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Siebmanns, S., Ulander, M., Sandberg, J., Johansson, L., Johansson, P. & Broström, A. (2018). Internet-based CBT for insomnia in the general population - a description of design, measurements and interventions in recent RCT studies. Paper presented at 24th Congress of the European-Sleep-Research-Society (ESRS), Basel, SWITZERLAND, SEP 25-28, 2018. Journal of Sleep Research, 27(1, SI), 290-291, Article ID P436.
Open this publication in new window or tab >>Internet-based CBT for insomnia in the general population - a description of design, measurements and interventions in recent RCT studies
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 1, SI, p. 290-291, article id P436Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Objectives/Introduction: Internet-based cognitive behavioural therapy for insomnia (ICBTi) has been proposed as an effective, accessible, non-pharmacologic treatment for insomnia disorder. The objective was to perform a literature review of published randomized controlled trials (RCT).

Methods: Literature review. PubMed was used to identify RCTs ofICBTi published since 2013. Keywords were insomnia, ICBT and RCT. The search resulted in 40 hits. Papers with study designs and methods not relevant to the objective were removed (n = 29). Reasons for exclusion were: only study protocol, not internet-based, and results based on old data.

Results: Design: Recruitment were done via e-mail, from websites, online ads, and advertisements in local newspapers.

Inclusion criteria: Six studies based their inclusion only on ISI score (from >7to>=15). 3 studies used a combination of ISI and DSM-IV. Two studies used DSM-IV only.

Sample sizes: 4 studies had less than 100 participants, and 2 studies over 200, the mean number was 139 participants (48-303). The mean age varied from 15 to 52 years. Significantly more female participants in all studies.

Data collection: ISI combined with sleep diary was the most commonly used primary or secondary outcome measurements (n =7), 2 used ISI only, and 2 used sleep diary only. Other common instruments were, PSQI, HADS, DBAS-16 and CES-D. All studies had pre- and post-treatment measurements, but none during the intervention. The follow-up-period varied between 8 weeks and 3 years. The most common follow-up time was 6 months (n = 4), with a range from 4 weeks3years.Intervention: Most of the studies (n = 10) used traditional ICBTi-treatments (i.e., stimulus control, sleep restriction, relaxation, sleep hygiene). One study did not include stimulus control. The treatment duration were six weeks (n = 8), eight weeks (n = 2) and nine weeks (n = 1). All except one used therapist guided support.

Results: All studies showed significant post treatment improvements on sleep outcomes.

Conclusions: All studies showed significant improvement with regard to sleep. The total number of participants in the studies was relatively low. Most studies are not based on clinical samples, which may affect the generalizability of the findings.

Disclosure: Nothing to disclose

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-41659 (URN)000444228300618 ()
Conference
24th Congress of the European-Sleep-Research-Society (ESRS), Basel, SWITZERLAND, SEP 25-28, 2018
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-01Bibliographically approved
Siebmanns, S., Ulander, M., Sandberg, J., Johansson, L., Johansson, P. & Broström, A. (2018). "You can’t always get what you want” - methodological challenges with an internet-based CBT intervention for insomnia among patients with cardiovascular disease. Paper presented at 24th Congress of the European-Sleep-Research-Society (ESRS), Basel, SWITZERLAND, SEP 25-28, 2018. Journal of Sleep Research, 27(1, SI), 291-291, Article ID P437.
Open this publication in new window or tab >>"You can’t always get what you want” - methodological challenges with an internet-based CBT intervention for insomnia among patients with cardiovascular disease
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 1, SI, p. 291-291, article id P437Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Objectives/Introduction: Internet‐based cognitive behavioural therapy for insomnia (ICBTi) is a frequently used intervention. Published studies are promising, but methodological limitations (e.g., heterogeneity, low number of participants, unclear adherence to the intervention) have been reported. The aim was to describe methodological challenges perceived in the Hit‐IT study, an ongoing ICBTi study for patients with insomnia and cardiovascular disease (CVD).

The Hit‐IT study: Design: RCT with 1‐year follow‐up. All patients with CVD (i.e., myocardial infarction, heart failure, atrial fibrillation and angina) from 6 primary care centers are screened for insomnia and during a clinical examination diagnosed according to DSM‐V criteria.Intervention: 9 weeks I‐CBTi (1‐week introduction, 2 weeks psychoeducation on CVD/insomnia, 6 weeks of sleep hygiene, stimulus control and sleep restriction) vs 3 weeks internet‐based sleep hygiene education.Questionnnaires: Sleep (Pittsburg Sleep Quality Index, Insomnia Severity Index, sleep diary), depressive‐ and cardiac symptoms (Patient Health Qurestionnaire‐9, Cardiac Anxiety Questionnaire) and Quality of Life (SF‐12) at baseline, during and after intervention (after 6 and 12 months).

Methods: Interim analysis with descriptive statistics.

Results: Out of 2170 approached patients with diagnosed CVD1508 (70%) responded (No=1330/Yes=178). Of the 178 approvals (124 men/54 women), 54 did not complete internet‐based screening (no e‐mail, declined participation and for unknown reasons). Of the 124 participants who completed screening, 40 (34 men/6 women, age range 42‐84 years) were excluded (ISI < 8). In addition, 32 were excluded after telephone contact and clinical examination (declined participation n = 10, no clinical insomnia n = 14, sleep apnea n = 4,restless legs n = 2, epilepsy n = 1, pharmacological side effect n = 1). Currently 46 participants have been randomized in the Hit‐IT study (15 females, 31 males, mean age 71 years/Range 41‐92 years). 19 participants have completed control group (1 dropout related to technical problems, 3 in treatment). In the intervention group, 6 have completed, 4 intentions to treat, 3 dropouts (n = 2 unknown reason, n = 1 technical problems), 10 participants in treatment.

Conclusions: Clear methodological challenges with regard to the strenuous patient inclusion process are identified. The current study has a higher mean age and higher number of participating men than current ICBTi studies in general population.

Disclosure: Nothing to disclose.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Neurology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-41696 (URN)000444228300619 ()
Conference
24th Congress of the European-Sleep-Research-Society (ESRS), Basel, SWITZERLAND, SEP 25-28, 2018
Available from: 2018-10-02 Created: 2018-10-02 Last updated: 2018-10-02Bibliographically approved
Hellström, I., Håkansson, C., Eriksson, H. & Sandberg, J. (2017). Development of older men’s caregiving roles for wives with dementia. Scandinavian Journal of Caring Sciences, 31(4), 957-964
Open this publication in new window or tab >>Development of older men’s caregiving roles for wives with dementia
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 957-964Article in journal (Refereed) Published
Abstract [en]

This secondary analysis of qualitative interviews describes how older Swedish men approach the caregiver role for a wife with dementia, over time. An increasing number of male caregivers will become primary caregivers for partners living with dementia at home, and they will likely be caregivers for an extended period of time. It has been stated that caregiving experiences influence how older men think of themselves. The theoretical starting point is a constructivist position, offering an understanding of older caregiving men's constructions and reconstructions of themselves and their caregiver roles. Seven men, who were cohabiting with their wives, were interviewed on up to five occasions at home during a 5- to 6-year period. The findings comprise three themes; me and it, me despite it, it is me, depict how these men gradually take on and normalise the caregiving tasks, and how they develop and internalise a language based on their caring activities. The results provide understanding about the relationship between men as caregivers and how this influences them as individuals. By careful attention to each caregiving man's individual needs rather than making gendered assumptions about men and caring, the aim of the caregiver support for men might best target men's own meaning to the caring in their the everyday practices.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
constructivism; dementia; gender; informal caregivers; older men; secondary analysis
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-34740 (URN)10.1111/scs.12419 (DOI)000416413000035 ()28124456 (PubMedID)2-s2.0-85035332781 (Scopus ID)
Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2018-03-14Bibliographically approved
Boström, M., Ernsth Bravell, M., Björklund, A. & Sandberg, J. (2017). How older people perceive and experience sense of security when moving into and living in a nursing home: [Hur äldre personer uppfattar och erfar trygghet i flytt till och boende i särskilt boende för äldre. En fallstudie]. European Journal of Social Work, 20(5), 697-710
Open this publication in new window or tab >>How older people perceive and experience sense of security when moving into and living in a nursing home: [Hur äldre personer uppfattar och erfar trygghet i flytt till och boende i särskilt boende för äldre. En fallstudie]
2017 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 20, no 5, p. 697-710Article in journal (Refereed) Published
Abstract [en]

Sense of security is important throughout the lifespan not at least in advanced age with increased risks of functional declines and decreased social capital. Despite this, knowledge concerning older person’s perceptions and experiences of sense of security when moving into nursing homes is scarce. This study is a longitudinal, descriptive, exploratory case study with in-depth interviews and observations of three older persons in the age of 87, 88, and 91 years in a mid-sized municipality in the south of Sweden, in order to highlight how sense of security is experienced when moving into and living in a nursing home. Data were analysed using qualitative content analysis, which resulted in one main theme and four categories. The main theme, ‘Adaptation and sense of security’, indicates older persons’ need to adapt to the new context of the nursing home, and how this relates to their sense of security. The categories – ‘Control’, ‘Struggling for understanding’, ‘Lack of influence’, and ‘Grasping’ – suggest that older persons’ sense of security is reduced when they must adjust to routines without sufficient management and understanding. When able to maintain control over daily routines, and felt as a part of the new context, they perceived a sense of security.

Abstract [sv]

Trygghet är viktigt genom hela livet, inte minst som äldre med tilltagande funktionedsättningar. Kunskap behövs gällande äldre personers uppfattning av trygghet i flytt från ordinärt till särskilt boende. Syftet med studien var att öka förståelsen av hur äldre personer med skiftande omsorgsbehov uppfattar och erfar trygghet, i flytt från ordinärt till särskilt boende. En explorativ fallstudie med intervjuer och observation av tre äldre personer i åldrarna 87, 88 och 91 år genomfördes över en tidsperiod på 3 -4 månader; före flytten till särskilt boende; 3 -5 dagar efter flytt; 2 -4 veckor efter flytt då genomförandeplanen ägde rum och slutligen efter 12 -16 veckor efter flytt. Vid varje intervjutillfälle användes samma fokusområden och följdfrågor. Kvalitativ innehållsanalys användes för att analysera datamaterialet, vilket resulterade i ett huvudtema och fyra kategorier. Huvudtemat indikerar äldre personer genom hela flyttprocessen behöver anpassa sig till den nya miljön på särskilt boende för att uppleva trygghet. Anpassning till de nya rutinerna gav visserligen struktur i vardagen och uppfattades som en säkerhet, men inte nödvändigtvis som trygghet. Då de äldre personerna kunde behålla kontrollen och kunskapen över dagliga rutiner, och kände sig som en del av den nya sammanhang uppfattas de en känsla av trygghet.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Case study, control, routines, in-depth interviews, sense of security, fallstudie, upplevelse av kontroll, rutiner, djupintervju, känsla av trygghet
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-23857 (URN)10.1080/13691457.2016.1255877 (DOI)000413972900008 ()2-s2.0-85002050769 (Scopus ID)
Available from: 2014-05-23 Created: 2014-05-23 Last updated: 2018-01-24Bibliographically approved
Lind, S., Wallin, L., Brytting, T., Fürst, C. J. & Sandberg, J. (2017). Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions. Health Policy, 121(11), 1194-1201
Open this publication in new window or tab >>Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions
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2017 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 121, no 11, p. 1194-1201Article in journal (Refereed) Published
Abstract [en]

In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care. 

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Acute care hospital, Consolidated framework for implementation research, Guidelines, Implementation, Palliative care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
urn:nbn:se:hj:diva-37669 (URN)10.1016/j.healthpol.2017.09.011 (DOI)000415782400013 ()28969921 (PubMedID)2-s2.0-85030319378 (Scopus ID)
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2018-02-27Bibliographically approved
Siebmanns, S., Ulander, M., Sandberg, J., Johansson, L., Johansson, P. & Broström, A. (2017). Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S31-S31
Open this publication in new window or tab >>Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S31-S31Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Insomnia is defined as a subjective complaint of difficulty to initiate sleep, difficulty to maintain sleep, and early morning awakenings that occur at a minimum of 3 nights per week for 3 months. The prevalence of insomnia in the general adult population is estimated to 12–20%. The prevalence is even higher among those with cardiovascular disease (CVD). Insomnia has a significant impact on the individual’s health and quality of life.

Aim: To examine causes, consequences and nursing interventions for insomnia in patients with CVD.

Design: Literature review.

Method: Electronic search through PubMed and Cinahl for studies published 2001-2016. Insomnia, CVD, causes, consequences, interventions and nurse-led intervention were used as keywords. Detected duplicates, irrelevant studies and others (i.e., editorials, letters) were removed. “Insomnia and CVD” resulted in 214 hits, “insomnia and CVD and causes” in 394 hits, “insomnia and CVD and consequences” in 35 hits, and “insomnia and CVD and interventions” resulted in 51 hits.

Results: Insomnia causes impaired daytime functioning, poorer cognitive function and a feeling of isolation. The pathophysiological consequences of insomnia are associated with increased risk for arteriosclerosis and CVD (i.e., caused by an increased inflammatory processes). Pharmacological treatment for insomnia have been used for some time (i.e., sedative, hypnotics and antidepressant), but there are concerns about tolerance and dependence, as well as other side effects (i.e., falls, cognitive changes and unusual sleep behaviours) which requires a thorough risk and benefit analysis before prescription. Non-pharmacological treatments such as Cognitive behavioural therapy (CBT) and internet-based CBT (I-CBT) for insomnia, led by therapists, is a less expensive intervention used in previous studies for othe rpatient groups. Despite positive results for both CBT andI-CBT (i.e., improved performance, increased quality of life and reduced symptom burden) in these studies no nurse-led interventions (i.e., of any type) intended for patients with CVD and insomnia were found.

Conclusion: I-CBT for insomnia seems to be an accessible and effective treatment for other patient groups. The lack of nurse-led interventions, highlights the need for future studies in patients with CVD and insomnia.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-36001 (URN)000401775600051 ()
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-12 Created: 2017-06-12 Last updated: 2017-06-12Bibliographically approved
Siebmanns, S., Ulander, M., Sandberg, J., Johansson, L., Johansson, P. & Broström, A. (2017). Internet-based Intervention to treat insomnia in patients with cardiovascular disease. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S75-S75
Open this publication in new window or tab >>Internet-based Intervention to treat insomnia in patients with cardiovascular disease
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S75-S75Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Insomnia (i.e., trouble initiating sleep,maintaining sleep or difficulties getting enough sleep) is a prevalent problem among patients with cardiovascular disease (CVD). It is associated with physical and mental symptoms such as impaired daytime functioning, worries and depressive symptoms. Recent studies in other patient groups have described Internet-based Cognitive behavioral treatment (I-CBT) as a promising accessible and cost effective intervention. Few if any studies are conductedin CVD patients with insomnia despite the possibility of reduced symptom burden, reduced cardiovascular morbidity and improved quality of life (QoL).

Aim: To describe the design, content and measures in theHit-IT study, an intervention developed to treat insomnia in patients with CVD.

Design: An explorative design with 1 year followup including 200 primary care patients with CVD and insomnia from 4 centers. Patients will be randomized to 9 weeks of I-CBT, or to a control group receiving internetbased sleep hygiene without support.

CONTENT: The I-CBT intervention starts with a 1 week introduction, 2 weeks of psychoeducation (i.e., CVD and insomnia), followed by a 6 weeks treatment part (i.e., sleep hygiene, stimulus control and sleep restriction). Participants can communicate with a nurse and receive feedback during treatment. A psychologist will act as back-up.

MEASURES: Questionnaires will be administered at baseline, during and post intervention at 6 and 12 months’. The questionnaires will focus on e.g., educational effects, as well as on effects regarding symptoms; sleep/insomnia (PSQI, ISI, ESS, sleep diary), depressive symptoms (PHQ-9), as well as QoL (SF12). The participants’ experience of the program will be explored by repeated interviews (at baseline, after 3 weeks, 6 weeks and after the intervention).

Conclusion: Depending on its effectiveness a nurseled I-CBT program can be a possible tool for insomnia treatment in cardiovascular care.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-35921 (URN)000401775600127 ()
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2017-06-09Bibliographically approved
Dalteg, T., Sandberg, J., Malm, D., Sandgren, A. & Benzein, E. (2017). The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation. Journal of Clinical Nursing, 26(21-22), 3699-3709
Open this publication in new window or tab >>The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation
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2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, p. 3699-3709Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To explore illness beliefs in couples where one spouse has atrial fibrillation.

Background: Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation.

Design: A qualitative hermeneutic design.

Methods: Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation.

Results: The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief 'The heart is a representation of life', two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief 'Change is an integral part of life', two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief 'Adaptation is fundamental in life', two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

Conclusion: Couples' interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Atrial fibrillation; Couples; Hermeneutics; Illness beliefs; Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-32270 (URN)10.1111/jocn.13742 (DOI)000417389400041 ()28122413. (PubMedID)2-s2.0-85017403061 (Scopus ID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-01-03Bibliographically approved
Dalteg, T., Sandberg, J., Malm, D., Sandgren, A. & Benzein, E. (2017). The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S41-S41, Article ID 116.
Open this publication in new window or tab >>The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S41-S41, article id 116Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple’s illness beliefs play an important role in convalescence and illness management, and no previous studies have examined illness beliefs in couples living with AF.

Purpose: To explore illness beliefs in couples where one spouse has atrial fibrillation.

Methods: Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with AF.

Results: The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief “Theheart is a representation of life,” two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief “Change is an integral part of life,” two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief “Adaptation is fundamental in life,” two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

Conclusion: Couples’ interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-35994 (URN)000401775600071 ()
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-12 Created: 2017-06-12 Last updated: 2018-07-04Bibliographically approved
Lind, S., Wallin, L., Brytting, T., Furst, C. J. & Sandberg, J. (2016). Implementation of evidence-based palliative care in acute care hospitals: Obstacles and opportunities as described by politicians, hospital managers and health care professionals. Paper presented at 9th World Research Congress of the European Association for Palliative Care (EAPC), Dublin, Ireland, 9-11 June 2016. Palliative Medicine: A Multiprofessional Journal, 30(6), NP300, Article ID PO114.
Open this publication in new window or tab >>Implementation of evidence-based palliative care in acute care hospitals: Obstacles and opportunities as described by politicians, hospital managers and health care professionals
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2016 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 30, no 6, p. NP300-, article id PO114Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: In high income countries, such as Sweden, a large proportion of all deaths occur at hospitals which is commonly not consistent with the desire of the patient and next-of-kin. A common way to translate knowledge into clinical practice is to create practice guidelines for different levels of the health care organization. During the last years, national clinical guidelines for palliative care and guidance from the NBHW have been published for the first time in Sweden. Hence, the aim of this study was to identify perceptions of obstacles and opportunities for implementation of evidence-based palliative care in acute care hospitals, as described by local politicians, chief medical officers and health care professionals.

Method: Interviews were conducted with local politicians, chief medical officers and health care professionals and analysed through a directed qualitative content method, guided by The Consolidated Framework for Implementation Research.

Results: Palliative care was commonly mentioned as a comprehensive way for alleviation of patients’ suffering with the overall goal for maintaining quality of life, especially in end of life care. Palliative care at the hospital was described by the staff as characterized by sudden disease, rapid changes back and forth between life and death and difficulties to predict the outcome. The environment, the culture, poor communication and poor cooperation in the work team were described as obstacles for implementation. The informants mentioned the newly published documents as important but the knowledge about the content varied a lot. A newly formed internal group with the assignment to develop the palliative care at the clinic was emphasized by all health care professionals as a good opportunity to get support and local guidelines.

Conclusion: An active process at different levels in the health care organization is important for a successful implementation of evidence-based palliative care in acute care hospitals.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-34741 (URN)0.1177/0269216316646056 (DOI)
Conference
9th World Research Congress of the European Association for Palliative Care (EAPC), Dublin, Ireland, 9-11 June 2016
Note

Abstracts of the 9th World Research Congress of the European Association for Palliative Care (EAPC).

Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2017-11-29Bibliographically approved
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