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Hellström, A., Hagell, P., Broström, A., Ulander, M., Luik, A. I., Espie, C. A. & Årestedt, K. (2019). A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data. PLoS ONE, 14(3), 1-13, Article ID e0213533.
Open this publication in new window or tab >>A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 3, p. 1-13, article id e0213533Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Insomnia symptoms are common among young adults and affect about 5% to 26% of 19 to 34-year-olds. In addition, insomnia is associated with poor mental health and may affect daily performance. In research, as well as in clinical practice, sleep questionnaires are used to screen for and diagnose insomnia. However, most questionnaires are not developed according to current DSM-5 diagnostic criteria. An exception is the recently developed Sleep Condition Indicator (SCI), an eight-item scale screening for insomnia.

AIM: The aim of this study was to perform a Classical Test Theory (CTT) based psychometric evaluation of the SCI in a sample of Swedish university students, by taking the ordinal nature of item level data into account.

METHODS: The SCI was translated into Swedish and distributed online to undergraduate students at three Swedish universities, within programs of health, psychology, science or economy. Of 3673 invited students, 634 (mean age 26.9 years; SD = 7.4) completed the questionnaire that, in addition to the SCI, comprised other scales on sleep, stress, lifestyle and students' study environment. Data were analyzed according to CTT investigating data completeness, item homogeneity and unidimensionality.

RESULTS: Polychoric based explorative factor analysis suggested unidimensionality of the SCI, and internal consistency was good (Cronbach's alpha, 0.91; ordinal alpha, 0.94). SCI scores correlated with the Insomnia Severity Index (-0.88) as well as with sleep quality (-0.85) and perceived stress (-0.50), supporting external construct validity.

CONCLUSIONS: These observations support the integrity of the of the SCI. The SCI demonstrates sound CTT-based psychometric properties, supporting its use as an insomnia screening tool.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Psychology Neurology
Identifiers
urn:nbn:se:hj:diva-43397 (URN)10.1371/journal.pone.0213533 (DOI)000461166300038 ()30870454 (PubMedID)2-s2.0-85062951355 (Scopus ID)GOA HHJ 2019;HHJADULTIS (Local ID)GOA HHJ 2019;HHJADULTIS (Archive number)GOA HHJ 2019;HHJADULTIS (OAI)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-03-29Bibliographically approved
Saffari, M., Lin, C.-Y., Koenig, H. G., O’Garo, K.-G. N., Broström, A. & Pakpour, A. H. (2019). A Persian version of the Affiliate Stigma Scale in caregivers of people with dementia. Health Promotion Perspectives, 9(1), 31-39
Open this publication in new window or tab >>A Persian version of the Affiliate Stigma Scale in caregivers of people with dementia
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2019 (English)In: Health Promotion Perspectives, ISSN 2228-6497, Vol. 9, no 1, p. 31-39Article in journal (Refereed) Published
Abstract [en]

Background:

Dementia is prevalent among older adults and frequently causes dependence on family caregivers. Caregivers may experience a form of stigmatization called affiliate stigma that negatively affects their mental health. The current study sought to establish the psychometric properties of a tool to measure affiliate stigma among Iranian caregivers.

Methods:

Overall, 541 caregivers of older people with dementia were included in this cross-sectional study. Several measures were used to assess the psychometric properties of the Affiliate Stigma Scale (ASS) including the Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Short Form 12 (SF-12), Rosenberg Self-Esteem Scale (RSES), and Multidimensional Scale of Perceived Social Support (MSPSS). Convergent and discriminate validity were examined. Exploratory and confirmatory factor analyses were utilized to assess the factor structure of the ASS and a Rasch model was used to evaluate the measurement functioning of the scale.

Results:

Factor loadings ranged from 0.69 to 0.83 and test-retest reliability from 0.72 to 0.89. Item difficulty ranged widely from -0.66 to 0.89. No considerable differential item functioning (DIF) was found across gender. Confirmatory factor analysis confirmed the three cognitive, affective, and behavioral dimensions of the scale (comparative fit index [CFI]=0.931 to 0.995, root mean square error of approximation [RMSEA]=0.046 to 0.068). Internal consistency was acceptable (Cronbach’s alpha: 0.88 to 0.94). Significant and positive relationships were found between affiliate stigma and depression, anxiety, and caregiving burden (beta = 0.35 to 0.46).

Conclusion:

The ASS is a psychometrically valid measure for assessing affiliate stigma in Iranian caregivers of people with dementia. Application of this tool among other caregivers, languages and cultures deserves further study.

Place, publisher, year, edition, pages
Tabriz University of Medical Sciences, 2019
Keywords
Stigma, Family caregivers, Dementia, Psychometrics
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-43112 (URN)10.15171/hpp.2019.04 (DOI)000456575000004 ()30788265 (PubMedID)2-s2.0-85065551653 (Scopus ID)POA HHJ;HHJADULTIS (Local ID)POA HHJ;HHJADULTIS (Archive number)POA HHJ;HHJADULTIS (OAI)
Available from: 2019-02-20 Created: 2019-02-20 Last updated: 2019-06-12Bibliographically approved
Lin, C.-Y., Cheng, A. S. K., Nejati, B., Imani, V., Ulander, M., Browall, M., . . . Pakpour, A. H. (2019). A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer. Journal of Sleep Research, Article ID e12891.
Open this publication in new window or tab >>A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer
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2019 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, article id e12891Article in journal (Refereed) Epub ahead of print
Abstract [en]

For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia – Athens Insomnia Scale and Insomnia Severity Index – among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61–0.87; test–retest reliability = 0.72–0.82; infit mean square = 0.81–1.17; outfit MnSq = 0.79–1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61–0.81; test–retest reliability = 0.72–0.82; infit mean square = 0.72–1.14; outfit mean square = 0.76–1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
confirmatory factor analysis, insomnia, oncology, psychometrics, Rasch analysis, sleep disorders
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-45538 (URN)10.1111/jsr.12891 (DOI)31328319 (PubMedID)2-s2.0-85069828622 (Scopus ID);HHJADULTIS (Local ID);HHJADULTIS (Archive number);HHJADULTIS (OAI)
Available from: 2019-08-12 Created: 2019-08-12 Last updated: 2019-08-12
Strand, M., Broström, A. & Haugstvedt, A. (2019). Adolescents' perceptions of the transition process from parental management to self-management of type 1 diabetes.. Scandinavian Journal of Caring Sciences, 33(1), 128-135
Open this publication in new window or tab >>Adolescents' perceptions of the transition process from parental management to self-management of type 1 diabetes.
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 1, p. 128-135Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to describe how adolescents perceive the transition from being dependent on their parents to managing their own type 1 diabetes.

DESIGN: An explorative design with a phenomenographic approach was used.

METHODS: Semistructured interviews took place during 2016-2017 with 18 strategically sampled adolescents (7 boys and 11 girls, aged 16-18 years) with type 1 diabetes from five Norwegian paediatric diabetes centres.

FINDINGS: Three descriptive categories, each comprising three perceptions, emerged: (1) Taking responsibility for own diabetes is a process comprised 'It is natural to take over responsibility for own diabetes', 'Expectations from parents and healthcare personnel', and 'The adolescents want more independence'. (2) Taking responsibility for own diabetes was dependent on coping comprised 'Feeling proud to handle their own diabetes', 'The transition is like a roller coaster', and 'Taking responsibility means that it is your fault if you make mistakes'. (3) It is demanding to take responsibility for own diabetes comprised 'Taking responsibility for own diabetes requires knowledge and skills', 'It is time-consuming to take responsibility for own diabetes', and 'Having responsibility for own diabetes is like being examined every day'.

CONCLUSIONS: Adolescents want to take over the responsibility for their diabetes treatment from their parents, but they need knowledge, experience and skills to succeed. Parents, friends and health professionals are important supporters during the transition.

RELEVANCE TO CLINICAL PRACTICE: Health professionals need to know their patients to identify the adolescents' need for support. Self-care is considered essential in the management of diabetes. Education sessions are an important part of the transition to control own diabetes. Such education should also include parents and friends.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
adolescents, interviews, phenomenographic approach, qualitative method, transition, type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:hj:diva-41572 (URN)10.1111/scs.12611 (DOI)000462154100013 ()30152532 (PubMedID)2-s2.0-85053204767 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2018-09-25 Created: 2018-09-25 Last updated: 2019-04-11Bibliographically approved
Johansson, P. A., Westas, M., Andersson, G., Alehagen, U., Broström, A., Jaarsma, T., . . . Lundgren, J. (2019). An internet-based cognitive behavioral therapy program adapted to patients with cardiovascular disease and depression: Randomized controlled trial. Journal of Medical Internet Research, 21(10), 1-14, Article ID e14648.
Open this publication in new window or tab >>An internet-based cognitive behavioral therapy program adapted to patients with cardiovascular disease and depression: Randomized controlled trial
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2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 10, p. 1-14, article id e14648Article in journal (Refereed) Published
Abstract [en]

Background: Depression is a common cause of reduced well-being and prognosis in patients with cardiovascular disease (CVD). However, there is a lack of effective intervention strategies targeting depression.

Objective: The study aimed to evaluate the effects of a nurse-delivered and adapted internet-based cognitive behavioral therapy (iCBT) program aimed at reducing depression in patients with CVD.

Methods: A randomized controlled trial was conducted. A total of 144 patients with CVD with at least mild depression (Patient Health Questionnaire–9 [PHQ-9] score ≥5) were randomized 1:1 to a 9-week program of iCBT (n=72) or an active control participating in a Web-based discussion forum (online discussion forum [ODF], n=72). The iCBT program, which included 7 modules, was adapted to fit patients with CVD. Nurses with an experience of CVD care provided feedback and a short introduction to cognitive behavioral therapy. The primary outcome, depression, was measured using PHQ-9. Secondary outcomes were depression measured using the Montgomery-Åsberg Depression Rating Scale–self-rating version (MADRS-S), health-related quality of life (HRQoL) measured using Short Form 12 (SF-12) survey and EuroQol Visual Analogue Scale (EQ-VAS), and the level of adherence. An intention-to-treat analysis with multiple imputations was used. Between-group differences in the primary and secondary outcomes were determined by the analysis of covariance, and a sensitivity analysis was performed using mixed models.

Results: Compared with ODF, iCBT had a significant and moderate treatment effect on the primary outcome depression (ie, PHQ-9; mean group difference=−2.34 [95% CI −3.58 to −1.10], P<.001, Cohen d=0.62). In the secondary outcomes, compared with ODF, iCBT had a significant and large effect on depression (ie, MADRS-S; P<.001, Cohen d=0.86) and a significant and moderate effect on the mental component scale of the SF-12 (P<.001, Cohen d=0.66) and the EQ-VAS (P<.001, Cohen d=0.62). Overall, 60% (n=43) of the iCBT group completed all 7 modules, whereas 82% (n=59) completed at least half of the modules. No patients were discontinued from the study owing to a high risk of suicide or deterioration in depression.

Conclusions: Nurse-delivered iCBT can reduce depression and improve HRQoL in patients with CVD, enabling treatment for depression in their own homes and at their preferred time.

Place, publisher, year, edition, pages
Journal of Medical Internet Research, 2019
Keywords
Cardiovascular disease, Cognitive behavior therapy, Depression, Internet, Randomized controlled trial
National Category
Nursing Cardiac and Cardiovascular Systems Psychiatry
Identifiers
urn:nbn:se:hj:diva-46729 (URN)10.2196/14648 (DOI)000489649600001 ()31584000 (PubMedID)2-s2.0-85073221407 (Scopus ID)GOA HHJ 2019 (Local ID)GOA HHJ 2019 (Archive number)GOA HHJ 2019 (OAI)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Ericsson, C., Skagerström, J., Schildmeijer, K., Årestedt, K., Broström, A., Pakpour, A. H. & Nilsen, P. (2019). Can patients contribute to safer care in meetings with healthcare professionals? A cross-sectional survey of patient perceptions and beliefs.. BMJ Quality and Safety, 28(8), 657-666, Article ID bmjqs-2018-008524.
Open this publication in new window or tab >>Can patients contribute to safer care in meetings with healthcare professionals? A cross-sectional survey of patient perceptions and beliefs.
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2019 (English)In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 28, no 8, p. 657-666, article id bmjqs-2018-008524Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate patients' perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings.

DESIGN: Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics.

SETTING: The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017.

PARTICIPANTS: Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units).

MAIN OUTCOME MEASURES: Patients' perceptions of meetings with physicians and nurses, beliefs concerning patients' contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years.

RESULTS: Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years.

CONCLUSIONS: Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
adverse events, epidemiology and detection, medical error, measurement/epidemiology, patient safety, patient satisfaction
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
urn:nbn:se:hj:diva-44175 (URN)10.1136/bmjqs-2018-008524 (DOI)000477894500008 ()31018984 (PubMedID)2-s2.0-85065298242 (Scopus ID)HOA HHJ 2019;HHJÖvrigtIS (Local ID)HOA HHJ 2019;HHJÖvrigtIS (Archive number)HOA HHJ 2019;HHJÖvrigtIS (OAI)
Available from: 2019-06-07 Created: 2019-06-07 Last updated: 2019-08-09Bibliographically approved
Nejati, B., Lin, C.-C., Aaronson, N. K., Cheng, A. S. K., Browall, M., Lin, C.-Y., . . . Pakpour, A. H. (2019). Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma. Psycho-Oncology, 28(7), 1490-1497
Open this publication in new window or tab >>Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma
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2019 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 7, p. 1490-1497Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To identify determinants of shared decision making in patients with multiple myeloma (MM) to facilitate the design of a program to maximize the effects of shared decision making.

METHODS: This prospective longitudinal study recruited 276 adult patients (52% male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS), Patient Communication Pattern Scale (PCPS), and 9-Item Shared Decision-Making Questionnaire (SDM-Q-9) at baseline and the SDM-Q-9 again 6 months later. One family member of the patient completed the Family Decision-Making Self-Efficacy (FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate the associations between eHealth literacy (eHEALS), trust in the health care system (MTHCSS), self-efficacy in family decision making (FDMSE), patient communication pattern (PCPS), and shared decision making (SDM-Q-9).

RESULTS: SEM showed satisfactory fit (comparative fit index = 0.988) and significant correlations between the following: eHealth literacy and trust in the health care system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern (β = 0.242, P < 0.001); trust in the health care system and patient communication pattern (β = 0.397, P < 0.001); self-efficacy in family decision making and patient communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision making (β = 0.267, P < 0.001); and patient communication pattern and shared decision making (β = 0.349, P < 0.001).

CONCLUSIONS: Patient communication and eHealth literacy were found to be important determinants of shared decision making. These factors should be taken into consideration when developing strategies to enhance the level of shared decision making.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
cancer, multiple myeloma, oncology, patient communication, shared decision making, structural equation modeling
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:hj:diva-45078 (URN)10.1002/pon.5105 (DOI)000474293000016 ()31087365 (PubMedID)2-s2.0-85066822686 (Scopus ID);HHJADULTIS,HHJIMPROVEIS (Local ID);HHJADULTIS,HHJIMPROVEIS (Archive number);HHJADULTIS,HHJIMPROVEIS (OAI)
Available from: 2019-06-25 Created: 2019-06-25 Last updated: 2019-08-30Bibliographically approved
Lin, C.-Y., Imani, V., Broström, A., Årestedt, K., Pakpour, A. H. & Griffiths, M. D. (2019). Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents.. Frontiers in Psychology, 10, Article ID 149.
Open this publication in new window or tab >>Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents.
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2019 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 10, article id 149Article in journal (Refereed) Published
Abstract [en]

The 7-item Gaming Addiction Scale (GAS) is a brief instrument based on DSM criteria to assess gaming addiction. Although the psychometric properties of the GAS have been tested using classical test theory, its psychometric properties have never been tested using modern test theory (e.g., Rasch analysis). The present study used a large adolescent sample in Iran to test the psychometric properties of the Persian GAS through both classical test and modern test theories. Adolescents (n = 4442; mean age = 15.3 years; 50.3% males) were recruited from Qazvin, Iran. In addition to the GAS, all of them completed the following instruments: the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and a generic quality of life instrument. Two weeks later, all participants completed the GAS again. Confirmatory factor analysis (CFA) and Rasch analysis were used to test the unidimensionality of the GAS. Pearson correlation coefficients were used to test the test-retest reliability, and a regression model was used to test the criterion-related validity of the GAS. Both CFA and Rasch analysis supported the unidimensionality of the GAS. Pearson correlations coefficients showed satisfactory test-retest reliability of the GAS (r = 0.78 to 0.86), and the regression model demonstrated the criterion-related validity of the GAS (β = 0.31 with IGDS-SF9; 0.41 with PSQI). Based on the results, the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
Rasch model, adolescent gaming, confirmatory factor analysis, gaming addiction, online addiction
National Category
Psychology
Identifiers
urn:nbn:se:hj:diva-43223 (URN)10.3389/fpsyg.2019.00149 (DOI)000457845600002 ()30804841 (PubMedID)2-s2.0-85061038332 (Scopus ID)GOA HHJ 2019;HHJADULTIS (Local ID)GOA HHJ 2019;HHJADULTIS (Archive number)GOA HHJ 2019;HHJADULTIS (OAI)
Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-01Bibliographically approved
Wu, E., Broström, A. & Mårtensson, J. (2019). Experiences of Undergoing Enhanced External Counterpulsation in Patients With Refractory Angina Pectoris: A Qualitative Study. Journal of Cardiovascular Nursing, 34(2), 147-158
Open this publication in new window or tab >>Experiences of Undergoing Enhanced External Counterpulsation in Patients With Refractory Angina Pectoris: A Qualitative Study
2019 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 34, no 2, p. 147-158Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Enhanced external counterpulsation (EECP) is a noninvasive treatment recommended for patients with refractory angina pectoris (RAP), which generally includes 35 one-hour sessions over 7 weeks. No study has described how patients experience the time before, during, and between sessions, as well as the time after EECP treatment.

OBJECTIVE:

The aim of this study was to describe how patients with RAP experience EECP treatment.

METHODS:

Semistructured interviews took place with 15 strategically selected patients (11 men, 58-91 years old) who had finished 7 weeks of EECP at the 2 existing EECP clinics in Sweden. Data were analyzed using inductive qualitative content analysis.

RESULTS:

The results were divided into 4 content areas, each comprising 3 categories: (1) experiences before EECP was initiated comprised uncharted territory, being given a new opportunity, and gain insight; (2) experiences during EECP sessions comprised physical discomfort, need of distraction, and sense of security; (3) experiences between EECP sessions comprised physical changes, socializing, and coordinating everyday life; and (4) experiences after 1 course of EECP treatment comprised improved physical well-being, improved mental well-being, and maintaining angina in check.

CONCLUSIONS:

Enhanced external counterpulsation was perceived as an unknown treatment option among these patients with RAP. Nurses should emphasize education before and during treatment based on individualized care needs to improve knowledge and treatment experience, as well as prevent discomfort. There is a great need to increase the awareness of EECP among healthcare professionals because it can improve the life situation for patients with RAP.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
alternative therapies, angina pectoris, coronary artery disease, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-46430 (URN)10.1097/JCN.0000000000000530 (DOI)000480798800021 ()30273260 (PubMedID)2-s2.0-85061249170 (Scopus ID)
Available from: 2019-10-03 Created: 2019-10-03 Last updated: 2019-10-03Bibliographically approved
Neher, M., Nygårdh, A., Nilsen, P., Broström, A. & Johansson, P. (2019). Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review. European Journal of Cardiovascular Nursing, 18(5), 346-357
Open this publication in new window or tab >>Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 5, p. 346-357Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Comorbid psychological distress (i.e. insomnia and depression) is experienced by 20-40% of patients with cardiovascular disease. This has a considerable impact on their health and quality of life, leading to frequent re-hospitalisations, higher healthcare costs and a shorter life expectancy. Internet-based cognitive behavioural therapy shows great potential for treating psychological distress in cardiovascular disease. Effective and feasible treatments can, however, only benefit patients if they are fully implemented in clinical care.

AIM: This scoping review aimed to explore the literature for internet-based cognitive behavioural therapy in cardiovascular disease and for strategies to implement the intervention.

METHODS: We searched electronic databases, journals and internet sources to find original studies about internet-based cognitive behavioural therapy in cardiovascular disease, adhering to scoping methodology guidelines. After identifying 267 titles, we screened 40 abstracts and chose 11 full-text articles for full-text screening. The results sections in four articles were searched for outcomes that related to the effectiveness and implementation of internet-based cognitive behavioural therapy by directed qualitative content analysis using an implementation framework.

RESULTS: Three of the four articles fulfilling the inclusion criteria concerned internet-based cognitive behavioural therapy for treating mild to moderate depressive symptoms in cardiovascular disease, and none focused on insomnia. The studies showed evidence for the effectiveness of internet-based cognitive behavioural therapy, and/or described patient factors influencing clinical effectiveness. Our qualitative content analysis showed that many implementation aspects and stakeholder perspectives remain unexplored.

CONCLUSIONS: Internet-based cognitive behavioural therapy promises to alleviate patient suffering in cardiovascular disease. There is, however, little research about internet-based cognitive behavioural therapy for cardiovascular disease, and about how this evidence-based intervention is implemented.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Implementation, computer-assisted therapy, depression, insomnia, internet, remote consultation
National Category
Cardiac and Cardiovascular Systems Psychiatry
Identifiers
urn:nbn:se:hj:diva-43367 (URN)10.1177/1474515119833251 (DOI)000469834300002 ()30795698 (PubMedID)2-s2.0-85062326670 (Scopus ID)
Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2019-06-20Bibliographically approved
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