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  • 1.
    Axelsson, Åsa B.
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Zettergren, Margaretha
    Institute of Nursing, Faculty of Health Caring Sciences, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Axelsson, Christer
    Institute of Nursing, Faculty of Health Caring Sciences, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Good and bad experiences of family presence during acute care and resuscitation. What makes the difference?2005Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, nr 2, s. 161-169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Family presence (FP) in the resuscitation room is still controversial, and its appropriateness for patient and family has been discussed. We examined both positive and negative experiences in order to establish the reasons for the difference.

    Aim:

    The aim of the present literature review was to describe patients', relatives' and staff's opinions and experiences of FP during invasive procedures and resuscitation.

    Method:

    12 original papers, published between January 1995 and February 2003, were reviewed. Most patients and relatives agreed that they had positive experiences of FP. They described how FP enhanced the feeling of support and connectedness within the family. Family members believed that FP helped them in their grieving process. Most staff members without FP experience felt that FP would increase the risk of psychological distress for the family. Those who had participated in an FP programme believed that FP was not only beneficial for the family but also for staff.

    Conclusion:

    Family presence during resuscitation and acute care has the potential to enhance the care of the patient and to benefit everyone involved. However, implementation of FP during resuscitation must take account of potential problems.

  • 2.
    Baigi, Amir
    et al.
    R and D Unit, Primary Health Care, Halland County Council, Falkenberg, Sweden.
    Bering, Charlotte
    Department of Medicine, Visby Hospital, Visby, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Almerud, Sofia
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Non-attendees' attitudes to the design of a cardiac rehabilitation programme focused on information of risk factors and professional involvement2009Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, nr 1, s. 62-66Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Enhancing the accuracy of the content of cardiac rehabilitation programmes (CRPs) and providing the mediators preferred by patients can increase attendance rates in line with secondary prevention goals. The aim of this study was therefore to explore non-attendees' attitudes to the design of a CRP focused on information of risk factors and professional involvement. Method: Consecutive patients with coronary heart disease (n = 100) who declined to participate in a CRP answered a questionnaire focusing on patients' attitudes to risk factors and cardiac rehabilitation. Results: Non-attendees considered that information of hypertension and information of sedentary lifestyle constituted the most important content of a CRP. Physicians, nurses and social workers were considered the most suitable professional categories. Females preferred nurses when discussing smoking issues while males preferred physicians. More males compared to females preferred occupational therapists for dealing with stress, physicians for depression and social workers for social isolation. Conclusions: Non-attendees' attitudes are similar to those of attendees and quite traditional in that they favour physician or nurse-led activities. There is a difference in attitude between male and female.

  • 3.
    Bolse, Kärstin
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Flemme, Inger
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ivarsson, Anita
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Jinhage, Britt-Marie
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Carroll, Diane
    Massachusetts General Hospital, Boston.
    Edvardsson, Nils
    Sahlgrenska University Hospital, Gothenburg.
    Hamilton, Glenys A.
    Massachusetts General Hospital, Boston.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Life situation related to the ICD implantation: self-reported uncertainty and satisfaction in Swedish and US samples2002Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, nr 4, s. 243-251Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to describe changes in the life situation related to the ICD implantation of Swedish and US samples with regard to uncertainty and satisfaction. The life situation was measured by reference to the uncertainty caused by the condition and satisfaction with the life situation. Inferential statistics were used to analyse changes within and between the Swedish and US samples. Uncertainty showed a statistically significant difference between the Swedish and US samples before as well as after the ICD implantation. A higher level of uncertainty was indicated for the US sample prior to the ICD implantation and for the Swedish sample following the implantation. In the Swedish sample, satisfaction with life showed a statistically significant difference within the socio-economic domain, indicating a higher degree of satisfaction 3 months after implantation. Satisfaction within the domains of health and functioning, socio-economics and psychological-spiritual showed a statistically significant difference between the Swedish and US samples both before and after ICD implantation, indicating a higher degree of satisfaction in the US sample. The previous study shows that the ICD-patient's life situation is changed after the implantation and that it is necessary to provide the patient with information and education based on their own preconditions. The fact that US sample was investigated at a later stage after ICD implantation than the Swedish sample may have influenced the results of the study.

  • 4.
    Bolse, Kärstin
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Thylen, Ingela
    Department of Medical and Health Sciences, Linköping University, Linköping Sweden.
    Strömberg, Anna
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Healthcare professionals' experiences of delivering care to patients with an implantable cardioverter defibrillator2012Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, nr 4, s. 346-352Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: An implantable cardioverter defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After an ICD implantation, the entire life situation of the patient their next of kin can be affected psychologically and socially. Healthcare professionals play a vital role in providing educational counselling, support and technical follow-up of the device, but little is known about their experiences.

    AIM: This paper describes the experiences of Swedish healthcare professionals in delivering care to patients with an ICD.

    METHODS: A qualitative, descriptive design based on a phenomenographic approach was used. Data were collected through interviews with 12 specialist ICD nurses and 12 physicians, representing 16 ICD implantation centres in Sweden.

    FINDINGS: Two descriptive categories comprising seven subcategories emerged. Striving to provide competent care comprised the subcategories: providing access to care, improving one's qualifications and individualising care. Striving to infuse confirmation incorporated the subcategories: promoting independence, providing existential support, mediating security and comprising needs of next of kin.

    CONCLUSIONS: The healthcare professionals described how they wished to develop the care further. Both nurses and physicians were consistent in wanting to provide competent and confirming care based on a holistic perspective with high accessibility to the ICD team. The findings describe how healthcare professionals strive to provide professional clinical care in order to give the patients tools to handle their life situation. They suggested that more structured education and counselling according to guidelines should be provided. They also highlighted the need to increase their own competence by improving their knowledge and skills.

  • 5.
    Cider, Asa
    et al.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Mårtensson, Jan
    Jönköping University, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Strömberg, Anna
    Linköping University, Linköping, Sweden.
    Pihl, Emma
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Response to 'Exercise programmes and quality of life in the elderly important facts'2012Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, nr 1, s. 128-128Artikkel i tidsskrift (Fagfellevurdert)
  • 6.
    Falk, Solvig
    et al.
    Malmö University, Department of Health and Society.
    Wahn, Anna-Karin
    Malmö University, Department of Health and Society.
    Lidell, Evy
    Malmö University, Department of Health and Society.
    Keeping the maintenance of daily life in spite of Chronic Heart Failure: A qualitative study2007Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, nr 3, s. 192-199Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Patients with CHF (Chronic Heart Failure) is an increasing group in the society. They often experience increasing powerlessness and depression in daily life as well as difficulties adhering to other physical symptoms. Many patients have difficulties to deal with daily demands.

    Aims:

    To describe how persons, living with CHF, perceived the maintenance of their daily life.

    Methods:

    This study was following a phenomenographic method in order to describe variations of perceptions. Data was collected through taped interviews, taken from 17 patients. The sample was selected from patients attending a specialist Chronic Heart Failure day care unit.

    Results:

    Five main categories were identified from 345 statements describing variations in how patients with CHF kept maintenance in their daily life. The categories include: dealing with the realities of life, dealing with thoughts about life's infinity, taking responsibility, dealing with the surrounding world and keeping up with values of life.

    Conclusion:

    The illness symptoms clearly affected daily routines but participants showed remarkable resolve and showed that values in life could be maintained albeit with a few adjustments. No patient expressed a desire to give up. Understanding patients' perceptions the specialist nurse can transfer these knowledge to other patients in similar situations.

  • 7.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    The role of the nurse in cardiac rehabilitation programmes2002Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, nr 1, s. 15-18Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cardiac rehabilitation programmes are intended to enhance the effect of acute treatment actions and to prevent risk factors, thus leading to an improvement in the patient's well being and recovery. Accordingly, all cardiac rehabilitation activities do not take place at the same time, which is the reason why the nurse's role changes in character over time. The aim of this paper is, therefore, to highlight the role of the nurse in cardiac rehabilitation programmes. The nurse's multiple roles in cardiac rehabilitation have a 'spider in the web-like' character and, depending on the phase of the patient's recovery, he/she acts as a container, a counsellor, a coach and an educator. To implement a successful cardiac rehabilitation, the nurse needs to have improved evaluation tools in clinical practice as well as to be self-critical and serve as a good role model. Finally, the cardiac rehabilitation nurse has to have a four-fold comprehensive perspective of the cardiac rehabilitation concept; an impact perspective, a timing perspective, a lifespan perspective, and a personal perspective.

  • 8.
    Fridlund, Bengt
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Hildebrandt, Linda
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Hildingh, Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Status and trends in Swedish dissertations in the area of cardiovascular nursing2007Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, nr 1, s. 72-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Europe, cardiovascular nursing (CVN) is a young branch of nursing science. The explicit knowledge contained in CVN dissertations has, so far, not been studied in Europe, and this is especially true in the case of Sweden. Accordingly, the aim of this literature study was to describe the status of and compare trends in Swedish dissertations in the area of CVN in terms of organisational structure, approach, research strategy, social orientation and socio-demographic aspects. The literature search resulted in 29 dissertations and a 26-item questionnaire that illuminated the problem areas. Most dissertations were produced in the universities of Göteborg, Halmstad and Linköping; a minority had a nurse as main supervisor; rehabilitation was the most common CVN approach; very few of the dissertations had an experimental design; and the majority was hospital-based. The main trends were (A) an increase in dissertations that were written during the last 6 years, (B) an increased number of nurses as main supervisors as well as publication in nursing journals, (C) an increase in hospital care settings while a decrease in community settings, and finally, (D) an increased number of dissertations addressing the issues of tertiary prevention as well as focusing on patients and next-of-kin as target groups. An important implication is to stimulate nurse-led interventions at all preventative levels in order to maintain or improve the cardiac health of both healthy and sick individuals, but also in order to visualize CVN and distinguish it from cardiology.

  • 9.
    Fridlund, Bengt
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Mårtensson, Jan
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Cardiovascular nursing in RN and higher education in Swedish universities: A national survey2004Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, nr 3, s. 255-259Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cardiovascular nursing (CVN) is rapidly developing and has accumulated a large amount of evidence to support interventions aimed at reducing suffering and hastening recovery. However, knowledge of the extent and content of CVN training in Sweden is lacking. The aim of this study was therefore to identify and describe CVN in the Swedish RN education as well as in higher education, with reference to type of course and credits, content, area and target group. A nationwide survey was carried out in Sweden at all university level nursing schools (N=26) by means of a 25-item questionnaire, which was analysed by descriptive statistics. The findings show that 69% and 23% of the schools awarded 0–1 credits [0–1.5 European Credit Transfer and Accumulation System (ECTS)] and 2–3 credits (3–4.5 ECTS), respectively for cardiology/CVN in the RN education. Target areas outside the hospital setting reported by 23% and 19% of nursing schools were primary health care and community care, respectively. Special target groups in addition to the general public were the elderly (42%) and women (58%). Advanced courses in CVN comprising 10–40 credits (15–60 ECTS) were held by 27% of nursing schools, but no school had a specialist or Master level education. Important educational implications from the study of the RN education are the establishment of a minimum credit figure and to reach out into primary health care.

  • 10.
    Hildingh, Cathrine
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden.
    A 3-year follow-up of participation in peer support groups after a cardiac event2004Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, nr 4, s. 315-320Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Secondary prevention is an important component of a structured rehabilitation programme following a cardiac event. Comprehensive programmes have been developed in many European countries, the vast majority of which are hospital based. In Sweden, all patients with cardiac disease are also given the opportunity to participate in secondary prevention activities arranged by the National Association for Heart and Lung Patients [The Heart & Lung School (HL)]. The aim of this 3-year longitudinal study was to compare persons who attended the HL after a cardiac event and those who declined participation, with regard to health aspects, life situation, social network and support, clinical data, rehospitalisation and mortality. Totally 220 patients were included in the study. The patients were asked to fill in a questionnaire on four occasions, in addition to visiting a health care center for physical examination. After 3 years, 160 persons were still participating, 35 of whom attended the HL. The results show that persons who participated in the HL exercised more regularly, smoked less and had a denser network as well as more social support from nonfamily members than the comparison groups. This study contributes to increased knowledge among healthcare professionals, politicians and decision makers about peer support groups as a support strategy after a cardiac event.

  • 11.
    Johansson, Ingela
    et al.
    Department of Medical and Health Sciences, Nursing Science, Linköping University, Department of Cardiology, Linköping University Hospital, Linköping, Sweden .
    Fluur, Christina
    Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
    Strömberg, Anna
    Department of Medical and Health Sciences, Nursing Science, Linköping University, Linköping, Sweden.
    Bolse, Kärstin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Patients' experiences of the ICD from a life perspective; with focus on end-of-life issues2012Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, nr Suppl. 1, s. S17-S17Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The implantable cardioverter defibrillator (ICD) deliver life saving therapy in patients who have survived sudden cardiac death (SCD) or are at such risk due to underlying heart condition. In spite of the life saving capacity of the ICD, eventually underlying heart disease, or a non-cardiac disease, will end the life of the patient. Around 30 % of all patients will experience one or multiple ICD shocks in the final weeks of their lives, adding to stress and anxiety in patients and their family.

    Aim: To describe ICD patients´ conceptions on end-of-life (EOL) issues, with special reference to deactivation or non replacement of the ICD.

    Material and Method: Data was collected during 2011 at five Swedish hospitals. The population consisted of 37 ICD recipients with the exclusion of those nearing EOL  or with terminal illness. The method was a manifest content analysis approach, based on interviews.

    Results: The ICD recipients described how they lived with an uncertain illness trajectory, but had not reflected on possible course of events in the future. Lack of deeper understanding of the true lifesaving capacity during the illness trajectory was revealed. Most participants had an overall positive view and focused on the ICD as a way to avoid SCD and had not considered death by other causes. Discussions with the healthcare providers focusing on EOL issues had very seldom taken place. The participants had not reflected on EOL issues earlier; they considered the ICD as something that always should be there as a lifesaver. They wanted to postpone the discussion and decision about deactivation until the very end. When patients were asked to anticipate their preferences if they should be terminally ill, the majority stated that they would not choose to deactivate the ICD, even if they received multiple shocks. This was true for both patients with heart failure who received the ICD for primary prevention, as well as for those who already had survived a SCD.

    Implication: Despite comprehensive guidelines relating to the issue of ICD and deactivation in EOL, complexities with implementation of the guidelines continue to be raised in clinical practice. Heart Rhythm Society recommend healthcare providers to stepwise discuss the question of deactivation of the ICD during the illness trajectory, the ultimate motivation being the risk for multiple shocks preventing a “peaceful” death. However, our results showed that this is not always the patient’s desire, and in clinical practice these discussions can be both challenging and raise an ethical dilemma. The postponement or total avoidance of the EOL discussion may ultimately lead to problems when death is imminent.

    Conclusion: Deactivation or not replacing the ICD in terminal illness is seldom brought up for discussion with the healthcare providers. ICD recipients lack deeper understanding of the true life saving capacity of the device during their illness trajectory and tend not to think about EOL matters. Some patients choose not to make a decision at all; others want to prolong life at any price and others, still, face finality and reflect on existential issues. Many ICD recipients reach their final stage of disease unaware of the fact that they have a choice.

     

  • 12.
    Karlsson, Ann-Kristin
    et al.
    Department of Internal Medicine, Hospital Varberg, Sweden, Sweden.
    Johansson, Mats
    Department of Internal Medicine, Hospital Varberg, Sweden, Sweden.
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fragility - the price of renewed life: Patients experiences of open heart surgery2005Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, nr 4, s. 290-297Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Open heart surgery often implies a threat to life and is associated with fear and anxiety. It is also a strong encroachment on body and integrity and adjusting life afterwards could be difficult. Despite improvements in treatment the patients' reactions appear to be unchanged. Introducing a lifeworld perspective would supply a different kind of knowledge based upon the patients' own experiences coloured by their linguistic usage and bodily expressions.

    Aim:

    The aim of this study was to describe patients' experiences of open heart surgery in a lifeworld perspective.

    Method:

    Fourteen patients treated with coronary artery bypass surgery and/or heart valve operation were in-depth interviewed in 2003. The phenomenological method was used for the interviews as well as for the analysis. The informants reflected on their experiences of the illness, meetings with health care, family relations and wishes for the future.

    Findings:

    The essence of the phenomenon was fragility. Fragility was understood through the following categories: distance, uncertainty, vulnerability, reliance and gratitude.

    Conclusions:

    Patients want to be treated as unique individuals. They ask for more dialogues with the staff. Awareness of their supposed lifelong fragility implies that health care staff acquires an open and holistic approach.

  • 13.
    Karlsson, Ann-Kristin
    et al.
    Department of Public Health and Community Medicine/Primary Health Care, Göteborg University, Gothenburg, Sweden.
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Johansson, Mats
    Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Depressed mood over time after open heart surgery impacts patient well-being: A combined study2008Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, nr 4, s. 277-283Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Depression is a common cause of decreased well-being after open heart surgery (OHS) and a risk factor for new cardiac events. Little is known about the long-term prevalence of depressive symptoms after OHS or their effect on well-being. The aim of this study was to explore the presence of depressed mood in patients during the recovery phase after open heart surgery as well as depressed mood and well-being 3 years later.

    Method: Eighty consecutively included patients completed a questionnaire about depressed mood at 5 weeks, 5 months and 3 years after OHS. A telephone interview took place after receipt of the third questionnaire to explore their well-being. Quantitative and qualitative data were analysed separately and thereafter together.

    Result: Depressed mood occurred in 52% of the patients during recovery or 3 years after OHS. The qualitative content analysis produced the theme of transition, which was based on three categories.

    Conclusion: Depressed mood was reported by the majority of patients during recovery after OHS and had a long-term effect on their well-being. OHS constituted a transition for all patients, but those with depressed mood had difficulty finishing the transition process and reorientating life.

  • 14.
    Kristofferzon, Marja-Leena
    et al.
    Department of Caring Science and Sociology, University of Gävle.
    Johansson, Ingela
    Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Brännström, Margareta
    Department of Nursing, Umeå University, Umeå, Sweden.
    Arenhall, Eva
    Department of Cardiology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Baigi, Amir
    General Practice and Public Health, Halland County Council, Falkenberg, Sweden.
    Brunt, David
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Fridlund, Bengt
    Shool of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Nilsson, Ulrica
    Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Persson, Sylvi
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Rask, Mikael
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Wieslander, Inger
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Lund University Hospital and Lund University, Lund, Sweden.
    Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: a pilot study2010Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, nr 3, s. 168-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required.

    AIMS: The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

    METHODS: A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

    RESULTS: Two separate factor analyses each revealed a two-factor structure on both occasions: "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test-retest values for all but one question exceeded 0.70.

    CONCLUSIONS: The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

  • 15.
    Lidell, Evy
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Family support-a burden to patient and caregiver2002Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, nr 2, s. 149-152Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this paper was to describe family support in terms of the sources as well as the consequences of burden for caregivers, patients and family interaction. Caregivers' sources of burden were related to difficulties in coping with patients' emotional responses, physical complaints and altered life style behaviour as well as future oriented factors. Consequences in terms of caregivers' perceptions of emotional distress and personal losses are elucidated. In terms of family support, when focusing on sources of burden for patients' concerning family support, emotional support is emphasised and related to overprotection. Two different definitions of the overprotection concept are used in order to elucidate different consequences of the phenomenon. Sources and consequences of burden are also related to family interaction. The family is regarded as a system in which a cardiac disease may cause an imbalance. Poor marital quality or poor family functioning is described as a hindrance to a new balance. To summarise, the reviewed literature unanimously shows that the interactive support between family members when dealing with cardiac disease constitutes a considerable emotional burden. Therefore the support for emotional communication within the family should take priority. The knowledge described can provide a foundation for the development of family support in the cardiac area.

  • 16.
    Lidell, Evy
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Höfer, Stefan
    Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria.
    Saner, Hugo
    Cardiovascular Prevention, Rehabilitation and Sports Medicine, University Hospitals Inselspital, Bern, Switzerland.
    Perk, Joep
    Institute of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Oldridge, Neil
    College of Health Sciences, University of Wisconsin-Milwaukee, School of Medicine and Public Health, University of Wisconsin-Madison, and Aurora Cardiovascular Services, Aurora Medical Group, Milwaukee, Wisconsin, USA.
    Health-related quality of life in European women following myocardial infarction: A cross-sectional study2015Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, nr 4, s. 326-333Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Coronary heart disease is a major contributor to women’s health problems.

    Design: Self-perceived social support, well-being and health-related quality of life (HRQL) were documented in the cross-sectional HeartQoL survey of European women one and six months after a myocardial infarction.

    Methods: European women were recruited in 18 European countries and grouped into four geographical regions (Southern Europe, Northern Europe, Western Europe and Eastern Europe). Continuous socio-demographic variables and categorical variables were compared by age and region with ANOVA and χ2, respectively; multiple regression models were used to identify predictors of social support, well-being and HRQL.

    Results: Women living in the Eastern European region rated social support, well-being and HRQL significantly lower than women in the other regions. Older women had lower physical HRQL scores than younger women. Eastern European women rated social support, well-being and HRQL significantly lower than women in the other regions. Prediction of the dependent variables (social support, well-being and HRQL) by socio-demographic factors varied by total group, in the older age group, and by region; body mass index and managerial responsibility were the most consistent significant predictors. © The European Society of Cardiology 2014.

  • 17.
    Malm, D.
    et al.
    Department of Cardiology, County Hospital Ryhov, Jönköping.
    Svensson, E.
    Department of Statistics, Örebro University.
    Karlsson, J. E.
    Department of Cardiology, County Hospital Ryhov, Jönköping.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Health-related quality of life in pacemaker patients: a single and multidimensional self-rated health comparison study2003Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 2, nr 4, s. 291-302Artikkel i tidsskrift (Fagfellevurdert)
  • 18.
    Nilsson, Ulrica G
    et al.
    Centre of Health Care Sciences Orebro University Hospital, Örebro and School of Health and Medical Sciences, Örebro University, Sweden.
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Skåne University Hospital and Lund University, Sweden.
    Alm-Roijer, Carin
    The Faculty of Health and Society, Malmö University, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The desire for involvement in healthcare, anxiety and coping in patients and their partners after a myocardial infarction2013Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, nr 5, s. 461-467Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: There is a lack of data about the information preferences of patients and their partners after a myocardial infarction. Aim: This paper explores anxiety, depression, coping and the desire to be actively involved in care in relation to age, gender and education level in myocardial infarction patients and partners. Methods: One hundred and twenty-eight patients and their partners answered the Swedish version of the Krantz Health Opinion Survey, the Hospital Anxiety and Depression Scale, and the Mastery Scale one year after the patient’s myocardial infarction. Results: More active roles in decision-making during care were desired by females, younger patients and partners, and patients and partners with higher education levels. Female partners reported more anxiety than male partners, and female patients reported more depression than male patients. No differences between groups were detected in coping; overall coping was rated high. Conclusions: Secondary prevention should consist of person-centred support to both the patients and their partners, since factors such as age, gender and education level can influence information preferences during patient care. © The European Society of Cardiology 2012.

  • 19.
    Odell, Annika
    et al.
    Department of Cardiology, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden.
    Grip, Lars
    Department of Cardiology, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden.
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Restenosis after percutaneous coronary intervention (PCI): Experiences from the patients' perspective2006Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, nr 2, s. 150-157Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    PCI has been established as an effective treatment for coronary artery disease. Restenosis is a recurrence of a significant narrowing in the treated vessel. Although a part of the investigative and research funding is invested in the prevention and resolving the restenosis problem, little is known about its clinical significance apart from further revascularisation.

    Aim:

    The intention of this study was to clarify the patients perspective of what it means to suffer from documented restenosis after PCI.

    Method:

    Patients interviewed had undergone PCI. Data collection and analysis was done simultaneously according to Grounded Theory methodology and continued until new interviews provided no additional information.

    Results:

    “Living with uncertainty” was identified as the core category, and the central focus in the data explains what it means to patients' to suffer from restenosis. The core category was further illuminated in four additional categories labelled “fighting for access to care”, “moderating health threats”, “trying to understand” and “controlling relatives anxiety”.

    Conclusion:

    Patients' perceptions of illness and illness-related events, such as symptoms, diagnosis, treatment and prognosis, are considerably affected by uncertainty. This infiltrates their struggle to acquire the care needed, their endeavour to comprehend and moderate health threats, and caring for their family.

  • 20.
    Pihl, Emma
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Cider, Åsa
    Physiotherapy Department, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Strömberg, Anna
    Department of Medicine and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Mårtensson, Jan
    Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Exercise in elderly patients with chronic heart failure in primary care: Effects on physical capacity and health-related quality of life2011Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, nr 3, s. 150-158Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: 

    Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). 

    AIM: 

    The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.

    METHODS: 

    An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12 months.

    RESULTS: 

    Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. 

    CONCLUSION: 

    This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population. ©Sage Publications

  • 21.
    Thylen, Ingela
    et al.
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Wenemark, Marika
    Division of Community Medicine, Linköping University, Linköping, Sweden.
    Fluur, Christina
    Department of Cardiology, County Council of Östergötland, Linköping, Sweden.
    Strömberg, Anna
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Bolse, Kärstin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Årestedt, Kristofer
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Development and evaluation of the EOL-ICDQ as a measure of experiences, attitudes and knowledge in end-of-life in patients living with an implantable cardioverter defibrillator2013Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 2, s. 142-151Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Due to extended indications and resynchronization therapy, many implantable cardioverter defibrillator (ICD) recipients will experience progressive co-morbid conditions and will be more likely to die of causes other than cardiac death. It is therefore important to elucidate the ICD patients' preferences when nearing end-of-life. Instead of avoiding the subject of end-of-life, a validated questionnaire may be helpful to explore patients' experiences and attitudes about end-of-life concerns and to assess knowledge of the function of the ICD in end-of-life. Validated instruments assessing patients' perspective concerning end-of-life issues are scarce.

    Aim: The purpose of this study was to develop and evaluate respondent satisfaction and measurement properties of the 'Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients' Questionnaire' (EOL-ICDQ).

    Methods: The instrument was tested for validity, respondent satisfaction, and for homogeneity and stability in the Swedish language. An English version of the EOL-ICDQ was validated, but has not yet been pilot tested.

    Results: The final instrument contained three domains, which were clustered into 39 items measuring: experiences (10 items), attitudes (18 items), and knowledge (11 items) of end-of-life concerns in ICD patients. In addition, the questionnaire also contained items on socio-demographic background (six items) and ICD-specific background (eight items). The validity and reliability properties were considered sufficient.

    Conclusions: The EOL-ICDQ has the potential to be used in clinical practice and future research. Further studies are needed using this instrument in an Anglo-Saxon context with a sample of English-speaking ICD recipients. © The European Society of Cardiology 2013.

  • 22.
    Wickholm, Maritha
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Women's health after a first myocardial infarction: a comprehensive perspective on recovery over a 4-year period2003Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 2, nr 1, s. 19-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Little attention has so far been focused on follow ups of women's long-term recovery after a myocardial infarction (MI), especially from a comprehensive perspective.

    AIM:

    The aim of this study was to prospectively determine women's self-rated health after a first MI from a comprehensive perspective on recovery over a 4-year period.

    METHODS:

    Consecutively chosen women (n=240) who had suffered a first MI were asked to complete a self-rated questionnaire regarding health (including not only biophysical, but also behavioral, emotional, social and working conditions) before being discharged from hospital as well as 1 and 4 years later. The results were analyzed by descriptive and inferential statistics.

    RESULTS:

    Health improvements, especially during the first year, could be observed in the women's behavioral condition regarding their attitude to diet consciousness, exercise, simultaneous capability and smoking behavior as well as in the emotional condition regarding their stressful life events, depressed mood and loss of control. In the social condition, the women considered that the healthcare professionals had improved their support over time as well as treating the women's complaints more seriously. Regarding the working condition, the women felt that they were being controlled at work, especially during the first year after the MI.

    CONCLUSIONS:

    Based on a comprehensive perspective on women's recovery after a first MI, a favorable development of the women's health was observed in the behavioral and emotional conditions while deterioration in the social and working conditions was observed over time. Thus, further efforts are needed in the two latter conditions by means of further studies in combination with greater support from healthcare professionals.

  • 23.
    Wieslander, Inger
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Baigi, Amir
    Göteborg University.
    Turesson, Christina
    Central Hospital Halmstad.
    Fridlund, Bengt
    Växjö University.
    Women's social support and social network after their first myocardial infarction: a 4-year follow-up with focus on cardiac rehabilitation2005Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, nr 4, s. 278-285Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Knowledge about women's recovery following a myocardial infarction (MI) with focus on how their social support and network change over time as a result of participation in a cardiac rehabilitation programme (CRP) is not well established. Aim: The aim of this study was to describe and compare social support and network changes over a 4-year period in women with a first MI, based on socio-demographic and situational data. Method: A longitudinal, comparative study with a non-randomised design including pre- and post-tests (1 and 4 years after MI) was carried out in 18 hospitals in Sweden. Consecutively chosen women (N = 240) answered a questionnaire on the subject of social support and network. Results: The women who participated in a CRP were mainly dependent upon professional support during the first year after MI (p < 0.0001), while those who declined to participate in a CRP needed professional support throughout the whole 4-year period (p = 0.001). Participation in CRP was dependent on the women's age, those under 60 years (p = 0.050). Conclusion: There is a need to develop CRPs that are specifically designed for women based ontheir age and family relationships. Nurses' training programmes should place greater emphasis on cardiac rehabilitation from the perspective of women with focus on professional support. © 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  • 24.
    Winberg, Birgitta
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Self-reported behavioural and medical changes in women after their first myocardial infarction: a 4-year comparison between participation and non-participation in a cardiac rehabilitation programme2002Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, nr 2, s. 101-107Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Women's recovery following a myocardial infarction (MI) has not yet been studied in a thorough manner.

    AIM: Therefore, the aim of this study was to compare women's self-reported behavioural and medical changes, both in those women who voluntarily participated and those women who did not participate in a cardiac rehabilitation programme (CRP).

    METHODS: A non-randomised comparative study design, including pre- (baseline) and post-tests (1 and 4 years after), was implemented in 18 hospitals in Sweden. Consecutively chosen women suffering their first MI (N=240) completed a questionnaire regarding behavioural and medical factors.

    RESULTS: At baseline, significant differences existed between the groups regarding time stress (increased in the CRP group) and hypertension (increased in the non-CRP group). The behavioural factors improved, irrespective of CRP participation or not, with the exception of time stress, which was consistently high in the CRP group both 1- and 4-years after the MI. Regarding the medical factors, the significant difference in hypertension disappeared after 1 year. Four years after the MI, the CRP group reported significantly less rehospitalisation and more interventive cardiology compared to the non-CRP group.

    CONCLUSION: The women benefited from CRP participation in relation to medical factors, but not at all in relation to behavioural factors. Accordingly, randomised clinical trials are necessary to perform in order to determine the effects of a long-term individual-based supportive CRP, performed by well-educated healthcare professionals.

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