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Fridlund, Bengt
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Publications (10 of 396) Show all publications
Arenhall, E., Eriksson, M., Nilsson, U., Steinke, E. E. & Fridlund, B. (2018). Decreased sexual function in partners after patients’ first-time myocardial infarction. European Journal of Cardiovascular Nursing, 17(6), 521-526
Open this publication in new window or tab >>Decreased sexual function in partners after patients’ first-time myocardial infarction
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 6, p. 521-526Article in journal (Refereed) Published
Abstract [en]

Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.

Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.

Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.

Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.

Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction. 

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Longitudinal, myocardial infarction, sexual function, sexual relationships, spouse, Watts Sexual Function Questionnaire
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:hj:diva-38892 (URN)10.1177/1474515117751904 (DOI)000440433800007 ()29291637 (PubMedID)2-s2.0-85041537787 (Scopus ID)HHJADULTIS (Local ID)HHJADULTIS (Archive number)HHJADULTIS (OAI)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-08-24Bibliographically approved
Bala, S.-V., Forslind, K., Fridlund, B. & Hagell, P. (2018). Measuring person-centred care in nurse-led outpatient rheumatology clinics. Musculoskeletal Care, 16(2), 296-304
Open this publication in new window or tab >>Measuring person-centred care in nurse-led outpatient rheumatology clinics
2018 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 296-304Article in journal (Refereed) Published
Abstract [en]

Background: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

Objective: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

Methods: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

Results: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

Conclusion: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
measurement, nurse-led rheumatology clinics, outpatient, person-centred care
National Category
Nursing Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hj:diva-40947 (URN)10.1002/msc.1234 (DOI)000435802900007 ()29484828 (PubMedID)2-s2.0-85042523791 (Scopus ID)
Note

This study was supported by grants from the Stig and Ragna Gorthon Foundation in Helsingborg, Sweden, and the Foundation for Assistance to Disabled People in Skåne (Stiftelsen för Bistånd åt Rörelsehindrade i Skåne). The authors thank all participants for their cooperation and for sharing their experiences, and the nurses for their commitment and help in recruiting participants. We also thank the BARFOT study group for facilitating the conduct of the study.

Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-07-05Bibliographically approved
Amofah, H. A., Broström, A., Fridlund, B., Haaverstad, R., Instenes, I., Kuiper, K. K., . . . Norekval, T. M. (2018). Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy. European Journal of Cardiovascular Nursing, 17, 104-105
Open this publication in new window or tab >>Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 104-105Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.

Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.

Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.

Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.

Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.

Place, publisher, year, edition, pages
Sage Publications, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-41230 (URN)10.1177/1474515118787764 (DOI)000440339600176 ()
Available from: 2018-08-24 Created: 2018-08-24 Last updated: 2018-08-24Bibliographically approved
Bala, S.-V., Forslind, K., Fridlund, B., Samuelson, K., Svensson, B. & Hagell, P. (2018). Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument. Musculoskeletal Care, 16(2), 287-295
Open this publication in new window or tab >>Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument
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2018 (English)In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 287-295Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

METHODS: A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic.

RESULTS: The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire.

CONCLUSIONS: A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
measurement, nurse-led rheumatology clinics, outpatient, person-centred care conceptual framework
National Category
Nursing Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:hj:diva-38893 (URN)10.1002/msc.1233 (DOI)000435802900006 ()29417713 (PubMedID)2-s2.0-85041676259 (Scopus ID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-07-05Bibliographically approved
Pakpour, A. H., Lin, C.-Y., Kumar, S., Fridlund, B. & Jansson, H. (2018). Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.. Journal of Investigative and Clinical Dentistry, 9(1), Article ID e12264.
Open this publication in new window or tab >>Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.
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2018 (English)In: Journal of Investigative and Clinical Dentistry, ISSN 2041-1618, E-ISSN 2041-1626, Vol. 9, no 1, article id e12264Article in journal (Refereed) Published
Abstract [en]

AIM: In the present study, we evaluated the direct and mediating (indirect) effects of clinical oral conditions, dental anxiety, sense of coherence (SOC), and socioeconomic variables on oral health-related quality of life (OHRQoL) and general health-related quality of life (GHRQoL) in Iranian adolescents.

METHODS: A longitudinal design was used with a sample of 1052 (694 males, mean age=15.05 years) schoolchildren from Qazvin, Iran. Each participant completed a background information sheet and the following scales at baseline: Modified Dental Anxiety Scale, SOC, PedsQL 4.0 Generic Core Scale, and PedsQL Oral Health Scale. The PedsQL 4.0 Generic Core and Oral Health scales were recompleted at the 18-mo follow up.

RESULTS: Father's education, monthly family income, dental anxiety, Community Periodontal Index (CPI), decayed, missing, and filled teeth (DMFT), and SOC significantly and directly predicted OHRQoL at 18 mo. Father's education had indirect effects on OHRQoL through CPI and DMFT, family income had indirect effects through DMFT, and dental anxiety had indirect effects through CPI. OHRQoL at 18 mo (β=0.499) and SOC (β=0.084) had significant and direct and mediating effects through OHRQoL on GHRQoL, while father's education, monthly family income, dental anxiety, CPI, and DMFT only showed mediating effects.

CONCLUSIONS: Clinical oral indicators had direct effects on OHRQoL, but mediated the effects of dental anxiety and socioeconomic status on both OHRQoL and GHRQoL.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
adolescent, longitudinal study, oral health, oral health-related quality of life, structural equation modeling
National Category
Dentistry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-38899 (URN)10.1111/jicd.12264 (DOI)000424272100001 ()28386989 (PubMedID)HHJOralIS (Local ID)HHJOralIS (Archive number)HHJOralIS (OAI)
Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2018-02-22Bibliographically approved
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)000440243400021 ()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: 2018-08-24Bibliographically approved
Henricson, M., Fridlund, B., Mårtensson, J. & Hedberg, B. (2018). The validation of the Supervision of Thesis Questionnaire (STQ). Nurse Education Today, 65, 11-16
Open this publication in new window or tab >>The validation of the Supervision of Thesis Questionnaire (STQ)
2018 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 65, p. 11-16Article in journal (Refereed) Published
Abstract [en]

Background: The supervision process is characterized by differences between the supervisors’ and the students’ expectations before the start of writing a bachelor thesis as well as after its completion. A review of the literature did not reveal any scientifically tested questionnaire for evaluating nursing students’ expectations of the supervision process when writing a bachelor thesis.

Objectives: The aim of the study was to determine the construct validity and internal consistency reliability of a questionnaire for measuring nursing students’ expectations of the bachelor thesis supervision process.

Design & Methods: The study had a developmental and methodological design carried out in four steps including construct validity and internal consistency reliability statistical procedures: construction of the items, assessment of face validity, data collection and data analysis.

Settings & Participants: This study was conducted at a university in southern Sweden, where students on the “Nursing student thesis, 15 ECTS” course were consecutively selected for participation. Of the 512 questionnaires distributed, 327 were returned, a response rate of 64%.

Results: Five factors with a total variance of 74% and good communalities, ≥0.64, were extracted from the 10-item STQ. The internal consistency of the 10 items was 0.68. The five factors were labelled: The nature of the supervision process, The supervisor's role as a coach, The students’ progression to self-support, The interaction between students and supervisor and supervisor competence.

Conclusions: A didactic, useful and secure questionnaire measuring nursing students’ expectations of the bachelor thesis supervision process based on three main forms of supervision was created.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Bachelor thesis, Construct validity, Expectations, Internal consistency, Questionnaire, Supervision, adult, article, data analysis, expectation, face validity, female, human, human experiment, male, nursing student, Sweden, validation process
National Category
Nursing Educational Sciences
Identifiers
urn:nbn:se:hj:diva-38984 (URN)10.1016/j.nedt.2018.02.010 (DOI)000431747100003 ()29522961 (PubMedID)2-s2.0-85042876027 (Scopus ID)
Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2018-07-11Bibliographically 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: 2018-07-04Bibliographically 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
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