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Hedberg, B., Malm, D., Karlsson, J.-E., Årestedt, K. & Broström, A. (2018). Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation. European Journal of Cardiovascular Nursing, 17(5), 446-455
Open this publication in new window or tab >>Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 5, p. 446-455Article in journal (Refereed) Published
Abstract [en]

Background:

Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making.

Aim:

The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms.

Methods:

A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale–Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data.

Results:

Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication.

Conclusion:

Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Atrial fibrillation, decision making, patient-based outcome measure, risk communication
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-37870 (URN)10.1177/1474515117741891 (DOI)XYZ ()29135285 (PubMedID)2-s2.0-85041497464 (Scopus ID)
Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-05-31Bibliographically approved
Broström, A., Pakpour, A. H., Nilsen, P., Gardner, B. & Ulander, M. (2018). Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners' beliefs and practices. Journal of Sleep Research, 1-10
Open this publication in new window or tab >>Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners' beliefs and practices
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

The benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners' beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners' beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence-promotion actions. One-hundred and forty-two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence-promotion actions (20 items). Confirmatory factor analysis and second-order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence-promotion actions. Patients' knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Adherence, Continuous positive airway pressure, Obstructive sleep apnea, Patient education
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-39057 (URN)10.1111/jsr.12675 (DOI)2-s2.0-85042564274 (Scopus ID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-03-27
Lin, C.-Y., Pakpour, A. H., Broström, A., Fridlund, B., Årestedt, K., Strömberg, A., . . . Mårtensson, J. (2018). Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients.. Journal of Cardiovascular Nursing, 33(3), 281-288
Open this publication in new window or tab >>Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients.
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2018 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 3, p. 281-288Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The 9-item European Heart Failure Self-Care Behavior scale (EHFScB-9) is a self-reported questionnaire commonly used to capture the self-care behavior of people with heart failure (HF).

OBJECTIVE: The aim of this study was to investigate the EHFScB-9's factorial structure and categorical functioning of the response scale and differential item functioning (DIF) across subpopulations in Iran.

METHODS: Patients with HF (n = 380; 60.5% male; mean [SD] age, 61.7 [9.1] years) participated in this study. The median (interquartile range) of the duration of their HF was 6.0 (2.4-8.8) months. Most of the participants were in New York Heart Association classification II (NYHA II, 61.8%); few of them had left ventricular ejection fraction assessment (11.3%). All participants completed the EHFScB-9. Confirmatory factor analysis was used to test the factorial structure of the EHFScB-9; Rasch analysis was used to analyze categorical functioning and DIF items across 2 characteristics (gender and NYHA).

RESULTS: The 2-factor structure ("adherence to regimen" and "consulting behavior") of the EHFScB-9 was confirmed, and the unidimensionality of each factor was found. Categorical functioning was supported for all items. No items displayed substantial DIF across gender (DIF contrast, -0.25-0.31). Except for item 3 ("Contact doctor or nurse if legs/feet are swollen"; DIF contrast, -0.69), no items displayed substantial DIF across NYHA classes (DIF contrast, -0.40 to 0.47).

CONCLUSIONS: Despite the DIF displayed in 1 item across the NYHA classes, the EHFScB-9 demonstrated sound psychometric properties in patients with HF.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
confirmatory factor analysis, heart failure, Rasch, self-care behavior scale
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-39222 (URN)10.1097/JCN.0000000000000444 (DOI)28858887 (PubMedID)2-s2.0-85045200162 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-27Bibliographically approved
Strong, C., Lin, C.-Y., Jalilolghadr, S., Updegraff, J. A., Broström, A. & Pakpour, A. H. (2018). Sleep hygiene behaviours in Iranian adolescents: An application of the Theory of Planned Behavior. Journal of Sleep Research, 27(1), 23-31
Open this publication in new window or tab >>Sleep hygiene behaviours in Iranian adolescents: An application of the Theory of Planned Behavior
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 1, p. 23-31Article in journal (Refereed) Published
Abstract [en]

Poor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)-which centres on an individual's attitude toward performing the behaviour, subjective norms and perceived behavioural control-has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a self-reported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents' sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self-reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker-Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health-care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents' sleep hygiene behaviours, rather than rely solely upon increasing adolescents' sleep hygiene knowledge.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
General health questionnaire, Health behaviour, Pittsburgh Sleep Quality Index, Psychological health
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-36605 (URN)10.1111/jsr.12566 (DOI)000419994500003 ()28593637 (PubMedID)2-s2.0-85020266808 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2017-07-04 Created: 2017-07-04 Last updated: 2018-02-07Bibliographically approved
Lin, C.-Y., Broström, A., Nilsen, P. & Pakpour, A. H. (2018). Using extended theory of planned behavior to understand aspirin adherence in pregnant women.. Pregnancy Hypertension, 12, 84-89
Open this publication in new window or tab >>Using extended theory of planned behavior to understand aspirin adherence in pregnant women.
2018 (English)In: Pregnancy Hypertension, ISSN 2210-7789, E-ISSN 2210-7797, Vol. 12, p. 84-89Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To use the Theory of Planned Behavior (TPB) combined with action and coping planning plus global relationship with husband to explain the aspirin adherence in a sample of women with high-risk pregnancy.

METHODS: A total of 535 Iranian women (mean age = 32.29 ± 4.98; year of marriage = 6.89 ± 3.61) completed the study. Each participant filled out several questionnaires on TPB (i.e., a widely applied theory describing how behaviors are influenced by beliefs, attitudes, perceived behavioral control and behavioral intentions), action planning, coping planning and relationship with husband at baseline. Eight weeks later, each participant completed the Five-item Medication Adherence Rating Scale (MARS-5) and underwent the blood test on aspirin serum level to provide the subjective and objective aspirin adherence information, respectively. Structural equation modeling (SEM) was applied to test three proposed models on aspirin adherence.

RESULTS: The TPB with planning plus relationship with husband was supported (comparative fit index = 0.969; Tucker-Lewis index = 0.950). Behavioral intention was the mediator in the associations of aspirin adherence and the following variables: attitude, perceived behavioral control, and relationship with husband. Action and coping planning mediated the associations of aspirin adherence and the two variables of behavioral intention and perceived behavioral control. Relationship with husband mediated the association of subjective norm and aspirin adherence.

CONCLUSIONS: The TPB model with (action and coping) planning plus relationship with husband serves a potential mechanism to explain the aspirin adherence for women with high risk of pregnancy. Possible implications are discussed based on our results.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Aspirin adherence, Health action process approach, Pregnancy, Structural equation modeling, Theory of planned behavior
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychology
Identifiers
urn:nbn:se:hj:diva-39282 (URN)10.1016/j.preghy.2018.04.001 (DOI)000433429700016 ()29674206 (PubMedID)2-s2.0-85045083489 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2018-04-27 Created: 2018-04-27 Last updated: 2018-06-21Bibliographically approved
Eriksson, K., Wikström, L., Fridlund, B., Årestedt, K. & Broström, A. (2017). Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery - A quantitative study with repeated measures. Journal of Advanced Nursing, 73(11), 2664-2675
Open this publication in new window or tab >>Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery - A quantitative study with repeated measures
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2664-2675Article in journal (Refereed) Published
Abstract [en]

Aim: To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery.

Background: Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day.

Design: Descriptive, quantitative repeated measures.

Methods: General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together.

Results: Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery.

Conclusion: Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Assessment, Nurse-patient interaction, Nurse-patient relationships, Pain, Postoperative care, Quantitative approaches
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-35340 (URN)10.1111/jan.13331 (DOI)000418363000018 ()28475240 (PubMedID)2-s2.0-85020059107 (Scopus ID)
Funder
Medical Research Council of Southeast Sweden (FORSS), 376851Futurum - Academy for Health and Care, Jönköping County Council, Sweden, 598311
Note

Part of doctoral thesis in its submitted form.

Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2018-01-31Bibliographically approved
Pakpour, A. H., Lin, C.-Y., Malm, D., Broström, A., Fridlund, B. & Webb, T. L. (2017). Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life and mortality rates in older patients undergoing coronary artery bypass surgery?. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S1-S2
Open this publication in new window or tab >>Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life and mortality rates in older patients undergoing coronary artery bypass surgery?
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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. S1-S2Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Objective: Patients undergoing coronary artery bypass graft (CABG) surgery are required to take a complex regimen of medications for a long time, and they may have negative outcomes because they struggle to adhere to this regimen. Designing effective interventions to promote medication adherence is therefore important. The present study aimed to evaluate the long-term effects of a multifaceted intervention (psycho-education, motivational interviewing, and short message services) on medication adherence, quality of life (QoL), and mortality rates in older patients undergoing CABG surgery.

Methods: Patients aged over 65 years from 12 centers were assigned to the intervention (EXP; n = 144) or treatment as usual (TAU; n = 144) groups using cluster randomization with center level. Medication adherence was evaluated using Medication Adherence Rating Scale (MARS), pharmacy refill rate, and lipid profile; QoL using Short-Form 36.Data were collected at baseline; three, six, and eighteen months after intervention. Survival status was followed up at eighteen months. Multi-level regressions and survival analyses for hazard ratio (HR) were used for analyses.

Results: Compared to patients who received TAU, the MARS, pharmacy refill rate, and lipid profile of patients in the EXP group improved six months after surgery (p <0.01) and remained so eighteen months after surgery (p< 0.01). QoL also increased among patients in the EXP group as compared to those who received TAU at eighteen month post-surgery (physical component summary score p= 0.02; mental component summary score p = 0.04). HR in the EXP group compared to the TAU group was 0.38 (p = 0.04).

Conclusion: The findings suggest that a multifaceted intervention can improve medication adherence in older patients undergoing CABG surgery, with these improvements being maintained after eighteen months. QoL and survival rates increased as a function of better medication adherence.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-36035 (URN)000401775600003 ()HHJövrigtIS (Local ID)HHJövrigtIS (Archive number)HHJövrigtIS (OAI)
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Note

ClinicalTrials.gov NCT02109523

Available from: 2017-06-13 Created: 2017-06-13 Last updated: 2017-06-13Bibliographically approved
Lin, C.-Y., Yaseri, M., Pakpour, A. H., Malm, D., Broström, A., Fridlund, B., . . . Webb, T. L. (2017). Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life, and mortality rates in older patients undergoing coronary artery bypass surgery? A multicenter, randomized controlled trial with 18-month follow-up. Drugs & Aging, 34(2), 143-156
Open this publication in new window or tab >>Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life, and mortality rates in older patients undergoing coronary artery bypass surgery? A multicenter, randomized controlled trial with 18-month follow-up
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2017 (English)In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 34, no 2, p. 143-156Article in journal (Refereed) Published
Abstract [en]

Background: Patients undergoing coronary artery bypass graft (CABG) surgery are required to take a complex regimen of medications for extended periods, and they may have negative outcomes because they struggle to adhere to this regimen. Designing effective interventions to promote medication adherence in this patient group is therefore important.

Objective: The present study aimed to evaluate the long-term effects of a multifaceted intervention (psycho-education, motivational interviewing, and short message services) on medication adherence, quality of life (QoL), and mortality rates in older patients undergoing CABG surgery.

Methods: Patients aged over 65 years from 12 centers were assigned to the intervention (EXP; n = 144) or treatment-as-usual (TAU; n = 144) groups using cluster randomization at center level. Medication adherence was evaluated using the Medication Adherence Rating Scale (MARS), pharmacy refill rate, and lipid profile; QoL was evaluated using Short Form-36. Data were collected at baseline; 3, 6, and 18 months after intervention. Survival status was followed up at 18 months. Multi-level regressions and survival analyses for hazard ratio (HR) were used for analyses.

Results: Compared with patients who received TAU, the MARS, pharmacy refill rate, and lipid profile of patients in the EXP group improved 6 months after surgery (p < 0.01) and remained so 18 months after surgery (p < 0.01). QoL also increased among patients in the EXP group as compared with those who received TAU at 18 months post-surgery (physical component summary score p = 0.02; mental component summary score p = 0.04). HR in the EXP group compared with the TAU group was 0.38 (p = 0.04).

Conclusion: The findings suggest that a multifaceted intervention can improve medication adherence in older patients undergoing CABG surgery, with these improvements being maintained after 18 months. QoL and survival rates increased as a function of better medication adherence. ClinicalTrials.gov NCT02109523.

Place, publisher, year, edition, pages
Springer, 2017
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-34626 (URN)10.1007/s40266-016-0429-3 (DOI)000394143400007 ()28004259 (PubMedID)2-s2.0-85006839800 (Scopus ID)HHJADULTIS, HHJIMPROVEIS (Local ID)HHJADULTIS, HHJIMPROVEIS (Archive number)HHJADULTIS, HHJIMPROVEIS (OAI)
Available from: 2017-01-09 Created: 2017-01-09 Last updated: 2017-10-26Bibliographically approved
Pakpour, A. H., Broström, A., Mårtensson, J., Malm, D. & Fridlund, B. (2017). Cardiac rehabilitation teams‘ psychosocial determinants for sexual counseling of women with Takotsubo cardiomyopathy: A theory-based longitudinal study. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S53-S54
Open this publication in new window or tab >>Cardiac rehabilitation teams‘ psychosocial determinants for sexual counseling of women with Takotsubo cardiomyopathy: A theory-based longitudinal study
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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. S53-S54Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Patients with Takotsubo cardiomyopathy (TSCM) especially female, may be at risk of poor psychological adjustment and deteriorated health related quality of life. Sexual dysfunction is a significant problem for patients with TSCM. Therefore, Sexual counseling should be integrated into the cardiac rehabilitation services. However, cardiac rehabilitation teams reluctant to address patient’s sexual problems. The aim of this study was to determine factors which effect on performing sexual counseling among cardiac rehabilitation team.

Methods: In this longitudinal study, two hundred and forty-four specialists (i.e., physical therapists, nurses, psychologists, social workers, rehabilitation specialists and cardiologists), who were working in cardiac rehabilitation teams participated in the study at eight referral hospitals in Iran (i.e., Tehran, Qazvin, Tabriz and Zahedan). The teams were asked to complete study measures including sexual knowledge (25 items), attitude (12 items), subjective norm (5 items), perceived behavioral control (8 items), behavioral intention (2 items) and perceived barriers (17 items). Six month later, the teams were then contacted to ask the frequency of the sexual counseling sessions during the past six months.

Results: Cardiac rehabilitation teams reported that sex was rarely discussed with patients (14.3%). Attitudes, subjective norms and perceived behavioral control (PBC) emerged as significant direct predictors of intention to perform sexual consulting. Multiple logistic regression analysis showed that cardiac rehabilitation teams with strong behavioral intention (OR = 1.83, 95 % CI, 1.08  to 3.10) and low perceived barriers (OR = 0.69, 95 % CI, 0.49 to 0.97) were more likely to perform the subsequent sexual consulting.

Conclusions: Existing cardiac rehabilitation activities are likely to continue to fail to promote patient’s sexual functioning after cardiac events in the absence of effective strategies to reduce the underlying barriers toward sexual counseling. Interventions should be targeted on reducing barriers toward sexual counseling in cardiac rehabilitation teams.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-35954 (URN)000401775600093 ()HHJövrigtIS (Local ID)HHJövrigtIS (Archive number)HHJövrigtIS (OAI)
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2017-06-09Bibliographically approved
Broström, A., Fridlund, B., Hedberg, B., Nilsen, P. & Ulander, M. (2017). Communication between patients with obstructive sleep apnoea syndrome and healthcare personnel during the initial visit to a continuous positive airway pressure clinic. Journal of Clinical Nursing, 26(3-4), 568-577
Open this publication in new window or tab >>Communication between patients with obstructive sleep apnoea syndrome and healthcare personnel during the initial visit to a continuous positive airway pressure clinic
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2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 3-4, p. 568-577Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To describe facilitators and barriers from a patient perspective in communications between patients with obstructive sleep apnoea syndrome and healthcare personnel during the first meeting when continuous positive airway pressure is initiated.

Background: Adherence to continuous positive airway pressure treatment tends to be poor, especially at the initial phase of treatment. Communication between the patient and healthcare personnel has not been studied from the patient perspective, as either a barrier or facilitator for adherence.

Methods: A descriptive design using qualitative content analysis was used. Interviews with 25 patients with obstructive sleep apnoea syndrome took place after their initial visit at four continuous positive airway pressure clinics. A deductive analysis based on The 4 Habits Model (i.e. emphasise the importance of investing in the beginning of the consultation, elicit the patient's perspective, demonstrate empathy and invest in the end of the consultation) was conducted.

Results: Building confidence (i.e. structure building, information transfer, commitment) or hindering confidence (i.e. organisational insufficiency, stress behaviour, interaction deficit) was associated with investing in the beginning. Motivating (i.e. situational insight, knowledge transfer, practical training) or demotivating (i.e. expectations, dominance and power asymmetry, barriers) was associated with eliciting the patient's perspective. Building hope (i.e. awareness, sensitivity, demonstration of understanding) or hindering hope (i.e. unprepared, uncommitted, incomprehension) was associated with showing empathy. Agreement (i.e. confirmation, responsibilities, comprehensive information) or disagreement (i.e. structural obscurity, irresponsibility, absent-mindedness) was associated with investing in the end.

Conclusions: Understanding of facilitators and barriers, as described by patients, can be used to improve contextual conditions and communication skills among healthcare personnel.

Relevance to clinical practice: A patient-centred communication technique should be used in relation to all stages of The 4 Habits Model to facilitate shared decision-making and improve adherence to continuous positive airway pressure treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Communication, Continuous positive airway pressure, Obstructive sleep apnoea, Shared decision-making
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-34270 (URN)10.1111/jocn.13592 (DOI)000396479700026 ()27685080 (PubMedID)2-s2.0-84997787381 (Scopus ID)
Available from: 2016-12-12 Created: 2016-12-12 Last updated: 2017-04-21
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1884-5696

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