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  • 1.
    Bondesson, Susanne M.
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Jakobsson, Ulf
    Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University.
    Edvinsson, Lars
    Department of Emergency Medicine, Clinical Sciences Lund, Lund University.
    Hallberg, Ingalill Rahm
    Department of Health Sciences Lund, Lund University.
    Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris2013In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 19, no 1, p. 139-147Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives  The aim of this study was to compare acute hospital utilization and costs for patients with refractory angina pectoris undergoing spinal cord stimulation (SCS) versus enhanced external counterpulsation (EECP). Method  Seventy-three persons were included in this register study. The acute hospital utilization and costs for SCS and EECP were followed over a period from 12 months before treatment to 24 months after treatment using Patient Administrative Support in Skåne for publicly organized care. Results  SCS was significantly more expensive than EECP (P < 0.001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were no significant differences between the groups for hospitalization days or admissions, including costs, at the different follow-ups. Conclusions  Cost-effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre-existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients.

  • 2.
    Holmberg, Leif
    Kristianstad University, School of Health and Society, Avdelningen för Ekonomi. Kristianstad University, Forskningsmiljön Organisatorisk Samverkan.
    Problem perception, technology and effectiveness in medical practice2013In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 19, no 5, p. 868-874Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives  Evidence-based medicine and clinical guidelines have been found difficult to implement in the clinical practice – mainly because lack of evidence quality and guidelines that, generally, do not account for variations in the medical cases. Variation in the medical cases enhances task uncertainty and uncertainty seems to be further enhanced through clinical guidelines. In this article, concept development is attempted, where task uncertainty is classified into a few medical problem-solving processes according to differences in medical technology and in the (initial) perception of the medical problem. Furthermore is argued the need for using different strategies in evaluating performance quality in medical health care depending on the variation in the degree of task uncertainty.

    Method  Qualitative data about medical activities related to certain diseases are used to exemplify problem-solving processes representing different types of task uncertainty.

    Results  It is argued that the main characteristics of medical problem-solving processes vary according to differences in medical technology and perception of perceived medical problem. Four main medical problem-solving processes are defined and demonstrated through empirical examples.

    Conclusion  What may be regarded as rational behaviour is different for each type of problem-solving processes. Consequently, the processes need different organizational settings and need to be evaluated according to different criteria. Furthermore, from a practical point of view, development and education related to problem perception would seem as important as development of medical technology.

  • 3.
    Jakobsson, Ulf
    et al.
    Department of Health Sciences, Lund University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Lindskov, Susanne
    Kristianstad University, Forskningsplattformen Hälsa i samverkan. Department of Geriatrics and Neurology, Central Hospital, Kristianstad.
    Hagell, Peter
    Department of Health Sciences, Lund University.
    Construct validity of the SF-12 in three different samples2012In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 18, no 3, p. 560-566Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives  Studies have challenged the validity and underlying measurement model of the physical and mental component summary scores of the 36-item Short-Form Health Survey in, for example the elderly and people with neurological disorders. However, it is unclear to what extent these observations translate to physical and mental component summary scores derived from the 12-item short form (SF-12) of the 36-item Short-Form Health Survey. This study evaluated the construct validity of the SF-12 in elderly people and people with Parkinson's disease (PD) and stroke.

    Methods  SF-12 data from a general elderly (aged 75+) population (n = 4278), people with PD (n = 159) and stroke survivors (n = 89) were analysed regarding data quality, reliability (coefficient alpha) and internal construct validity. The latter was assessed through item-total correlations, exploratory and confirmatory factor analyses.

    Results  Completeness of data was high (93–98.8%) and reliability was acceptable (0.78–0.85). Item-total correlations argued against the suggested items-to-summary scores structure in all three samples. Exploratory factor analyses failed to support a two-dimensional item structure among elderly and stroke survivors, and cross-loadings of items were seen in all three samples. Confirmatory factor analyses showed lack of fit between empirical data and the proposed items-to-summary measures structure in all samples.

    Conclusions  These observations challenge the validity and interpretability of SF-12 scores among the elderly, people with PD and stroke survivors. The standard orthogonally weighted SF-12 scoring algorithm is cautioned against. Instead, when the assumed two-dimensional structure is supported in the data, oblique scoring algorithms appear preferable. Failure to consider basic scoring assumptions may yield misleading results.

  • 4.
    Wang, T.
    et al.
    Kina.
    Jiang, H.
    Kina.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Wang, JK.
    Kina.
    Wang, L.
    Kina.
    The Minimal Eating Observation Form-II (MEOF-II): cross-cultural validation of the Chinese version for people with stroke2016In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 22, no 2, p. 207-212Article in journal (Refereed)
    Abstract [en]

    Rationale, Aims and Objectives: Eating difficulties are common among patients affected by stroke. A valid, reliable instrument for assessing eating difficulties in people with stroke is needed. The aim of this study was to translate the Minimal Eating Observation Form - version II (MEOF-II) for patients with stroke into Chinese and to comprehensively evaluate its reliability and validity.Methods: The scale of the original MEOF-II form was translated into Chinese using the cross-culture translation method, and 125 participants with stroke were assessed. Data were analysed by content validity index, Cronbach's alpha, correlations and exploratory factor analysis (EFA).Results: Reliability and validity were demonstrated for the scale. A three-factor structure was illustrated by EFA, and construct validity was demonstrated by good convergent and discriminant validity.Conclusions: The Chinese version (Ch-MEOF-II) shows good reliability and validity in this study and can be applicable to assess eating difficulties in people with stroke; The Ch-MEOF-II allows the early recognition of eating difficulties and thus provides guidance of proper clinical interventions. For future study, a confirmatory factor analysis may need to confirm the three-factor structure identified in this study. Furthermore, a cross-cultural comparison can be conducted with the availability of the three different validated language versions of the MEOF-II form.

  • 5.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Norberg, Erika
    Central Hospital Kristianstad.
    Stubbendorff, Anna
    County Council Skane.
    Hedin, Gita
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Wetterstrand, Martin
    Kristianstad University, School of Health and Society, Avdelningen för Design och datavetenskap.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Long-term effects of a computer-based nutritional training program for inpatient hospital care2017In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, no 4, p. 797-802Article in journal (Refereed)
    Abstract [en]

    Rationale

    A previous short-term study showed that a computer-based training in eating and nutrition increased the probability for hospital inpatients at undernutrition (UN) risk to receive nutritional treatment and care without increasing overtreatment (providing nutritional treatment to those not at UN risk).

    The aim of this study was to investigate if a computer-based training in eating and nutrition influences the precision in nutritional treatment and care in a longer-term perspective.

    Method

    A preintervention and postintervention study was conducted with a cross-sectional design at each time points (baseline and 7 months postintervention). Hospital inpatients > 18 years old at baseline (2013; n = 201) and follow-up (2014; n = 209) were included. A computer-based training was implemented during a period of 3 months with 297 (84%) participating registered nurses and nurse assistants. Undernutrition risk was screened for using the minimal eating observation and nutrition form-version II. Nutritional treatment and care was recorded using a standardized protocol.

    Results

    The share of patients at UN risk that received energy-dense food (+ 25.2%) and dietician consultations (+ 22.3%) increased between baseline and follow-up, while fewer received oral nutritional supplements (-18.9%). "Overtreatment" (providing nutritional treatment to those not at UN risk) did not change between baseline and follow-up.

    Conclusion

    The computer-based training increased the provision of energy-dense food and dietician consultations to patients at UN risk without increasing overtreatment of patients without UN risk.

  • 6.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Norberg, Erika
    Central Hospital Kristianstad.
    Stubbendorff, Anna
    The County Council of Skåne.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Wetterstrand, Martin
    Kristianstad University, School of Health and Society, Avdelningen för Design och datavetenskap.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Short-term effects of a computer-based nutritional nursing training program for inpatient hospital care2016In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 22, no 5, p. 799-807Article in journal (Refereed)
    Abstract [en]

    RATIONALE: This study aimed to explore whether a computer-based training in eating and nutrition for hospital nursing staff can influence the precision in nutritional treatment and care.

    METHOD: A pre-intervention and post-intervention study was conducted with a cross-sectional design at each time point. The settings were one intervention (IH) and two control hospitals (CH1 and CH2). Hospital inpatients >18 years old at baseline (2012; n = 409) and follow-up (2014; n = 456) were included. The computer-based training was implemented during a period of 3 months in the IH with 297 (84%) participating registered nurses and nurse assistants. Nutritional risk was screened for using the Minimal Eating Observation and Nutrition Form. Nutritional treatment and care was recorded using a standardized protocol RESULTS: In the IH, there was an increase in the share of patients at UN risk that received energy-dense food (+16.7%) and dietician consultations (+17.3%) between baseline and follow-up, while fewer received feeding assistance (-16.2%). There was an increase in the share of patients at UN risk that received energy-dense food (+19.5%), a decrease in oral nutritional supplements (-30.5%) and food-registrations (-30.6%) in CH1, whereas there were no changes in CH2. 'Overtreatment' (providing nutritional treatment to those not at UN risk) was significantly higher in CH2 (52.7%) than in CH1 (14.3%) and in the IH (25.2%) at follow-up.

    CONCLUSION: The computer-based training seemed to increase the probability for patients at UN risk in the IH to receive nutritional treatment without increasing overtreatment.

1 - 6 of 6
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