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  • 1.
    Lind, Leili
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Lyth, Johan
    Region Östergötland, Regional Board, Research and Development Unit.
    Karlsson, Daniel M. G.
    Linköping University, Department of Biomedical Engineering.
    Wiréhn, Ann-Britt
    Region Östergötland, Regional Board, Research and Development Unit.
    Persson, Lennart
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    COPD patients require more health care than heart failure patients2018In: ERS International Congress 2018, 2018Conference paper (Refereed)
    Abstract [en]

    Background: Populations of elderly patients with advanced stages of chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing, urging the need for specialized health care in the patients’ home. A 4 year (2013-2017) telehealth intervention single-centre clinical study has been completed. We hypothesized that the two groups of patients, advanced COPD or HF, would exhibit differences regarding exacerbations and the need of health care.

    Objective: To study exacerbations of COPD or HF, and patients’ need of health care.

    Methods: A telemonitoring system, the Health Diary, which is based on digital pen technology, was employed. Patients with at least 2 hospital admissions the previous year were included. Responsible nurses and physicians at a specialized home care unit at a university hospital checked all daily patient reports. Physicians identified exacerbations using information provided through the telemonitoring system and patient contacts. Consumed health care was assessed as the number of patient contacts (home visits or telephone consultations).

    Results: Totally, 94 patients with advanced disease were enrolled (36 COPD and 58 HF patients) of which 53 patients (19 COPD and 34 HF patients) completed the 1-yr study period. The major reason for not completing the study was death (13 COPD, 15 HF patients). Average numbers of exacerbations were 3.1 and 0.8 and patient contacts were 94 and 67 per COPD and HF patient, respectively.

    Conclusions: Compared to HF patients, COPD patients exhibit exacerbations more frequently and demand much more home health care. This difference of health care consumption is mainly due to disease characteristics.

  • 2.
    Lyth, Johan
    et al.
    Region Östergötland, Regional Board, Research and Development Unit.
    Lind, Leili
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Karlsson, Daniel
    The National Board of Health and Welfare, Department for Knowledge-Based Policy of Social Services, eHealth and Structured Information Unit, Stockholm, Sweden.
    Persson, Lennart Hans
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Wiréhn, Ann-Britt
    Region Östergötland, Regional Board, Research and Development Unit.
    Can a telemonitoring system lead to decreased hospital admissions in elderly patients?2018Conference paper (Refereed)
    Abstract [en]

    Background: Populations of elderly patients with chronic obstructive pulmonary disease (COPD) or heart failure (HF) are growing. To prevent exacerbations leading to inpatient care, a 4 year (2013-2017) telehealth intervention non-randomized single-centre clinical study was performed. We hypothesized that the patients, grouped by advanced COPD or HF, would exhibit decreased need of hospital admissions.

    Objective: To study hospital admissions in patients with COPD or HF using a telemonitoring system, the Health Diary.

    Methods: A telemonitoring system, the Health Diary, based on digital pen technology, was employed. Patients with COPD or HF treated at the University Hospital in Linköping were included if they had at least 2 hospital admissions the previous year. Data on hospital admissions was obtained from the administrative healthcare database. Expected number of hospital admissions for the study year was calculated using 5-year data for a group of patients with matching diagnosis and history of hospital admissions and was compared to the actual value in the intervention group using Poisson regression.

    Results: Together with the included patients, 159 HF and 136 COPD non-intervention patients was used to calculate the expected values for hospital admissions. For the 58 included HF patients, the average number of hospital admissions of 0.81 was 32.8 percent (p=0.04) lower than expected. For the 36 included COPD patients, the average number of hospital admissions of 1.44 was 37.0 percent (p=0.02) lower than expected.

    Conclusions: Use of the telemonitoring system, the Health Diary, decreases hospital admissions in elderly with COPD and HF.

  • 3.
    Nilsen, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development.
    Ericsson, Carin
    Region Östergötland, Heart and Medicine Center.
    Skagerström, Janna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
    Schildmeijer, Kristina
    Linneuniversitet - Kalmar, Sweden .
    Patientmedverkan från retorik till praktik2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114Article in journal (Other academic)
  • 4.
    Nilsen, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development.
    Skagerström, Janna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
    Ericsson, Carin
    Region Östergötland, Heart and Medicine Center.
    Schildmeijer, Kristina
    Linneuniversitet, Kalmar, Sweden.
    Många faktorer påverkar om patienter kan medverka till säkrare vård - Intervjustudie visar läkares och sjuksköterskors perspektiv2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114Article in journal (Refereed)
    Abstract [en]

    Patient participation for safer health care - interviews with physicians and nurses

    Patient participation to achieve safer care is an area of growing policy, research and health care management and practice interest. Patients are uniquely placed to observe their treatment, care and physical environment throughout their journey in the health care system. However, very few studies have investigated health care providers attitudes and beliefs concerning patient participation for improved patient safety. This study explored factors that acted as facilitators and/or barriers to patient participation for safer care, as perceived by physicians and nurses in Swedish health care. Interviews were conducted with 13 physicians and 11 nurses, using a purposeful sampling strategy to achieve a heterogeneous sample of providers. We identified nine categories of factors, many of which functioned as barriers to patient participation to achieve safer care.

  • 5.
    O'Donnell, Amy
    et al.
    Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
    Abidi, Latifa
    Department of Health Promotion, Maastricht University, Maastricht, Limburg, Netherlands.
    Brown, Jamie
    Research Department of Behavioural Science and Health, University College London, London, UK, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
    Karlsson, Nadine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Roback, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Skagerström, Janna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
    Thomas, Kristin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Beliefs and attitudes about addressing alcohol consumption in health care: a population survey in England2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 391Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite robust evidence for their effectiveness, it has proven difficult to translate alcohol prevention activities into routine health care practice. Previous research has identified numerous provider-level barriers affecting implementation, but these have been less extensively investigated in the wider population. We sought to: (1) investigate patients' beliefs and attitudes to being asked about alcohol consumption in health care; and (2) identify the characteristics of those who are supportive of addressing alcohol consumption in health care.

    METHODS: Cross-sectional household interviews conducted as part of the national Alcohol Toolkit Study in England between March and April 2017. Data were collected on age, gender, social grade, drinking category, and beliefs and attitudes to being asked about alcohol in routine health care. Unadjusted and multivariate-adjusted logistic regression models were performed to investigate associations between socio-demographic characteristics and drinking category with being "pro-routine" (i.e. 'agree completely' that alcohol consumption should be routinely addressed in health care) or "pro-personal" (i.e. 'agree completely' that alcohol is a personal matter and not something health care providers should ask about).

    RESULTS: Data were collected on 3499 participants, of whom 50% were "pro-routine" and 10% were "pro-personal". Those in social grade C1, C2, D and E were significantly less likely than those in AB of being "pro-routine". Women were less likely than men to be "pro-personal", and those aged 35-44 or 65 years plus more likely to be "pro-personal" compared with participants aged 16-24. Respondents aged 65 plus were twice as likely as those aged 16-24 to agree completely that alcohol consumption is a personal matter and not something health care providers should ask about (OR 2.00, 95% CI 1.34-2.99).

    CONCLUSIONS: Most adults in England agree that health care providers should routinely ask about patients' alcohol consumption. However, older adults and those in lower socio-economic groups are less supportive. Drinking status appears to have limited impact on whether people believe that alcohol is a personal matter and not something health care providers should ask about.

    REGISTRATION: Open Science Framework ( https://osf.io/xn2st/ ).

  • 6.
    Schildmeijer, Kristina
    et al.
    Hälso- och vårdvetenskapliga institutionen, Linnéuniversitetet, Kalmar.
    Skagerström, Janna
    Region Östergötland, Regional Board, Research and Development Unit.
    Ericsson, Carin
    Region Östergötland, Heart and Medicine Center.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Så ville patienter förbättra vårdmötet för att få säkrare vård2018In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115Article in journal (Refereed)
  • 7.
    Skagerström, Janna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
    Ericsson, Carin
    Region Östergötland, Heart and Medicine Center.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Schildmeijer, Kristina
    Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden, .
    Patient involvement for improved patient safety: A qualitative study of nurses’ perceptions and experiences2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 4, p. 230-239Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore nurses’ perceptions and experiences of patient involvement relevant to patient safety.

    Design

    Qualitative design using individual semi-structured interviews.

    Methods

    Interviews with registered nurses (= 11) and nurse assistants (= 8) were conducted in 2015–2016. Nurses were recruited from five different healthcare units in Sweden. The material was analysed using conventional content analysis.

    Results

    The analysis resulted in four categories: healthcare professionals’ ways of influencing patient involvement for safer care; patients’ ways of influencing patient involvement for safer care; barriers to patient involvement for safer care; and relevance of patient involvement for safer care. The nurses expressed that patient involvement is a shared responsibility. They also emphasized that healthcare provider has a responsibility to create opportunities for the patient to participate. According to the nurses, involvement can be hindered by factors related to the patient, the healthcare provider and the healthcare system. However, respondents expressed that patient involvement can lead to safer care and benefits for individual patients.

  • 8.
    Utjes, Deborah
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Lyth, Johan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regional Board, Research and Development Unit.
    Lapins, Jan
    Karolinska University Hospital, Sweden.
    Eriksson, Hanna
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Reduced disease-specific survival following a diagnosis of multiple primary cutaneous malignant melanomas-a nationwide, population-based study2017In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 141, no 11, p. 2243-2252Article in journal (Refereed)
    Abstract [en]

    Outcome data comparing patients with multiple primary invasive cutaneous malignant melanomas (MPMs) to single primary invasive cutaneous malignant melanomas (SPMs) show conflicting results. We have analyzed differences in disease-specific survival between these patients in a nationwide population-based setting. From the Swedish Melanoma Register, 27,235 patients were identified with a first invasive cutaneous malignant melanoma (CMM) between 1990 and 2007, followed-up through 2013. Of these, 700 patients developed MPMs. Cox proportional hazard regression was used for adjusted cause-specific hazard ratios (HRs). An interval of amp;lt;= 5 years between CMM diagnoses was significantly correlated to a decreased CMM-specific survival in Stage I-II MPM-vs. SPM-patients (HR 1.32; 95% CI 1.04-1.67; p=0.02). MPM-patients with longer time interval between diagnoses experienced similar risk of CMM-death as SPM-patients. The risk of CMM-death increased by almost 50% above the expected outcome according to stage of the index CMM by the diagnosis of a second CMM (HR 1.48; 95% CI 1.19-1.85; p amp;lt; 0.001). MPM vs. SPM-patients had a worse outcome (HR 1.38; 95% CI 1.05-1.83; p=0.001). This emphasizes the importance of prevention efforts in SPM-patients to decrease the risk of subsequent CMMs and has implications for more vigilant follow-up in MPM-patients.

1 - 8 of 8
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