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  • 651.
    Ågren, Susanna
    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.
    Evangelista, Lorraine S.
    UC Irvine Program Nursing Science, CA USA .
    Davidson, Thomas
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. 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.
    Cost-effectiveness of a nurse-led education and psychosocial programme for patients with chronic heart failure and their partners2013Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 15-16, s. 2347-2353Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives.  This randomised controlled trial was conducted to estimate the cost-effectiveness of a nurse-led education and psychosocial support programme for patients with heart failure (HF) and their partners.

    Background.  There are few studies evaluating cost-effectiveness of interventions among HF patient–partner dyads.

    Methods.  Dyads randomised to the experimental group received nurse-led counselling, computer-based education and written materials aimed at developing problem-solving skills at two, six and 12 weeks after hospitalisation with HF exacerbation. The dyads in the control group received usual care. A cost-effectiveness analysis that included costs associated with staff time to deliver the intervention and travel costs was conducted at 12 months. Quality-adjusted life-year (QALY) weights for patients and partners were estimated by SF-6D.

    Results.  A total of 155 dyads were included. The intervention cost was €223 per patient. Participants in both groups showed improvements in QALY weights after 12 months. However, no significant difference in QALY weights was found between the patients in the two groups, nor among their partners.

    Conclusion.  The intervention was not proven cost-effective, neither for patients nor for partners. The intervention, however, had trends (but not significant) effects on the patient–partner dyads, and by analysing the QALY gained from the dyad, a reasonable mean cost-effectiveness ratio was achieved.

    Relevance to clinical practice.  The study shows trends of a cost-effective education and psychosocial care of HF patient–partner dyads.

  • 652.
    Ågren, Susanna
    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.
    Ivarsson, Bodil
    Department of Clinical Sciences, Lund University, Lund, Sweden.
    Psychosocial impact in family members before and up to two years after heart or lung transplantation.2015Konferensbidrag (Övrigt vetenskapligt)
  • 653.
    Ågren, Susanna
    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.
    Ivarsson, Bodil
    Department of Clinical Sciences, Lund University, Lund, Sweden.
    The Unsteady Mainstay of the Family: Adult Children’s Retrospective View on Social Support in Relation to Their Parent’s Heart Transplantation2015Konferensbidrag (Övrigt vetenskapligt)
  • 654.
    Ågren, Susanna
    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.
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery/THAI, Skåne University Hospital and Medical Services, Lund, Sweden.
    Rönning, Helén
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    The Unsteady Mainstay of the Family: Now Adult Children's Retrospective View on Social Support in Relation to Their Parent's Heart Transplantation.2014Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2014, artikel-id 541241Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The needs for support among children with a seriously ill parent, who is waiting for heart transplantation, are unknown today. The aim was to describe now adult children's experiences of social support in relation to a parent's heart transplant during childhood. Nine females and four males were interviewed. The median age for the children was 18 at the transplantation and their parents had been ill before for 18 months (median) and on waiting list for 161 days (mean). Three categories emerged: health care professionals' approaches, family and friends' approaches, and society approaches. Our results show that there was lack of support for children of heart transplantation patients. Support in the shape of information was in most cases provided by the sick or healthy parent. It is of great clinical importance to develop psychosocial support programs for children with a seriously ill parent waiting for heart transplantation (before, during, and after surgery).

  • 655.
    Ågren, Susanna
    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.
    Sjöberg, Trygve
    Skånes universitetssjukhus, Lund.
    Ekmehag, Björn
    Akademiska sjukhuset, Uppsala.
    Wiborg, Maj-Britt
    Skånes universitetssjukhus, Lund.
    Ivarsson, Bodil
    Avdelningen för thoraxkirurgi, Institutionen för kliniska vetenskaper, Lunds universitet; Medicinsk service, Region Skåne.
    Patients' self-perceived health, coping, anxiety, depression and stress before and up to 2 years after a heart or lung transplantation.2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Psychosocial factors are important aspects for patients before, on waiting list, and after a heart or lung transplantation.

    Aim: To illuminate patients' self-­‐perceived health, coping, anxiety, depression and stress before and up to 2 years after heart or lung transplantation.

    Method: Fifty-­‐four adult patients (28 cardiac and 26 lung) were included. They responded to questionnaires about quality of life, coping, anxiety, depression and stress when they were accepted for the transplant waiting list, then 6 months, 1 year and 2 years after a heart or lung transplantation. 

    Result: Mean waiting time was 37 weeks for cardiac patients and 29 weeks for lung patients. The patients had a lower coping ability and self-­‐perceived health at baseline and showed an improvement over time after the transplantation. Excluding pain, which increased and persisted over time after the transplantation, especially for the lung patients. Twenty-­‐three percent of all patients showed clinically anxiety before transplantation compared to 0-­‐8 % after transplantation. However, both before and after, clinical depression was significantly less frequent. Nearly half (44 %) of the patients scored medium or high level of intrusion stress and 38% of avoidance stress before the transplantation, which declined gradually over the years.

    Conclusion: Transplantation has led to positive psychosocial effects at 6 months, 1 year and 2 years after the heart or lung transplantation for most of the patients. The healthcare professionals must ensure to be aware of the challenges faced by their patients in daily living, not only the symptoms of their severe chronic disease but also psychosocial factors mainly before but even after a heart or lung transplantation. Patients have an underlying serious, chronic disease where severe long-­‐term life-­‐threatening complications suddenly can occur

  • 656.
    Ågren, Susanna
    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. Department of Cardiothoracic Surgery, Lund University, Lund, Sweden.
    Sjöberg, Trygve
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Ekmehag, Björn
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Wiborg, Maj-Britt
    Caring Science, Uppsala University, Sweden; Uppsala University Hospital, Uppsala, Sweden; Department of Cardiology, Skåne University Hospital Lund, Lund, Sweden.
    Ivarsson, Bodil
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Psycho-social aspects before and up to 2 years after heart or lung transplantation - experience of patients and their next of kin.2017Ingår i: Clinical Transplantation, ISSN 0902-0063, E-ISSN 1399-0012, Vol. 31, nr 3, artikel-id e12905Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Psychosocial factors are important for patients undergoing heart (HTx) or lung (LTx) transplantation, and for their next of kin (NoK).

    AIM: To describe health-related quality of life (patients only), anxiety, depression, stress, coping ability and burden (NoK only) for patients and their NoK before and up to 2 years after HTx or LTx.

    DESIGN: Adult patients (28 heart and 26 lung) and their appointed NoK were surveyed with questionnaires about specific psychosocial topics when they were accepted for the transplantation waiting list and 6 months, 1 year, and 2 years after transplantation.

    FINDINGS: Patients' coping ability and self-perceived health were low at baseline and improved over time after the transplantation. However, lung patients took longer time to recover in terms of health-related quality of life, depression, and stress than heart patients. Similarly, NoK of lung patients experienced a higher burden and more stress 1 year after transplantation than NoK of heart patients.

    CONCLUSIONS: Healthcare professionals should be aware of the psychosocial challenges patients and their NoK face in daily living and provide support both before and after heart or lung transplantation. Especially, given that these patients have a serious, chronic, underlying disease. This article is protected by copyright. All rights reserved.

  • 657.
    Ågren, Susanna
    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.
    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.
    Luttik, Marie Louise A.
    Hanze University of Appl Science, Netherlands.
    Caregiving tasks and caregiver burden; effects of an psycho-educational intervention in partners of patients with post-operative heart failure2015Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 44, nr 4, s. 270-275Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effects of a psycho-educational intervention on caregiver burden in partners of patients with postoperative heart failure. Background: Since partners of cardiac surgery patients play a significant role in the patients recovery, it is important to address their needs during hospitalization and after discharge. Methods: Forty-two patients with postoperative heart failure and their partners participated in a randomized controlled pilot study. Dyads in the intervention group received psycho-educational support from a multidisciplinary team. Dyads in the control group received usual care. Results: No significant differences were found in the performance of caregiving tasks and perceived caregiver burden in the control versus the intervention group. Conclusion: A pilot study exploring the effects of a psycho-educational intervention in patients and their partners did not reveal significant effects with regard to reduced feelings of burden in partners. Alleviating caregiver burden in partners may need a more intense or specific approach. (C) 2015 Elsevier Inc. All rights reserved.

  • 658.
    Årestedt, Kristofer
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linnaeus Univ, Sweden.
    Alvariza, Anette
    Ersta Skondal Bracke Univ Coll, Sweden; Dalens Hosp, Sweden.
    Boman, Kurt
    Res Unit, Sweden; Umea Univ, Sweden.
    Ohlen, Joakim
    Univ Gothenburg, Sweden.
    Goliath, Ida
    Karolinska Inst, Sweden.
    Håkanson, Cecilia
    Ersta Skondal Bracke Univ Coll, Sweden; Sophiahemmet Univ, Sweden.
    Furst, Carl Johan
    Lund Univ, Sweden; Reg Skåne, Sweden.
    Brännstrom, Margareta
    Umeå Univ, Sweden.
    Symptom Relief and Palliative Care during the Last Week of Life among Patients with Heart Failure: A National Register Study2018Ingår i: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 21, nr 3, s. 361-367Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Heart failure is a disease with high morbidity, mortality, and physical and psychological burden. More knowledge about the care provided for patients with heart failure close to death is needed. Objective: The aim was to describe key aspects of palliative care during the last week of life in patients with heart failure, as reported by healthcare professionals. Design: This is a national register study. Setting/Subjects: The study included 3981 patients with diagnosed heart failure as the underlying cause of death. Measurements: Data were obtained from the Swedish Register of Palliative Care, a national quality register that focuses on patients last week of life, independent of diagnosis or care setting. The register includes information about care interventions connected with key aspects of palliative care. Data are reported retrospectively by a nurse or physician at the healthcare unit where the patient dies. Results: Only 4.2% of patients with heart failure received specialized palliative care. In their last week of life, symptom prevalence was high, validated scales were seldom used, and symptoms were unsatisfactorily relieved. Around one-fifth (17%) of the patients in the study died alone. Less than half of family members had been offered bereavement support (45%). Moreover, one-third (28%) of the patients and more than half (61%) of the family members were reported to have had end-of-life discussions with a physician during the illness trajectory. Conclusion: The results indicate inadequate palliative care for patients with heart failure during their last week of life.

  • 659.
    Årestedt, Kristofer
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Linnaeus University, Kalmar, Sweden .
    Ågren, Susanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Flemme, Inger
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Moser, Debra K
    University Kentucky, Lexington, KY, USA.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    A psychometric evaluation of the four-item version of the Control Attitudes Scale for patients with cardiac disease and their partners2015Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, nr 4, s. 317-325Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:The four-item Control Attitudes Scale (CAS) was developed to measure control perceived by patients with cardiac disease and their family members, but extensive psychometric evaluation has not been performed.Objective:The aim was to translate, culturally adapt and psychometrically evaluate the CAS in a Swedish sample of implantable cardioverter defibrillator (ICD) recipients, heart failure (HF) patients and their partners.Methods:A sample (n=391) of ICD recipients, HF patients and partners were used. Descriptive statistics, item-total and inter-item correlations, exploratory factor analysis, ordinal regression modelling and Cronbach's alpha were used to validate the CAS.Results:The findings from the factor analyses revealed that the CAS is a multidimensional scale including two factors, Control and Helplessness. The internal consistency was satisfactory for all scales (α=0.74-0.85), except the family version total scale (α=0.62). No differential item functioning was detected which implies that the CAS can be used to make invariant comparisons between groups of different age and sex.Conclusions:The psychometric properties, together with the simple and short format of the CAS, make it to a useful tool for measuring perceived control among patients with cardiac diseases and their family members. When using the CAS, subscale scores should be preferred.

  • 660. Årestedt, L.
    et al.
    Martinsson, Caroline
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Uhlin, F.
    Eldh, Ann Catrine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Patient participation in dialysis care: a qualitative study of patients’ and health professionals’ perspectivesIngår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625Artikel i tidskrift (Refereegranskat)
  • 661.
    Åsenhed, Liselotte
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting.
    Kilstam, Jennie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Örebro läns landsting.
    Alehagen, Siw
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Baggens, Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Becoming a father is an emotional roller coaster - an analysis of first-time fathers' blogs2014Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 9-10, s. 1309-1317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives. To identify and describe the process of fatherhood during the partner’s pregnancy among expectant,first-time fathers.Background. Pregnancy seems to be a demanding period for expectant fathers, and this period is a part of their transition tofatherhood. Blogs can be seen as personal diaries and offer an alternative method of collecting data as they are an arena forsharing experiences and narratives.

    Design. An explorative qualitative design.Methods. Blogs from the Internet by eleven first-time fathers living in Sweden were included in the study. Qualitative contentanalysis was used for the analysis of the blogs.

    Results. A theme emerged expressing the latent content of the text: ‘Becoming a father for the first time is an emotional rollercoaster where the role of the expectant father is not obvious’ and five different categories describing the manifest content: thepregnancy, a new life, to make the child real, preparations for the delivery and the arrival of the child, and a new role in life.

    Conclusions. The metaphor ‘roller coaster’ indicates the tension between different feelings about the men’s future as fathers.They are searching for answers on how to be a good father. They feel excluded when they visit antenatal care centres andhave difficulties finding out how to support their partner. This is an existential period when they understand themselves asadults and also miss relatives who have died. During pregnancy, the men start to communicate with their child, and thisinteraction gives a sense of reality and creates hope and joy about being a father.Relevance to clinical practice. Staff involved in antenatal care can use the knowledge from this study when meeting withexpectant fathers. Perspectives expressed in blogs may enhance the professionals’ understanding that the transition processof fatherhood is complex.

    Key words: blogs, first-time fathers, pregnancy, qualitative content analysis, qualitative study, reproductive health, sexuality,transition

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