    Bremer, Anders
    University of Borås, Sweden; Kalmar County Hospital, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Axelsson, Åsa B.
    University of Gothenburg, Sweden.
    Cronberg, Tobias
    Lund University, Sweden.
    Djärv, Therese
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Sweden; Uppsala University, Sweden.
    Larsson, Ing-Marie
    Uppsala University, Sweden.
    Lilja, Gisela
    Lund University, Sweden.
    Sunnerhagen, Katharina S.
    University of Gothenburg, Sweden.
    Wallin, Ewa
    Uppsala University, Sweden.
    Ågren, Susanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Åkerman, Eva
    Skåne University Hospital, Sweden; Karolinska Institute, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Sweden; Ersta Sköndal University of Coll, Sweden; Kalmar County Hospital, Sweden.
    Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender2017Ingår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, s. 27-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe health status and psychological distress among in -hospital cardiac arrest (IHCA) survivors in relation to gender. Methods: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS). Results: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQVAS among survivors were 0.78 (ql-q3 = 0.67-0.86) and 70 (ql -q3 = 50-80) respectively. The values were significantly lower (p amp;lt; 0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self -care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p amp;lt; 0.001) and symptoms of depression (p amp;lt; 0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found. Conclusions: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed. (C) 2017 Elsevier B.V. All rights reserved.

  • 300.
    Israelsson, Johan
    et al.
    Kalmar County Hospital, Sweden; Linnaeus University, Sweden.
    Persson, Carina
    Linnaeus University, Sweden.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Årested, Kristofer Franzén
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Is there a difference in survival between men and women suffering in-hospital cardiac arrest?2014Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, nr 6, s. 510-515Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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