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Publications (10 of 144) Show all publications
Lin, C.-Y., Cheng, A. S. K., Nejati, B., Imani, V., Ulander, M., Browall, M., . . . Pakpour, A. H. (2020). A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer. Journal of Sleep Research, 29(1), 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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2020 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 29, no 1, article id e12891Article in journal (Refereed) Published
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, 2020
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)000505736000005 ()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: 2020-01-30Bibliographically approved
Rajabi Majd, N., Broström, A., Ulander, M., Lin, C.-Y. -., Griffiths, M. D., Imani, V., . . . Pakpour, A. H. (2020). Efficacy of a Theory-Based Cognitive Behavioral Technique App-Based Intervention for Patients With Insomnia: Randomized Controlled Trial. Journal of Medical Internet Research, 22(4), Article ID e15841.
Open this publication in new window or tab >>Efficacy of a Theory-Based Cognitive Behavioral Technique App-Based Intervention for Patients With Insomnia: Randomized Controlled Trial
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2020 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 22, no 4, article id e15841Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sleep hygiene is important for maintaining good sleep and reducing insomnia. OBJECTIVE: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients. METHODS: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time. RESULTS: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes. CONCLUSIONS: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03605732; https://clinicaltrials.gov/ct2/show/NCT03605732. 

Place, publisher, year, edition, pages
JMIR publications, 2020
Keywords
app-based intervention, cognitive behavioral therapy, insomnia, sleep hygiene, theory of planned behavior
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-48317 (URN)10.2196/15841 (DOI)000522620500001 ()32234700 (PubMedID)2-s2.0-85082732853 (Scopus ID)GOA HHJ 2020; HHJADULTIS (Local ID)GOA HHJ 2020; HHJADULTIS (Archive number)GOA HHJ 2020; HHJADULTIS (OAI)
Available from: 2020-05-08 Created: 2020-05-08 Last updated: 2020-05-08Bibliographically approved
Svanborg, E., Ulander, M., Broström, A. & Sunnergren, O. (2020). Palatal Sensory Function Worsens in Untreated Snorers but not in CPAP-Treated Patients With Sleep Apnea, Indicating Vibration-Induced Nervous Lesions. Chest, 157(5), 1296-1303
Open this publication in new window or tab >>Palatal Sensory Function Worsens in Untreated Snorers but not in CPAP-Treated Patients With Sleep Apnea, Indicating Vibration-Induced Nervous Lesions
2020 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 157, no 5, p. 1296-1303Article in journal (Refereed) Published
Abstract [en]

Background: Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated snorers, and CPAP-treated patients underwent repeated sensory testing of the soft palate in a prospective long-term study. Methods: Cold detection threshold (CDT) testing at the soft palate and lip with a thermode and nocturnal respiratory recordings were performed in 2008 to 2009 with retesting 6 to 7 years later. Results: In 25 untreated snorers, palatal CDT worsened from a median (25th-75th percentile range) 4.2°C (3.2-5.9) to 11.0°C (7.0-17.4) (P < .001). The apnea-hypopnea index increased from a median 7.0 to 14.0 events/h (P < .05). There was no significant correlation between changes in CDT and the apnea-hypopnea index. In 21 nonsnoring control subjects, palatal CDT increased from a median 3.2°C to 5.6°C (P < .005). In 19 CPAP-treated patients, palatal CDT did not significantly change; eight patients had improved values. CDTs worsened significantly more in the snorers group than in the control subjects (P < .05) and the CPAP-treated patients (P < .001). There was no significant difference between control subjects and CPAP-treated patients. Conclusions: CDT worsened considerably over time in untreated snorers, significantly more than in nonsnoring control subjects and CPAP-treated patients. Untreated snorers therefore risk developing poor sensitivity in the upper airway. In contrast, efficient treatment of OSA seems to protect the sensory innervation, as the CPAP-treated group maintained their sensitivity to cold and, in some cases, the sensitivity even improved. 

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
cold detection thresholds, palatal nervous lesions, progression, sensory nervous lesions, sleep apnea, adult, aged, apnea hypopnea index, Article, body mass, calculation, cold detection threshold test, cold sensitivity, controlled study, female, function test, human, lip, major clinical study, male, oxygen desaturation, positive end expiratory pressure, priority journal, prospective study, sex difference, sleep disordered breathing, soft palate, very elderly
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-48584 (URN)10.1016/j.chest.2020.01.032 (DOI)000532715300043 ()32059960 (PubMedID)2-s2.0-85083507636 (Scopus ID)
Funder
Swedish Heart Lung FoundationMedical Research Council of Southeast Sweden (FORSS)
Available from: 2020-05-29 Created: 2020-05-29 Last updated: 2020-05-29Bibliographically approved
Lin, C.-Y., Imani, V., Griffiths, M. D., Broström, A., Nygårdh, A., Demetrovics, Z. & Pakpour, A. H. (2020). Temporal associations between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults. Journal of Sleep Research, Article ID e13076.
Open this publication in new window or tab >>Temporal associations between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults
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2020 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, article id e13076Article in journal (Refereed) Epub ahead of print
Abstract [en]

The extant literature has suggested relationships between an individual's chronotype (in relation to morningness/eveningness) and several outcomes, including addictive disorders, psychological distress and daytime sleepiness. Moreover, sleep quality has been proposed to be a mediator in the aforementioned relationships. Consequently, the aim of the present study was to investigate the complex relationship between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness, with the potential mediators of sleep quality and insomnia. All participants (N = 1,791 [30.1% males]; mean age = 27.2 years, SD = 10.1) completed a battery of psychometric scales, including a reduced version of the Morningness-Eveningness Questionnaire (at baseline), the Pittsburgh Sleep Quality Index and Insomnia Severity Index (1 month after baseline assessment), the Bergen Social Media Addiction Scale, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale (2 months after baseline assessment). The impacts of morningness-eveningness on problematic social media use, anxiety, depression and daytime sleepiness were found in the mediation models. Furthermore, the mediated effects of insomnia and sleep quality were observed. The present study's results emphasize the importance of promoting healthy sleep habits and sleep hygiene behaviours, and that of early detection of sleep problems among individuals who have the eveningness chronotype, because this would significantly improve their health outcomes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
behavioural addiction, chronotype, daytime sleepiness, eveningness, morningness, sleep, social media addiction
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-48453 (URN)10.1111/jsr.13076 (DOI)32406567 (PubMedID)HOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (Local ID)HOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (Archive number)HOA HHJ 2020;HHJADULTIS,HHJIMPROVEIS (OAI)
Available from: 2020-05-19 Created: 2020-05-19 Last updated: 2020-05-19
Lin, C.-Y., Broström, A., Årestedt, K., Mårtensson, J., Steinke, E. E. & Pakpour, A. H. (2020). Using extended theory of planned behavior to determine factors associated with help-seeking behavior of sexual problems in women with heart failure: a longitudinal study. Journal of Psychosomatic Obstetrics and Gynaecology, 41(1), 54-61
Open this publication in new window or tab >>Using extended theory of planned behavior to determine factors associated with help-seeking behavior of sexual problems in women with heart failure: a longitudinal study
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2020 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 41, no 1, p. 54-61Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: This study used extended theory of planned behavior (extended TPB) to understand the underlying factors related to help-seeking behavior for sexual problems among Iranian women with heart failure (HF).

METHODS: We recruited 758 women (mean age = 61.21 ± 8.92) with HF at three university-affiliated heart centers in Iran. Attitude, subjective norms, perceived behavioral control, behavioral intention, self-stigma of seeking help, perceived barriers, frequency of planning, help-seeking behavior, and sexual function were assessed at baseline. Sexual function was assessed again after 18 months. Structural equation modeling was used to explain change in sexual functioning after 18 months.

RESULTS: Attitude and perceived behavioral control were positively correlated to behavioral intention. Behavioral intention was negatively and self-stigma in seeking help was positively correlated to perceived barriers. Behavioral intention was positively and self-stigma in seeking help was negatively correlated to frequency of planning. Perceived behavioral control, behavior intention, and frequency of planning were positively and self-stigma in seeking help and perceived barriers were negatively correlated to help-seeking behavior. Help-seeking behavior was positive correlated to the change of FSFI latent score.

CONCLUSIONS: The extended TPB could be used by healthcare professionals to design an appropriate program to treat sexual dysfunction in women with HF.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Extended theory of planned behavior, heart failure, help-seeking, sexual function, women
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-43368 (URN)10.1080/0167482X.2019.1572743 (DOI)000518498000005 ()30829094 (PubMedID)2-s2.0-85062442921 (Scopus ID)HOA HHJ 2020;HHJADULTIS (Local ID)HOA HHJ 2020;HHJADULTIS (Archive number)HOA HHJ 2020;HHJADULTIS (OAI)
Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2020-04-01Bibliographically approved
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 2019;HHJADULTIS (Local ID)POA HHJ 2019;HHJADULTIS (Archive number)POA HHJ 2019;HHJADULTIS (OAI)
Available from: 2019-02-20 Created: 2019-02-20 Last updated: 2020-01-21Bibliographically approved
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: 2020-01-20Bibliographically 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
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