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  • 201.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    A Network for Eating and Nutrition as a platform for cooperation over the organisational borders between healthcare sectors in Sweden2014In: Journal of Health Sciences, ISSN 2232-7576, Vol. 4, no 3, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Introduction: Requirements to implement scientific knowledge in practice within the Swedish health and social care sectors have increased during the last decades. One of these networks was the Network for Eating and Nutrition that began in 2003. The aim of this study was to retrospectively evaluate how the Network for Eating and Nutrition has functioned during a period of ten years and in what way it has affected work practice.

    Methods: This is a descriptive qualitative study. Data sources for this study were meeting records collected over 10 years and two evaluation surveys (at five and 10 years).  Participants were members of the Network for Eating and Nutrition (n=12 at five years and n=10 at 10 years). The manifest qualitative content analysis was used.

    Results: The Network for Eating and Nutrition was seen as offering support for personal and organisational knowledge development. Further aspects of support from the workplaces of the members and the significance for the work places were described. Further the Network for Eating and Nutrition reached out to care receivers by using specifically tailored education programmes and material. The Network for Eating and Nutrition results and recommendations were described as important references for the development of nutrition routines.

    Conclusion: Networks between organisations with different professional backgrounds can form a basis for knowledge exchange both for focus on the specific topic but also on how to work with quality improvement, i.e. evidence based practice.

  • 202.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Aktionsforskningens grunder2013In: Aktionsforskning i vård och omsorg: tillämpning och teori / [ed] Liselotte Jakobsson, Malmö: Gleerups Utbildning AB, 2013, p. 85-94Chapter in book (Other academic)
  • 203.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Improvement of food distribution to home living elderly people by using action research approach2012In: Book of abstracts 2012: Nobel Day festivities Örebro University, 2012, p. 33-Conference paper (Refereed)
    Abstract [en]

    The study was performed in accordance with action research approach and included four phases: look, think, act and evaluate.

    Look phase was performed in the three steps:

    1. To gain insight into and describe the experiences of elderly home-living people who receive meals from municipality
    2. To explore various professional’s experiences of involvement in the food distribution process in order to get a comprehensive understanding of the organization and responsibilities and roles
    3. To describe decision makers views on the food distribution service

    Think phase was performed in the three steps:

    1. To reflect on what was important for the elderly people relating to their receiving meals distributed by the municipality
    2. To reflect on what the various involved professionals identify as most important to develop in the food distribution chain
    3. To reflect over suggested developmental areas and choose one of them and reflect over how to perform action and evaluation

    Act phase was performed in two steps:

    1. The knowledge in nutrition as developmental area was chosen to focus action on
    2. The way how to develop nutrition knowledge, the information letters,  was chosen
    3. The information letters were developed I collaboration with professionals and elderly people
    4. The 1700 information letters were distributed

    The evaluation phase was performed in three phases:

    1. The preliminary outcomes were given as feedback to involved representatives from various professionals
    2. The finally outcomes were given as feedback to decision makers
    3. Final feedback resulted in three future actions

    Outcomes from look and think phase are:

    1. The food distribution receivers expressed feelings of: to not have influence over food products the meals were made from, to feel isolated and confined at home due to difficulties getting out of the house and expressed sincere gratitude for the meal service from the municipality.
    2. The various professionals expressed that: food distribution is a fragmentary intervention where comprehensive perspective and roles of responsibility are lacking,  the fragmented organization seemed strictly divided and limited by constrains regarding time and money, the necessary observations and structured following up of nutrition status for food distribution receivers is missing,  and that knowledge in nutrition need to be continuously developed.
    3. The decision makers found areas to require facilitation for change related to food distribution: the monitoring of the food distribution receiver’s health and wellbeing, to focus on involved professional’s competence in nutrition and to create a forum for inter-professional communication.
  • 204.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Matdistribution till äldre2013In: Aktionsforskning i vård och omsorg: tillämpning och teori / [ed] Liselotte Jakobsson, Malmö: Gleerups Utbildning AB , 2013, p. 13-32Chapter in book (Other academic)
  • 205.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Skovdahl, Kirsti
    Hälsoakademin Örebro Universitet.
    Matdistribution från olika perspektiv - professioner, beslutsfattare och från äldre personer - en aktionsforskningsstudie2011Conference paper (Other (popular science, discussion, etc.))
  • 206.
    Palmquist, Eva-Lott
    et al.
    Kristianstads Kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Till dig som har matdistribution: ”Bra mat vid förstoppning eller trög mage”2013Other (Other (popular science, discussion, etc.))
  • 207.
    Persson, Carina
    et al.
    University of Gothenburg.
    Linder, Annika
    Region Västra Götaland.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Measurement properties of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) using Rasch analysis2017Conference paper (Other academic)
  • 208.
    Persson, Carina U
    et al.
    University of Gothenburg.
    Linder, Annika
    Physiotherapy Department NU-Hospital Group, Trollhättan/Uddevalla.
    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. Kristianstad University, Research Platform for Collaboration for Health.
    Measurement properties of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) using Rasch analysis2017In: European Journal of Physical and Rehabilitation Medicine, ISSN 1973-9087, E-ISSN 1973-9095, Vol. 53, no 6, p. 848-855Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A previous small-sample (n=150) Rasch analysis of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) suggested problems regarding response categories and redundant items that need confirmation in larger samples with more severe strokes.

    AIM: To evaluate the measurement properties of the SwePASS in patients with acute stroke.

    DESIGN: A multicentre, cross-sectional study.

    SETTING: Two stroke units in Western Sweden.

    POPULATION: The study cohort included 250 consecutive inpatients undergoing rehabilitation after acute stroke.

    METHODS: The SwePASS assessments were performed once within the first four days after admission to the stroke units. The data were analysed according to the Rasch measurement model regarding targeting, model fit, reliability, response category function, local dependence and differential item functioning.

    RESULTS: Postural control of 250 patients (median age, 76.5 years) was assessed with the SwePASS within median of two days after admission to the stroke units. The SwePASS covered a continuum of different levels of postural control, but had suboptimal targeting with insufficient representation of lower and higher levels of postural control. The reliability was high, the item fit statistics were generally acceptable and there was no differential item functioning by sex, age and stroke localization. However, response categories did not function as expected for four of the 12 SwePASS items and five items exhibited local dependency.

    CONCLUSIONS: The SwePASS exhibited several promising measurement properties. To improve the scale, poor targeting, illogical response categories and local dependency should be addressed.

    CLINICAL REHABILITATION IMPACT: The SwePASS provides valuable clinical information regarding postural control in the acute phase after stroke.

  • 209.
    Petersson, Pia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Johansson, Yvonne
    Kristianstad University, School of Health and Society.
    Kälström Olsson, Ingela
    Lindskov, Cecilia
    Kristianstad University, School of Health and Society, Avdelningen för Samhällsvetenskap.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Romance versus reality: five doctoral students' experiences of Action Reserach in the health care system in Sweden2007In: Action reserach beyond borders and divides, 2007Conference paper (Refereed)
  • 210.
    Petersson, Pia
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Haak, Maria
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health.
    Developing a model that support preventive home visit for seniors – a collaborative development and research project2019Conference paper (Refereed)
  • 211.
    Petersson, Ulrika
    et al.
    Neonatal Intensivvårdsavdelning, SUS, Lund.
    Sobiecki, Dariusz
    AIIVA, Infektionsklinik, SUS, Malmö.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Samuelson, Karin
    Institutionen för hälsa, vård och samhälle, Medicinska fakulteten, Lunds Universitet.
    Intensivvård ur ett genusperspektiv: en registerstudie2012In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 32, no 2, p. 51-55Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to describe in a gender specific perspective, demographic data from adult patients that have been treated in an intensive care unit.

    Background: Many studies show that there are differences between men and women when it comes to different aspects of health care. The knowledge of these differences is limited when relating to intensive care in Sweden.

    Method: Demographic data registered in the Swedish intensive care register including all intensive care cases during the year of 2009 (n=695) in an intensive care unit in a hospital in southern Sweden was analyzed. A group comparison between the sexes was made with the following variables: number of patients admitted, length of stay in the ICU, SAPS 3 (Simplified Acute Physiology Score) points, the five most common diagnosis, mortality and mortality per diagnosis.

    Results: The study showed an over-representation of men (62,2 %, p<0.001) in number of intensive care patients. The mortality was 9,9 % overall and significantly higher amongst men (11,8 %), compared with women (6,8 %, p=0.034). There were no differences between the sexes in length of stay, diagnosis, SAPS 3 points and mortality per diagnosis.

    Conclusions: This study has shown that more men than women are treated in the intensive care unit and that more men die during their time in the intensive care unit.

  • 212.
    Rask, Marie
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Linnaeus University.
    Swahnberg, Katarina
    Linnaeus University.
    Oscarsson, Marie
    Linnaeus University.
    Notification of an abnormal Pap smear result: an intervention study2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 28, no 2Article in journal (Refereed)
    Abstract [en]

    This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% of women in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.

  • 213.
    Rask, Marie
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Linnaeus University.
    Swahnberg, Katarina
    Oscarsson, Marie
    Swedish women's awareness of human papillomavirus, and health-related quality of life, anxiety, and depression after a notification of an abnormal Pap smear result: a cross-sectional study.2019In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 28, no 2, p. 96-101Article in journal (Refereed)
    Abstract [en]

    This study aims to assess (a) women's awareness of the human papillomavirus (HPV), (b) women's health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student's t-test, χ-tests, Fisher's exact test, the Mann-Whitney U-test, and Fisher-Freeman-Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (81.8-107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0-10.0) and 3.0 (1.0-5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women's HRQoL or on anxiety and depression.

  • 214.
    Rolandsson, Sara
    et al.
    Lund University.
    Andersson Sjöland, Annika
    Lund University.
    Brune, Jan C.
    Lund University.
    Li, Hongzhe
    Lund University.
    Kassem, Moustapha
    University of Southern Denmark.
    Mertens, Fredrik
    Lund University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Eriksson, Leif
    Lund University.
    Hansson, Lennart
    Lund University.
    Skog, Ingrid
    Lund University.
    Bjermer, Leif
    Lund University.
    Scheding, Stefan
    Lund University.
    Westergren-Thorsson, Gunilla
    Lund University.
    Primary mesenchymal stem cells in human transplanted lungs are CD90/CD105 perivascularly located tissue-resident cells2014In: BMJ Open Respiratory Research, ISSN 2052-4439, Vol. 1, no 1, p. e000027-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mesenchymal stem cells (MSC) have not only been implicated in the development of lung diseases, but they have also been proposed as a future cell-based therapy for lung diseases. However, the cellular identity of the primary MSC in human lung tissues has not yet been reported. This study therefore aimed to identify and characterise the ‘bona fide’ MSC in human lungs and to investigate if the MSC numbers correlate with the development of bronchiolitis obliterans syndrome in lung-transplanted patients. METHODS: Primary lung MSC were directly isolated or culture-derived from central and peripheral transbronchial biopsies of lung-transplanted patients and evaluated using a comprehensive panel of in vitro and in vivo assays. RESULTS: Primary MSC were enriched in the CD90/CD105 mononuclear cell fraction with mesenchymal progenitor frequencies of up to four colony-forming units, fibroblast/100 cells. In situ staining of lung tissues revealed that CD90/CD105 MSCs were located perivascularly. MSC were tissue-resident and exclusively donor lung-derived even in biopsies obtained from patients as long as 16 years after transplantation. Culture-derived mesenchymal stromal cells showed typical in vitro MSC properties; however, xenotransplantation into non-obese diabetic/severe combined immunodeficient (NOD/SCID) mice showed that lung MSC readily differentiated into adipocytes and stromal tissues, but lacked significant in vivo bone formation. CONCLUSIONS: These data clearly demonstrate that primary MSC in human lung tissues are not only tissue resident but also tissue-specific. The identification and phenotypic characterisation of primary lung MSC is an important first step in identifying the role of MSC in normal lung physiology and pulmonary diseases.

  • 215.
    Rosqvist, Kristina
    et al.
    Lund University.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Iwarsson, Susanne
    Lund University.
    Nilsson, Maria H
    Lund University.
    Odin, Per
    Lund University.
    Satisfaction with care in late stage Parkinson’s disease2019In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, Vol. 2019Article in journal (Refereed)
    Abstract [en]

    In late stage Parkinson’s disease (PD) (i.e., Hoehn and Yahr (HY) stages IV-V), both motor and nonmotor symptoms (NMS) are pronounced, and the patients become increasingly dependent on help in their daily life. Consequently, there is an increasing demand on health-care and social care resources for these patients and support for their informal caregivers. The aim of this study was to assess satisfaction with care in late stage PD patients and to identify factors associated with satisfaction with care. Moreover, to assess their informal caregivers’ satisfaction with support and to identify factors associated with caregivers’ satisfaction with support. Factors potentially associated with satisfaction with care/support were assessed in 107 late stage PD patients and their informal caregivers () and entered into multivariable logistic regression analyses. Fifty-eight (59%) of the patients and 45 (59%) of the informal caregivers reported satisfaction with their overall care/support. Patients satisfied with their care reported higher independence in activities of daily living (ADL) (Katz ADL index; ), less depressive symptoms (Geriatric Depression Scale, GDS-30; ), and higher individual quality of life (QoL) (Schedule for the Evaluation of Individual Quality of Life Questionnaire, SEIQoL-Q; ). Multivariable logistic regression analyses identified depressive symptoms () and independence in ADL () as independently associated with satisfaction with care. For informal caregivers, the analyses identified patients’ HY stage () and caregivers’ QoL (Alzheimer’s Carers Quality of Life Inventory, ACQLI; ) as independently associated with satisfaction with caregiver support. The results indicate that an effective both pharmacological and nonpharmacological PD therapy is important, to adequately treat motor and NMS (e.g., depressive symptoms) in order to improve depressive symptoms and patient independence in ADL. This may benefit not only the patients, but also their informal caregivers.

  • 216.
    Rosqvist, Kristina
    et al.
    Lund University.
    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.
    Odin, P.
    Lund University.
    Ekström, H.
    Lund University.
    Iwarsson, S.
    Lund University.
    Nilsson, M. H.
    Lund University.
    Factors associated with life satisfaction in Parkinson's disease2017In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 136, no 1, p. 64-71Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To identify factors associated with life satisfaction (LS) in people with Parkinson's disease (PD), including a specific focus on those with late-stage PD.

    MATERIAL AND METHODS: The study included 251 persons with PD (median age 70 years; PD duration 8 years). Analyses involved the total sample and a subsample with late-stage PD, that is Hoehn and Yahr stages IV and V (n=62). LS was assessed with item 1 of the Life Satisfaction Questionnaire (LiSat-11). Simple logistic regression analyses were performed for both the total sample and for the subsample with late-stage PD. For the total sample, a multivariable logistic regression analysis was also performed.

    RESULTS: In the total sample, 12 of the 20 independent variables were significantly associated with LS: need of help with ADL; walking difficulties; number of non-motor symptoms (NMS); fatigue; depressive symptoms; general self-efficacy; motor symptoms; pain; PD severity; freezing episodes; gender (woman); and fluctuations. When controlling for age and gender in the multivariable logistic regression model, depressive symptoms were negatively associated with high LS and general self-efficacy was positively associated with high LS. In late-stage PD, simple logistic regression analyses (controlling for age and gender) identified the following factors as associated with LS: number of NMS, general self-efficacy, walking difficulties and fatigue.

    CONCLUSIONS: This study provides new knowledge on factors associated with LS in a PD sample, including those with late-stage PD. As the ultimate goal for PD care should be improvement in LS, the results have direct clinical implication.

  • 217.
    Rosqvist, Kristina
    et al.
    Lunds universitet.
    Hagell, Peter
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Odin, Per
    Lunds universitet.
    Iwarsson, Susanne
    Lunds universitet.
    Ekström, Henrik
    Lunds universitet.
    Nilsson, Maria
    Lunds universitet.
    Life satisfaction in Parkinson’s disease: associated factors2016Conference paper (Other academic)
    Abstract [en]

    Objective: To identify factors associated with life satisfaction (LS) in people with Parkinson’s disease (PD), including a specific focus on those with late stage PD.

    Background: Despite that patients with PD have an increased risk of reduced LS, there is limited knowledge regarding which factors are associated with LS. Such knowledge could serve as an important base for optimizing treatment and care. Concerning patients with late stage PD, i e Hoehn and Yahr (HY) IV-V, no published study has specifically addressed LS for this group.

    Methods: Data from 251 persons with PD (median age 70 years and duration 8 years) was analyzed statistically; the total sample was assessed and a subsample with late stage PD was further evaluated separately. LS was assessed by item 1 of the Life Satisfaction Questionnaire (LiSat-11). A large number of independent variables were described in relation to HY for groups HY I-III and IV-V, differences between the groups were tested. Sample characteristics in relation to LS were tested with simple logistic regression analyses. Independent variables with a p-value < 0.3 in the simple logistic regressions were entered into a multiple logistic regression model. For the subsample with late stage PD, simple logistic regression analyses were calculated.

    Results: The simple logistic regression analyses showed that 11 out of the 20 independent variables were significantly associated with LS: need of help with ADL; walking difficulties; number of non-motor symptoms (NMS); fatigue; depressive symptoms; general self-efficacy; pain; PD severity; freezing episodes; gender (women) and fluctuations. When controlling for age and gender in the multiple logistic regression model, two independent variables were found to be independently associated with LS; depressive symptoms (negatively associated with high LS) and general self-efficacy (positively associated with high LS). For late stage PD, when controlling for age and gender in simple logistic regression analyses, associated factors with LS were: number of NMS, general self-efficacy, walking difficulties and fatigue, all except for general self-efficacy were negatively associated with high LS.

    Conclusions: This study identified factors associated with LS in a population with PD and further factors associated with LS for those with late stage PD. The ultimate goal for PD care should be improvement in LS and therefore the identification of associated factors has direct clinical implication.

  • 218.
    Rosqvist, Kristina
    et al.
    Lund University.
    Horne, Malcolm
    Australien.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Iwarsson, Susanne
    Lund University.
    Nilsson, Maria H
    Lund University.
    Odin, Per
    Lund University.
    Levodopa effect and motor function in late stage Parkinson's disease2018In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 8, no 1, p. 59-70Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It is unclear to which degree Levodopa (L-dopa) remains effective also in the late stage of Parkinson's disease (PD) and to which degree motor fluctuations and dyskinesias remain a problem.

    OBJECTIVE: To assess responsiveness of motor symptomatology to L-dopa in a group of patients with late stage PD. Moreover, to investigate the extent to which motor fluctuations and dyskinesias occur.

    METHODS: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. L-dopa responsiveness was assessed with a standardized L-dopa test in the defined "off" and defined "on" states. Motor function was assessed by the Unified PD Rating Scale (UPDRS) III and timed tests. Motor fluctuations and dyskinesias were assessed by the UPDRS IV. The participants were further monitored for 10 days with a mobile movement-analyses-system, the Parkinson's Kinetigraph (PKG). The median (q1-q3) L-dopa equivalent daily dose (LEDD) was 799 (536-973) mg.

    RESULTS: The UPDRS III score improved with ≥15% in 15 (50%) and with ≥30% in six (20%) participants during the L-dopa test. The median (q1-q3) UPDRS III score in "off" was 46 (37-53) and in "on" 36 (28-46). Twenty-one (70%) of the participants reported either predictable or unpredictable "off" fluctuations (items 36-37). The prevalence of dyskinesias (item 32, duration of dyskinesias ≥1) was 47%. The PKG indicated that dyskinesias primarily were mild and that a majority had a pronounced "off" symptomatology, spending a large proportion of the day either asleep or very inactive.

    CONCLUSIONS: Half of a group of patients with late stage PD had an L-dopa response of ≥15% on the UPDRS III. According to the UPDRS IV, a majority of the patients had motor fluctuations and about half had dyskinesias, although the PKG results suggested that these were not very severe.

  • 219.
    Rosqvist, Kristina
    et al.
    Lund University.
    Horne, Malcolm
    Australien.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Iwarsson, Susanne
    Lund University.
    Nilsson, Maria
    Lund University.
    Odin, Per
    Lund University.
    Levodopa effect and motor function in late stage Parkinson’s disease2017In: Movement Disorders, 2017, Vol. 32, p. 915-916Conference paper (Refereed)
    Abstract [en]

    Objective: To assess responsiveness to Levodopa (L-dopa) in patients with late stage Parkinson’s disease (PD). Moreover, to investigate if the L-dopa effect is stable or whether motor fluctuations and dyskinesias are present.

    Background: A majority of PD patients treated with L-dopa develop motor complications, in many cases within a few years of treatment. It is unclear to which degree L-dopa remains effective also in the last stages and whether motor fluctuations and dyskinesias remain a problem.

    Methods: The study included 30 patients with PD in Hoehn and Yahr (HY) stages IV and V in “on” and/or having a substantial need of help with ADL (<50% Schwab and England Scale) and having been diagnosed with PD for =7 years. Nineteen were men, median age 83 and median PD duration 12 years. Nineteen were in HY stage IV and 11 in V. L-dopa responsiveness was assessed with an L-dopa test and motor evaluation according to a standardized protocol in the defined “off” and defined “on” state. Motor performance was assessed by the Unified PD Rating Scale (UPDRS) III and timed tests for gait and hand-arm. The participants were further evaluated with a mobile movement-analyses-system, the Parkinson’s Kinetigraph (PKG) for 10 days.

    Results: The number of participants with an improvement in UPDRS III during L-dopa test of =15% were 15 (50%) and of =30% were 6 (20%). The median UPDRS III score in “off” was 46 (q1-q3, 37-53) and in “on” 36 (28-46), with a median improvement of 15.5% (8-27%), p<0.001. There was a statistically significant effect in almost all variables; UPDRS III total score; speech (item 18); resting tremor (item 20); tremor (items 20, 21); rigidity (item 22); bradykinesia (items 23-26, 31); gait (item 29); axial signs (items 18, 19, 22, 27-30); dyskinesias (Clinical Dyskinesia Rating Scale); hand-arm movement; gait test and blood pressure. According to the UPDRS IV, 67% experienced predictable off-fluctuations, while 30% had unpredictable off-fluctuations. The prevalence of dyskinesias according to item 32 (duration of dyskinesias =1) of the UPDRS IV was 47%. According to the PKG registrations, some patients were experiencing significant motor fluctuations, though very few had significant dyskinesias.

    Conclusions: Half of a group of patients with late stage PD (HY IV-V in “on”) had a significant L-dopa response (=15% on the UPDRS III). According to the UPDRS IV, a majority of the patients still had motor fluctuations and about half had dyskinesias.

  • 220.
    Rosqvist, Kristina
    et al.
    Lund University.
    Odin, Per
    Lund University.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Iwarsson, Susanne
    Lund university.
    Nilsson, Maria
    Lund University.
    Storch, Alexander
    Dopaminergic effect on non-motor symptoms in late stage Parkinson's disease2018In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 8, no 3, p. 409-420Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease.

    OBJECTIVE: To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function.

    METHOD: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function.

    RESULTS: NMS were common and many of the symptoms occurred in >80% of the individuals. The highest NMSS scores were seen within the NMSS domains 3: mood/apathy and 7: urinary in both the "off" and the "on" state. There was a statistically significant (p <  0.001) improvement in the modified NMSS total score (median) from 79 in "off" to 64 in "on". There were statistically significant differences between the "off" and the "on" state for domains 2: sleep/fatigue, 3: mood/apathy, 5: attention/memory, 6: gastrointestinal and 7: urinary. The differences in the NMSS score between the "off" and the "on" state were in general larger for motor responders than for motor non-responders. In motor non-responders, differences of the NMSS score between the "off" and the "on" state were found for the total score, domain 3: mood/apathy and its item 11-flat moods.

    CONCLUSION: There is an effect of dopaminergic medication on NMS in late stage PD, to some extent also for those with a non-significant response on motor function during L-dopa test. It is therefore of importance to optimize dopaminergic therapy in order to give the most effective symptomatic treatment possible.

  • 221.
    Rämgård, Margareta
    et al.
    Malmö Högskola.
    Peterson, Pia
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Vården som system2017In: Omvårdnad & äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, p. 553-564Chapter in book (Other academic)
  • 222.
    Rönn Emsfors, Åsa
    et al.
    Central Hospital Kristianstad.
    Elgán, Carina
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Patients' experiences of nursing actions during intravitreal treatment for wet age-related macular degeneration2015Conference paper (Other academic)
    Abstract [en]

    Purpose: The aim was to identify and describe nursing actions performed by nursing staff in which patients with wet age-related macular degeneration (AMD) experience good nursing care.

    Method: An explorative and descriptive qualitative design based on the Critical incident technique (CIT) was used. A strategic sample of 16 patients, aged 61-87 years (eleven women and five men) with wet AMD who received intravitreal treatment were interviewed.

    Results: Two main areas of good nursing care was identified during intravitreal treatment Being perceived as an individual and Creating confidence during visits, each area contained two categories. The two categories in the area Being perceived as an individual were; acting respectfully and being engaged. Acting respectfully was perceived when the nursing staff had a benevolent attitude and answered questions kindly and polite. The patients considered to be seen as an individual when the nursing staff were available for conversation and were present. The two categories in the area Creating confidence during visits were; encourage participation and inspiring confidence. Encouraging participation was perceived when the nursing staff continuously provided information. The nursing staff created confidence and trust by keeping promises and being honest.

    Conclusion: The interaction in the encounter between patient and caregiver is fundamental for patients' experience of good nursing care. It emphasise the importance of personal centred care even though the time for each patient is limited and the nursing staff have a demanding schedule. It would be desirable with specific guidelines for care of patient who gets intravitreal treatment. Without specific guidelines makes it difficult to implement person centred care and more quality time would benefit the patient.

                                                                                                   

  • 223.
    Schmidt, Manuela
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society. Lund University.
    Ekstrand, Joakim
    Kristianstad University, Faculty of Business, Avdelningen för ekonomi. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Bengtsson-Tops, Anita
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Self-reported needs for care, support and treatment of persons who frequently visit psychiatric emergency rooms in Sweden2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 9, p. 738-745Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate self-reported needs for care, support and treatment among persons who frequently visit psychiatric emergency rooms (PERs).

    DESIGN: A cross-sectional design. Qualitative and quantitative data were collected using an interview-based manual. Qualitative data were analysed using content analysis, whereas quantitative data were analysed using descriptive, non-parametric statistical tests.

    RESULTS: Persons who frequently visit PERs self-reported unmet needs for care, support and treatment in life domains such as health, socialisation, daytime activities, and emotional and financial security.

    CONCLUSION: To meet the needs of persons who frequently visit PERs, close cooperation between concerned welfare actors should be implemented.

  • 224.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE.
    Andersson, Karolina
    Lund University.
    Andersson, Margareta
    Lund University.
    Nilsson, Maria H.
    Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    The significance of walking from the perspective of people with Parkinson's disease2014In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 4, no 4, p. 657-663Article in journal (Refereed)
    Abstract [en]

    Background: Parkinson's disease (PD) is associated with progressive mobility and walking difficulties. Although these aspects have been found to be central from a patient perspective, the perceived significance of walking is less well understood. Objective: To explore the significance of walking as perceived and experienced by individuals with PD. Methods: Eleven persons with PD (seven men; median age, 71 years; median PD duration, 7 years) participated. Data were collected through semi-structured interviews, which were recorded and transcribed verbatim. Data were qualitatively analysed by systematic text condensation. Results: The ability to walk had a complex and multifaceted impact on the participants, including physical, psychological and emotional aspects as well as on the ability to be active in daily life and to participate in society. The central role of coping strategies was prominent in filtering emotional reactions to physical changes, and when managing the activities and participation in everyday situations. The sense of unpredictability, uncertainty and loss of control were underlying phenomena in all categories. Furthermore, inability to manage walking difficulties had a negative impact on the participants' self-concept. Conclusions: The central meaning of being able to walk appears to be intimately linked to an individual's social identity, emotional well-being and integrity. Consequently, being able to walk independently was a prerequisite to an autonomous life and participation in society. This implies that rehabilitation and other mobility interventions also need to consider individual emotional, psychological, and social implications, and to facilitate appropriate compensatory and coping strategies.

  • 225.
    Sjödahl Hammarlund, Catharina
    et al.
    Lund University.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Nilsson, Maria H
    Lund University.
    Motor and non-motor predictors of illness-related distress in Parkinson's disease2012In: Focus on Parkinson's disease, ISSN 0924-2015, Vol. 23, no 1, p. 27-28Article in journal (Other academic)
  • 226.
    Sjödahl Hammarlund, Catharina
    et al.
    Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Nilsson, Maria H.
    Lund University.
    Motor and non-motor predictors of illness-related distress in Parkinson's disease2012In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 18, no 3, p. 299-302Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify motor and non-motor symptoms independently associated with distress in Parkinson's disease (PD).

    METHOD: Clinical and patient-reported data from 118 people with PD (mean age and PD-duration, 64 and 8 years) were analyzed regarding associations with patient-reported distress using multiple regressions (controlling for age).

    RESULTS: Non-motor symptoms independently associated with distress were pain, fatigue, sleep, depression and anxiety (R(2), 0.81). The only significant motor aspect was mobility (R(2), 0.31). When considering both motor and non-motor symptoms, fatigue, pain, depression and sleep showed independent associations with distress (R(2), 0.76).

    CONCLUSION: Distress in PD is primarily associated with non-motor features.

  • 227.
    Sjödahl Hammarlund, Catharina
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Nilsson, Maria H
    Department of Health Sciences, Lund University, Lund, Sweden.
    Motoriska och icke-motoriska prediktorer för patientrapporterad distress vid Parkinsons sjukdom2012In: BestPractice Psykiatri/Neurologi, Vol. 3, no 12, p. 12-15Article, review/survey (Other academic)
  • 228.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
    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.
    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.
    Fall risk and its associated factors among older adults without home help services in a Swedish municipality2016In: Journal of Community Health Nursing, ISSN 0737-0016, E-ISSN 1532-7655, Vol. 33, no 4, p. 181-189Article in journal (Refereed)
    Abstract [en]

    During preventive home visits, the purpose of this study was, to identify the prevalence of fall risk and any associated factors. Participants (n=1471) were cognitively sound community-dwelling older adults (≥ 70 years) without home-help service, living in a Swedish municipality. The Downton Fall Risk Index and nine single items were used. Tiredness/fatigue, age ≥ 80, inability to walk one hour, inability to climb stairs and worrying were significantly associated with fall risk. Preventive home visits incorporating fall risk screening proved valuable, providing information for interventions aimed at preventing falls, maintaining independence and facilitating health among community dwelling participants.

  • 229.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
    Lexell, Jan
    Uppsala University .
    Brogårdh, Christina
    Lund University.
    Growing up with a disability following paralytic poliomyelitis: experiences from persons with late effects of polio2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe the experiences of growing up after acute paralytic poliomyelitis and strategies used to adapt to the new situation. Methods: Seven women and seven men (mean age 70 years, min-max 61-78 years) with late effects of polio, who had contracted paralytic polio in their childhood. Data were collected using semi-structured interviews, transcribed verbatim, and analyzed by systematic text condensation. Results: Memories of contracting acute paralytic poliomyelitis involved being immobilized and sent away from home for surgical and physiotherapeutic treatment. Growing up in a social context that was often tough and unfriendly resulted in the development of strategies, such as optimistic thinking, trying to blend in, trusting one's ability to manage, and to handle the preconceptions and expectations of others. At the onset of late effects of polio, some of these strategies were still functioning, whereas overachieving, disregarding pain, and weariness were not. Conclusion: The challenges of growing up with a disability following paralytic polio led to the development of various psychological strategies for managing daily life. By understanding these experiences and strategies, knowledge may be gained in assisting rehabilitation professionals to better support persons with late effects of polio in adapting to the new situation. Implications for rehabilitation At the onset of late effects of polio, strategies developed earlier in life, such as overachieving, disregarding pain, and weariness, may not function anymore. Understanding the experiences of growing up with poliomyelitis can support rehabilitation professionals to provide targeted interventions for people with late effects of polio and enable them to develop new adaptive strategies. Developing new strategies, such as accepting increased symptoms, and augmenting self-esteem and self-efficacy, may improve daily functioning among people with late effects of polio.

  • 230.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
    Lexell, Jan
    Lund University & Skåne University Hospital & Luleå University of Technology.
    Brogårdh, Christina
    Skåne University Hospital & Lund University.
    Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life.

    METHODS: Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation.

    RESULTS: The latent analysis resulted in three categories 'Various consequences of ageing with LEoP', 'Limitations in everyday activities and participation restrictions', and 'Strategies for managing daily life when ageing with LEoP' and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance.

    CONCLUSION: Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.

  • 231.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Research Environment PRO-CARE. Lund University.
    Nilsson, Maria H.
    Lund University.
    Gummesson, Christina
    Lund University.
    External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study2015In: Journal of Educational Evaluation for Health Professions, ISSN 1975-5937, Vol. 12, article id 33Article in journal (Refereed)
    Abstract [en]

    Purpose: Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students’ learning processes and their adaptation to self-directed learning online.

    Methods: Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years) participated. Qualitative content analysis and triangulation was used when investigating the students’ self-reflections, written during a five week self-directed, problem-oriented online course.

    Results: Two categories emerged: ‘the influence of the structured framework’ and ‘communication and interaction with teachers and peers.’ The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to overcome were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment.

    Conclusion: The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy

  • 232.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE.
    Nilsson, Maria H.
    Lund University.
    Idvall, Markus
    Lund University.
    Rosas, Scott R.
    Concept Systems, Inc., Ithaca, NY.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Conceptualizing and prioritizing clinical trial outcomes from the perspectives of people with Parkinson’s disease versus health care professionals: a concept mapping study2014In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 23, no 6, p. 1687-1700Article in journal (Refereed)
    Abstract [en]

    Background

    Focusing clinical investigations on outcomes that are meaningful from an end-user perspective is central in clinical research, particularly in chronic disorders such as Parkinson’s disease (PD). However, little is known about how end-users such as people with PD (PwPD) and health care professionals (HCPs) view and prioritize therapeutic outcomes.

    Purpose

    To compare the perspectives of PwPD and HCPs regarding prioritized areas for outcome measurement in clinical PD trials.

    Methods

    Concept mapping was used to identify prioritized outcomes (statements) through focus groups (n = 27; 12 PwPD, 12 HCPs, three researchers), statement sorting and importance rating (n = 38; 19 PwPD, 19 HCPs), followed by quantitative (multidimensional scaling, cluster analysis, procrustes analysis) and qualitative analysis.

    Results

    Sorting of 99 statements by PwPD and HCPs yielded 2D maps (PwPD/HCPs stress values, 0.31/0.21) with eight clusters per group. The correlation between raw sorting data of PwPD and HCPs was 0.80, and there was a significant concordance (m12 = 0.53; P < 0.001; i.e., r = 0.68) between the spatial arrangements in their respective maps. Qualitatively, the maps from the two groups represented partially different perspectives. There were no significant differences between PwPD and HCP item importance ratings.

    Conclusion

    Although similarities dominated, there were differences in how the relationships between items were perceived by the two groups, emanating from different perspectives, i.e., the clinical biomedical (“disease”) versus the lived experience (“illness”). This study illustrates the clinical importance of attention to the perspective of PwPD; taking this into account is likely to provide evidence from clinical investigations that are meaningful and interpretable for end-users.

  • 233.
    Sjödahl Hammarlund, Catharina
    et al.
    Department of Health Sciences, Lund University.
    Nilsson, Maria
    Department of Health Sciences, Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Measuring outcomes in Parkinson's disease: a multi-perspective concept mapping study2012In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 21, no 3, p. 453-463Article in journal (Refereed)
    Abstract [en]

    To identify and develop a conceptual map of prioritized areas and to determine their relative importance for outcome measurement in clinical Parkinson's disease (PD) trials, from the perspectives of health care professionals and people with PD.

    METHOD:

    We used concept mapping, a qualitative/quantitative method consisting of three steps: item generation through focus groups (n = 27; 12 people with PD, 12 health care professionals, 3 researchers), item sorting and rating (n = 38; 19 people with PD, 19 health care professionals), and data analysis (multidimensional scaling, cluster analysis).

    RESULTS:

    Ninety-nine items and eight clusters were generated. Clusters representing Participation; Mobility and motor functioning; Cognitive and executive functioning; and Emotions were the most homogenous. Statements within clusters representing Energy and abilities; Autonomic dysfunctions; Sensory, speech and swallowing problems; and Neuropsychiatric symptoms also related to statements outside their respective clusters. Clusters rated most important were Participation and Mobility and motor functioning, and the highest rated items were quality of life, walking ability, and sleeping problems.

    CONCLUSION:

    By the use of concept mapping, a multi-perspective conceptual map of prioritized aspects for the outcome measurement in PD was defined. These findings provide an initial conceptual basis toward improved outcome measurement priorities in clinical PD trials.

  • 234.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Nordmark, Eva
    Department of Health Sciences, Lund University.
    Gummesson, Christina
    Department of Health Sciences, Lund University.
    Integrating theory and practice by self-directed inquiry-based learning?: a pilot study2013In: European Journal of Physiotherapy, ISSN 2167-9169, Vol. 15, no 4, p. 225-230Article in journal (Refereed)
    Abstract [en]

    Inquiry-based learning (IBL) is a research-based model promoting self-directed learning. The aim was to describe how five physiotherapists experienced their learning during their participation in two inquiry-based online courses. Primary data was their written self-reflections. Triangulation was done based on the self-reflections and the free text comments from three course evaluation surveys. Data analyses were done by qualitative content analysis. Autonomy emerged as the main theme, which was structured into three categories: (i) learning processes; (ii) perceiving increased self-efficacy; and (iii) transfer and implementation of theories and skills to practice. Being able to choose the research topic according to professional interest increased motivation and perceived meaning. Interacting with peers brought new perspectives and deeper understanding. The data triangulation revealed partially new aspects. Retrospectively, the participants expressed having gained new skills, which was augmented by their perception of professional relevance and the integration of theory in the clinical practice. Expressions of increased self-efficacy and the transfer of knowledge, understanding and skills to clinical practice, was interpreted as important parts of autonomy. In conclusion, courses with a research-based design may promote motivation and self-efficacy. Forum for peer support and collaboration was perceived to augment the creativity and broaden the understanding.

  • 235.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Åström, Ingrid
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    The Impact of Living with Parkinson’s Disease: Balancing within a Web of Needs and Demands2018In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, Vol. 2018, article id 4598651Article in journal (Refereed)
    Abstract [en]

    This study explores the impact of living with Parkinson’s disease (PD). Nineteen persons (11 women) aged 55–84 diagnosed with PD 3–27 years ago participated. Data were collected through semistructured interviews, which were recorded, transcribed verbatim, and analysed by qualitative content analysis. Four categories represented the impact of living with PD: “Changed prerequisites for managing day-to-day demands,” “Loss of identity and dignity,” “Compromised social participation,” and “The use of practical and psychological strategies.” There was a shift from an internal to an external locus of control in managing, control, competence, relatedness, and autonomy. According to self-determination theory, a shift towards extrinsically motivated behaviours may occur when these basic needs are thwarted, leading to compensatory strategies or needs substitutes with negative consequences on health and well-being. We suggest a needs-based approach as an important starting point to better understand the consequences of living with PD and to explore the means for people with PD to acquire an improved quality of life on their own terms. In conclusion, our findings suggest for a shift in focus, from a biomedical to a needs-based approach to understand the impact of living with PD and facilitate more person-centred care and person-centred outcome measurement.

  • 236.
    Smith, Steve
    et al.
    Storbritannien.
    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.
    Saunders, Julia
    Storbritannien.
    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.
    Nutritional screening: a user-friendly tool adapted from Sweden2016In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 25, no 4, p. 208-211Article in journal (Refereed)
    Abstract [en]

    Screening for undernutrition is highly important and may reduce morbidity and mortality. The Minimal Eating Observation and Nutrition Form Version II (MEONF-II) is a nutritional screening tool specifically developed for use by nurses. The authors describe the translation, performance and appropriateness of MEONF-II for the UK. Following translation from Swedish to British English, the user-friendliness and appropriateness of the British MEONF-II was tested by 29 registered nurses and final-year student nurses on 266 hospital inpatients. The new British MEONF-II was perceived as highly user-friendly and appropriate. Assessors found MEONF-II to compare favourably with other similar tools in terms of preference, usefulness and helpfulness in providing good nutritional care. Dependency in activities and poorer subjective health were associated with a higher risk of undernutrition. These findings support the appropriateness of the British MEONF-II version and suggest it may act as a user-friendly facilitator for good nutritional nursing care.

  • 237.
    Steen Krawcyk, R.
    et al.
    Department of Health Sciences, Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Sjödahl Hammarlund, Catharina
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Danish translation and psychometric testing of the Rivermead Mobility Index2013In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 128, no 4, p. 20-25Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The Rivermead Mobility Index (RMI) is widely used in several neurological conditions including multiple sclerosis (MS), but its psychometric properties have not been documented in Scandinavia. Therefore, the aim of the study was to translate RMI from UK English into Danish and conduct an initial psychometric testing of the Danish RMI. MATERIALS AND METHODS: The Danish translation conducted by the forward-backward method was first field-tested regarding user-friendliness and relevance. It was then psychometrically tested among 40 outpatients with MS regarding unidimensionality (corrected item-total correlations, adherence to an assumed Guttman response pattern), reliability, and construct validity. RESULTS: Field testing found the Danish RMI relevant and user-friendly. Corrected item-total correlations were ≥0.47 and item responses fitted the Guttman pattern. There was a 47.5% ceiling effect, and reliability was 0.91. Correlations supported construct validity. CONCLUSION: The Danish RMI is user-friendly, unidimensional, reliable, and valid. The results correspond to those previously reported with the original UK RMI version. Ceiling effects are limiting but sample related. Larger samples representing a wider variety of MS severities are needed for firmer evaluation of the Danish RMI.

  • 238.
    Stiernman, Mia
    et al.
    Lund University.
    Maulina, Leva
    Latvia.
    Inta, Zepa
    Latvia.
    Jagomägi, Triin
    Estonia.
    Tanaskovic, Nenad
    Bosnia and Herzegovina .
    Velikova, Radost
    Bulgaria.
    Anastassov, Youri
    Bulgaria.
    Radojićić, Julija
    Serbia.
    Pesic, Zoran
    Serbia.
    Trifunović, Branislav
    Serbia.
    Drevensek, Martina
    Slovenia.
    Spataru, Radu
    Romania.
    Boljevic, Tanja
    Montenegro.
    Dimovska, Radmila
    Republic of Macedonia.
    Naumovski, Slave
    Republic of Macedonia .
    Rumsey, Nichola
    England.
    Zucchelli, Fabio
    England.
    Sharratt, Nicholas
    England.
    Argyrides, Mario
    Cyprus.
    Klintö, Kristina
    Lund University.
    Becker, Magnus
    Lund University.
    Persson, Martin
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Translation and pilot study of the cleft hearing appearance and speech questionnaire (CHASQ)2019In: European journal of plastic surgergy, ISSN 0930-343XArticle in journal (Refereed)
    Abstract [en]

    Background

    There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument.

    Methods

    The PRO measure—CHASQ—was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis.

    Results

    Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians’ role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument.

    Conclusions

    Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families.

    Level of evidence: Not rateable.

  • 239.
    Stiernman, Mia
    et al.
    Lund University.
    Österlind, Kerstin
    Skåne University Hospital.
    Becker, Magnus
    Lund University.
    Persson, Martin
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Parental and health care professional views on psychosocial and educational outcomes in patients with cleft lip and/or cleft palate2019In: European journal of plastic surgery, ISSN 0930-343X, E-ISSN 1435-0130, Vol. 42, no 4, p. 325-336Article in journal (Refereed)
    Abstract [en]

    Background

    Earlier research has investigated psychosocial and educational issues in populations of patients with cleft identifying several areas of concern. The objective of this study was to investigate current beliefs and knowledge about psychosocial and educational issues in parents and health care professionals (HCP) of children with cleft lip and/or palate (CL/P).

    Method

    Parents were interviewed concerning the view of society on people with visible differences, their child’s social life, educational progress, and information regarding psychosocial care. Interviews with HCPs concerned characteristics related with educational achievement, behavior, and social relationships. Fifteen parents of children 9 to 13 years of age with CL/P and 10 HCPs and were interviewed. Data from interviews was analyzed with thematic analysis.

    Results

    Eight children were reported to have emotional issues related to their cleft. Eleven parents, however, did not perceive that their child was treated differently in society. HCPs expressed concerns regarding for example coping with being different, low self-esteem, shyness, disadvantage on first impression, and acceptance of themselves. A majority of the HCPs did not think patient cognition and behavioral or physical development were specifically affected.

    Conclusions

    The results revealed that parent experience and views were diverse—from no specific problems related to the cleft, to both emotional and educational issues. The beliefs and level of knowledge in HCPs also varied. All HCPs, however, wished for more information and training regarding psychosocial issues.

  • 240.
    Stuhr-Olsson, Gunnel
    et al.
    Findus.
    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.
    Garpsäter, J
    Dietisternas Riksförbund för Geriatrisk och Gerontologisk Nutrition.
    De svälter i tysthet: ge oss fler dietister2016In: Aftonbladet, ISSN 1103-9000, no 20 novemberArticle in journal (Other (popular science, discussion, etc.))
  • 241.
    Sundström, Malin
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Petersson, Pia
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Rämgård, Margareta
    Malmö University.
    Varland, Linda
    The Municipality of Kristianstad.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Health and social care planning in collaboration in olderpersons’ homes: the perspectives of older persons, familymembers and professionals2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 147-156Article in journal (Refereed)
    Abstract [en]

    Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities. The aim of this study was to gain a deeper understanding of the HSCPC-meeting from the perspectives of older persons, family members, and professionals. Ten care planning meetings from two municipalities were consecutively included. Interviews in retrospect with ten older persons, eight family members, and ten groups of professionals who had attended the HSCPC-meeting at home were analysed with a hermeneutic approach. Four themes emerged: unspoken agendas and unpreparedness, security and enhanced understanding, asymmetric relationships, and ambiguity about the mission and need for follow-up. The comprehensive interpretation is that the professionals handled the HSCPC-meeting mainly as a routine task, while the older persons and family members viewed it as part of their life course. Older persons are in an inferior institutional, cognitive and existential position. However, meeting together in the home partly reduced their inferior position. Findings from this study provide some general suggestions for how HSCPC-meetings should be designed and developed: attention of power relations, the importance of meeting skills and follow-up.

  • 242. Svensson, Carita
    et al.
    Edfors, Ellinor
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Sjuksköterskors upplevelser av faktorer som bidrar till närvaro i mötet med äldre personer2017Report (Other academic)
    Abstract [sv]

    Hur upplever sjuksköterskan mötet med den äldre personen inom kommunal vård ochomsorg? Ett sätt för sjuksköterskan att känna närvaro i mötet är genom att helhjärtatlyssna på den äldre när hen inbjuder till samtal om sina tankar eller om livshistorian.Sjuksköterskan kan genom mötet uppleva en högre mening med sitt arbete och få enmöjlighet att etablera en relation med den äldre. Att vårda äldre personer ställer högakrav på omvårdnaden där en helhetssyn med fokus på personcentrerad omvårdnadstår i centrum och kunskaper i äldre personers psykologiska och sociala åldrande kanhjälpa sjuksköterskan vara närvarande i mötet. Syftet var att beskriva sjuksköterskorsupplevelser av faktorer som bidrar till möjligheten att vara närvarande i mötet medäldre personer inom kommunal vård och omsorg. Nio intervjuer genomfördes medsjuksköterskor inom kommunal vård och omsorg. Intervjuerna analyserades med hjälpav kvalitativ innehållsanalys. Resultatet visade att sjuksköterskorna hade som sin främstaintention att prioritera mötet med vårdtagaren. Faktorer som bidrog till sjuksköterskornasmöjlighet till närvaro i mötet med äldre var relaterade till; (I) mötet i form avatt kunna bygga på en tidigare relation, att ha gemensamma beröringspunkter, att haen ömsesidig öppenhet och vilja att dela varandras glädje- och sorgeämnen (II) vårdtagareni form av att vårdtagaren har förtroende för sjuksköterskan, att vårdtagareninbjuder till samtal och vårdtagarens tillstånd (III) sjuksköterskan i form av kunskaperom vårdtagaren och betydelsen av att vara närvarande i mötet, personlig mognad ochsjälvkännedom, att vara genuint intresserad av vårdtagaren och visa respekt och attkunna hantera sina känslor, samt (IV) organisationen i form av att ha tid, att ha möjlighetatt prioritera mellan olika arbetsuppgifter, hur vårdarbetet fördelas och organiserasoch den kontext som sjuksköterskan befinner sig i. Resultatet visade att sjuksköterskornahade som intention att vara närvarande i mötet. Det var dock inte alltid så lättatt få tid till mötet på grund av tids- och/eller personalbrist, men även sjuksköterskanspersonliga mognad och erfarenhet hade betydelse för att kunna/våga vara närvarandei mötet. En positiv och stödjande arbetsledning samt ett nära samarbete med kollegersågs som viktiga resurser i det dagliga omvårdnadsarbetet.

  • 243.
    Timpka, Jonathan
    et al.
    Lund University.
    Svensson, J.
    The Swedish Institute for Health Economics (IHE), Lund.
    Nilsson, M. H.
    Skåne University Hospital, Malmö.
    Pålhagen, S.
    Lund University.
    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. Kristianstad University, Research Platform for Collaboration for Health.
    Odin, P.
    Lund University.
    Workforce unavailability in Parkinson's disease2017In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 135, no 3, p. 332-338Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Individuals with Parkinson's disease (PD) become unavailable in the workforce earlier than comparable members of the general population. This may result in significant social insurance expenses, but as workforce participation can be a source for social interaction and a vital part of the personal identity, there are likely to be personal implications extending far beyond the economic aspects. This study aimed to identify aspects that may contribute to workforce unavailability in people with PD.

    MATERIALS & METHODS: This was a cross-sectional registry study using data from the Swedish national quality registry for PD and included persons with PD in Skåne County, Sweden who were younger than 65 years. Variables were selected from the registry based on earlier studies and clinical experience and were tested for association with unavailability in the workforce: first in a series of simple regression analyses and then in a multiple logistic regression analysis.

    RESULTS: A total of 99 persons with PD-of whom 59 were available and 40 were unavailable in the workforce-were included in the study. Age (OR per year: 1.47, 95% CI: 1.18-1.85; P < 0.01) and anxiety (OR: 6.81, 95% CI: 1.20-38.67; P = 0.03) were significant contributing factors for unavailability in the workforce.

    CONCLUSIONS: Based on the findings in this exploratory study, anxiety-a potentially modifiable factor-and age may be contributing factors for workforce unavailability in PD. However, prospective studies are warranted to confirm the findings and the causation of the association between anxiety and workforce unavailability needs to be clarified.

  • 244. Ting, Wang
    et al.
    Hong, Jiang
    Junqiao, Wang
    Jingfang, Liu
    Liang, Wang
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Eating difficulties in stroke survivors: a systematic review2015In: Journal of Nursing Science, ISSN 2352-0132, Vol. 30, no 5, p. 94-99Article in journal (Refereed)
  • 245. Ting, Wang
    et al.
    Hong, Jiang
    Junqiao, Wang
    Liang, Wang
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    脑卒中患者进食困难研究进展 [A review of eating difficulties after stroke]2014In: Journal of Nursing Science (护理学杂志), Vol. 29, no 23, p. 83-86Article in journal (Refereed)
    Abstract [zh]

    从国内外进食困难概述、导致脑卒中患者进食困难的主要因素、进食困难对脑卒中患者的影响、脑卒中患者进食困难的主要评估工具及其护理干预措施等方面进行综述。吞咽障碍并不是脑卒中患者进食方面存在的唯一问题,脑卒中进食困难应有更为广泛的内涵;导致患者进食困难的主要因素包括摄食障碍、咀嚼、吞咽障碍、言语沟通障碍等;进食困难会对患者的生理、心理及日常生活产生影响;进食困难的主要评估工具包括进食障碍评估量表(EDAS)和微型进食观察表(MEOF);可通过他人协助进食、改变体位及改变食物的性状等措施改善患者的进食困难状况。提出应开展探讨我国脑卒中患者进食困难的相关研究。

  • 246.
    Vallén, Christina
    et al.
    Central Hospital, Kristianstad.
    Hagell, Peter
    Department of Health Sciences, Lund University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Validity and user-friendliness of the minimal eating observation and nutrition form version II (MEONF II) for undernutrition risk screening2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, no 55, p. 5801-Article in journal (Refereed)
    Abstract [en]

    Objective To analyze the criterion-related validity and user-friendliness of the Minimal Eating Observation and Nutrition Form – Version II (MEONF – II) and Malnutrition Universal Screening Tool (MUST) in relation to the Mini Nutritional Assessment (MNA). In addition, the effect of substituting body mass index (BMI) with calf circumference (CC) was explored for the MEONF-II. Methods The study included 100 patients who were assessed for nutritional status with the MNA (full version), considered here to be the gold standard, and screened with the MUST and the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, BMI (or calf circumference), eating difficulties, and presence of clinical signs of undernutrition. Results The MEONF-II sensitivity (0.73) and specificity (0.88) were acceptable. Sensitivity and specificity for the MUST were 0.57 and 0.93, respectively. Replacing the BMI with CC in the MEONF-II gave similar results (sensitivity 0.68, specificity 0.90). Assessors considered MEONF-II instructions and items to be relevant, easy to understand and complete (100%), and the questions to be relevant (98%). MEONF-II and MUST took 8.8 and 4.7 minutes to complete, respectively, and both were considered relevant and easy to finish. In addition, MEONF-II was thought to reveal problems that allows for nursing interventions. Conclusions The MEONF-II is an easy to use, relatively quick, and sensitive screening tool to assess risk of undernutrition among hospital inpatients, which allows for substituting BMI with CC in situations where measures of patient height and weight cannot be easily obtained. High sensitivity is of primary concern in nutritional screening and the MEONF-II outperforms the MUST in this regard.

  • 247.
    Wagachchige Muthucumarana, Muditha
    et al.
    Sri Lanka.
    Samarasinghe, Kerstin
    Kristianstad University, Faculty of Health Science.
    Elgán, Carina
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Caring for stroke survivors: experiences of family caregivers in Sri Lanka – a qualitative study2018In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, no 6, p. 397-402Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Stroke is a life-changing event for both stroke survivors and their family caregivers. After receiving acute care at the hospital, family members are expected to take care of stroke survivors at home and to continue treatment and rehabilitation. The new role of "informal caregiver" is a challenge that creates many difficulties for family caregivers that are not explicit in the Sri Lankan context.

    OBJECTIVES:

    This study aimed at exploring family caregivers' experiences of providing informal care for dependent stroke survivors.

    METHODS:

    The sample was chosen by purposive sampling with a maximum variation by age, ethnicity, religion, educational level, relationship, and monthly income. Ten informal family caregivers to stroke survivors with hemiplegia who had been treated at the National Hospital of Sri Lanka participated in in-depth interviews analyzed using conventional content analysis.

    RESULTS:

    Qualitative content analysis of data resulted in an overriding theme, "Caring with love, against all odds," along with four categories, "Life alterations," "Lack of resources," "Compassionate care," and "Coping strategies." Although the increased workload, restricted social life, physical problems, and knowledge and financial deficits were challenging for the family caregivers, self-strength and supportive social networks helped them to compassionately care for their stroke survivor.

    CONCLUSIONS:

    The phenomenon of family caregivers providing informal care for stroke survivors was explicated as compassionate care, notwithstanding numerous difficulties. The findings motivate further research and strategies to minimize family caregivers' burden and facilitate the positive aspects of caregiving to promote the health and well-being of both stroke survivors and their families.

  • 248.
    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.

  • 249.
    Wendin, Karin
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Pajalic, Zada
    Örtman, Gerd
    Blücher, Anna
    Andersson, Håkan
    Lindborg, Ann-Louise
    Fogelberg, J
    Borgenstierna, C
    Nyberg, Maria
    Olsson, Viktoria
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    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.
    Mat, Näring och Robotar2014In: Dietistaktuellt, Vol. 23, no 5, p. 18-20Article in journal (Other (popular science, discussion, etc.))
  • 250.
    Wendin, Karin
    et al.
    Kristianstad University, Faculty of Natural Science, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, Faculty of Natural Science, Avdelningen för mat- och måltidsvetenskap.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Undernäring hos äldre med neurologisk sjukdom2019In: Neurologi i Sverige, ISSN 2000-8538, Vol. 2, no 19, p. 28-31Article in journal (Other academic)
    Abstract [sv]

    Maten och måltiderna är viktiga delar av våra liv. Det handlar om allt från hälsa och överlevnadtill social samvaro och kulturella aktiviteter. Vid sjukdom eller plötsliga förändringari livet ställs mycket på ända som kan ha en stor inverkan på vårt ätande och därmed på vårhälsa, vilket i sin tur kan leda till undernäring. Neurologiska sjuk domar och åldrande är vanligaorsaker till undernäring. I denna artikel ger professorerna Karin Wendin och AlbertWestergren, båda vid Högskolan Kristianstad, en översiktlig beskrivning av undernäring,vad det innebär att vara drabbad och vad man kan göra för att motverka undernäring.”Både åldrandet i sigoch neurologisk sjukdombidrar till minskadaktivitet och sannoliktminskad aptit.”

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