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Christensson, Lennart
Publications (10 of 41) Show all publications
Johansson, L., Wijk, H. & Christensson, L. (2017). Health Care Professionals' Usage and Documentation of a Swedish Quality Registry Regarding Preventive Nutritional Care. Quality Management in Health Care, 26(1), 15-21
Open this publication in new window or tab >>Health Care Professionals' Usage and Documentation of a Swedish Quality Registry Regarding Preventive Nutritional Care
2017 (English)In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 26, no 1, p. 15-21Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe health care staff members' usage and documentation in a Swedish quality registry focusing on a preventive care process regarding the risk area of malnutrition among persons with dementia. The preventive care process includes risk assessment, analysis of underlying causes, planning and performing interventions, as well as evaluating effects.

Methods: Data were collected from 2 Swedish quality registries, Senior Alert and the Swedish Dementia Register (Svedem). In total, 1929 people with dementia were assessed and 1432 registered as being at risk of malnutrition or malnourished.

Results: Performed nutritional interventions were registered in approximately 65% of cases. In more than 80% of registrations, the analyses of underlying causes were missing. Those who had registered underlying causes had significantly more interventions and the evaluation of the performed intervention was registered. The time between assessment and evaluation depended on care setting and ranged from 0 to 702 days.

Conclusions: Limitations in registration were noted; however, the register allows staff to focus on nutritional care and has resulted in many risk assessments. Rarely people were registered in all steps of the preventive care process. Large variances in when the performed interventions were evaluated makes it difficult to measure improvements.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017
National Category
Gerontology, specialising in Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
urn:nbn:se:hj:diva-34658 (URN)10.1097/QMH.0000000000000116 (DOI)000392122700003 ()28030460 (PubMedID)2-s2.0-85010282244 (Scopus ID)
Available from: 2017-01-10 Created: 2017-01-10 Last updated: 2018-01-13Bibliographically approved
Johansson, L., Wijk, H. & Christensson, L. (2017). Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program. The Journal of Nutrition, Health & Aging, 21(3), 292-298
Open this publication in new window or tab >>Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program
2017 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 3, p. 292-298Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome.

DESIGN: An analysis of data from SA with a pre-post design was performed.

SETTING: The participants were living in ordinary housing or special housing in Sweden.

PARTICIPANTS: 1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included.

INTERVENTION: A national preventive care program including individualized actions.

MEASUREMENTS: The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline).

RESULTS: 74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found.

CONCLUSION: Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Nursing process, nutrition assessment, quality improvement, registers
National Category
Geriatrics Nutrition and Dietetics Nursing
Identifiers
urn:nbn:se:hj:diva-35401 (URN)10.1007/s12603-016-0737-7 (DOI)000396203100010 ()28244569 (PubMedID)2-s2.0-84969941150 (Scopus ID)
Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-04-21Bibliographically approved
Emsfors, Å., Christensson, L. & Elgán, C. (2017). Nursing actions that create a sense of good nursing care in patients with wet age-related macular degeneration. Journal of Clinical Nursing, 26(17-18), 2680-2688
Open this publication in new window or tab >>Nursing actions that create a sense of good nursing care in patients with wet age-related macular degeneration
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 17-18, p. 2680-2688Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To identify and describe nursing actions performed by nurses that create a sense of good nursing care in patients with wet age-related macular degeneration.

Background: People who suffer from wet age-related macular degeneration risk central vision loss. Treatment with antivascular endothelial growth factor is the only available option at present that preserves vision and no definitive cure currently exists. Patients feel that they are compelled to accept this treatment because they might otherwise become blind.

Design: An explorative and descriptive design based on the critical incident technique was used.

Method: Interviews with 16 Swedish patients who all had received intravitreal treatment for wet age-related macular degeneration.

Results: Two main areas of good nursing care were identified: 'Being perceived as an individual' and 'Being empowered'. The first area was divided into two categories: being respectful and being engaged. Being respectful was observed when nurses had a benevolent attitude towards their patients and answered questions kindly and politely. Patients saw themselves as individuals when nurses were available for conversation and focused on them. The second area was divided into two categories: encouraging participation and creating confidence. Encouraging participation refers to when nurses provided information continuously. Nurses instilled confidence and trust in their patients by keeping promises and by being honest.

Conclusions: A respectful interaction between patients and caregivers is necessary for patients to obtain beneficial health care.

Relevance to clinical practice: Patient interviews revealed important information about nursing actions that created a sense of good nursing care in patients with wet age-related macular degeneration. Nurses acknowledged people as individuals and created trust by building partnerships and sharing decision-making. To address each patient's concerns, nurses need to prioritise each patient's narrative and participation by documenting agreements in their medical record. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Caring; Critical incidents; Interviews; Nurse-patient relations; Nursing; Nursing activity; Nursing care; Older patients; Ophthalmology; Patients' experience
National Category
Nursing Ophthalmology
Identifiers
urn:nbn:se:hj:diva-35417 (URN)10.1111/jocn.13749 (DOI)000408919200016 ()28152206 (PubMedID)2-s2.0-85017363537 (Scopus ID)
Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2018-01-05Bibliographically approved
Johansson, L., Björklund, A., Sidenvall, B. & Christensson, L. (2017). Staff views on how to improve mealtimes for elderly people with dementia living at home. Dementia, 16(7), 835-852
Open this publication in new window or tab >>Staff views on how to improve mealtimes for elderly people with dementia living at home
2017 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 16, no 7, p. 835-852Article in journal (Refereed) Published
Abstract [en]

Dementia commonly leads to difficulties in performing daily activities, which can also often affect the ability to prepare and eat meals. As a result, formal support to maintain good nutritional intake might be needed, but there is a lack of knowledge concerning how to support older persons with dementia living at home. The aim of this study was to explore and describe staff views on how to improve mealtimes for persons with dementia who are still living at home. A qualitative descriptive study was performed and data were collected during 2011–2012 through four focus group interviews with staff working in the homes of persons with dementia. Data were analyzed using inductive content analysis. The participants described several ways to improve mealtimes for persons with dementia and advocated adjustments facilitating the preservation of the persons’ independence. Finding suitable actions calls for knowledge about the person and his/her individual situation. Proposed actions were enabling meals at home, taking over, and moving meals outside of the home. In addition, it was found that, the types of meals served to these persons should be as familiar to the individual as possible. The results of this study indicate the importance of using a person-centered approach and meeting the individual needs when supporting people with dementia in regards to their meals when living at home. Individualized care in the home may be expensive, however, it is fair to say that people who become malnourished and admitted to hospitals is even more costly. Furthermore, sharing and reflecting experiences and knowledge can assist staff to identify ways to manage complex situations. Therefore, the use of refection should be a part of staff members’ everyday work.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
community care, content analysis, dementia, food provision, mealtime, nutrition, older people
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-28515 (URN)10.1177/1471301215619083 (DOI)000411689100013 ()26631823 (PubMedID)2-s2.0-85029528756 (Scopus ID)
Available from: 2015-12-08 Created: 2015-12-08 Last updated: 2018-02-08Bibliographically approved
Boysen, G. N., Nyström, M., Christensson, L., Herlitz, J. & Sundstrom, B. W. (2017). Trust in the early chain of healthcare: Lifeworld hermeneutics from the patient’s perspective. International Journal of Qualitative Studies on Health and Well-being, 2(1), Article ID 1356674.
Open this publication in new window or tab >>Trust in the early chain of healthcare: Lifeworld hermeneutics from the patient’s perspective
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2017 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 1, article id 1356674Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for a non-urgent condition and been referred to the healthcare centre.

METHOD:

A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patients participated: seven female and three male. The setting is the early chain of healthcare in south-western Sweden.

RESULTS:

The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient's lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the "voice of the lifeworld" enables the patient to feel trust.

CONCLUSION:

Trust in the early chain of healthcare entails caregivers' ability to pay attention to both medical and existential issues in compliance with the patient's information and questions. Thus, the patient must be invited to participate in assessments and decisions concerning his or her own healthcare, in a credible manner and using everyday language.

Place, publisher, year, edition, pages
CoAction Publishing, 2017
Keywords
Ambulance; caring relationship; caring science; healthcare centre; healthcare level; lifeworld hermeneutics; trust
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-37172 (URN)10.1080/17482631.2017.1356674 (DOI)000407339700001 ()28793852 (PubMedID)2-s2.0-85027691945 (Scopus ID)GOA HHJ 2017 (Local ID)GOA HHJ 2017 (Archive number)GOA HHJ 2017 (OAI)
Available from: 2017-09-04 Created: 2017-09-04 Last updated: 2019-06-05Bibliographically approved
Johansson, L., Wijk, H. & Christensson, L. (2016). Improving nutritional status among persons with dementia by performing individualized interventions. In: : . Paper presented at The Gerontological Society of America's 69th Annual Scientific Meeting, New Orleans, November 16-20, 2016..
Open this publication in new window or tab >>Improving nutritional status among persons with dementia by performing individualized interventions
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Poor nutritional status is common among persons with dementia and negatively associated with subjective health, mobility and mortality. When malnutrition occurs it is challenging to improve the nutritional status. The aim of the study was to investigate if a structured preventive care process could increase body weight, among persons with dementia at risk of malnutrition or malnourished. The structured preventive care process includes four steps which have been registered in a national quality register: 1) Risk assessment by Mini nutritional assessment-Short Form. 2) Team-based analysis of underlying causes (19 evidence-based risk factors) performed by staff including professionals like nurses, nurse assistants, occupational therapists and physiotherapists. 3)  Planning and performing interventions based on the need and problems of the individual (28 evidence-based actions) and 4) evaluation of performed interventions (body weight). A prepost design was used with body weight measured during baseline (0) and follow-up (7–106 days later). In total 526 persons with dementia at risk of malnutrition 176 The Gerontological Society of America Copyedited by: OUP at :: on January 10, 2017 http://gerontologist.oxfordjournals.org/ Downloaded from or malnourished, 65 years and older and with a care contact, were included. Results: 109 persons was registered in all four steps i.e. a team-based analysis of underlying causes have been performed. An improvement in the nutritional status was observed in these individuals (baseline Md 60.0 kg; follow-up Md 62.0  kg; p-value 0.013). No improvement was detected among those missing an analysis of underlying causes. Accordingly, by planning care in a structured way and give individualized interventions based on underlying causes can help improve nutritional status among persons with dementia at risk of malnutrition or malnourished.

Series
The Gerontologist, ISSN 0016-9013 ; 56(Suppl. 3):176-177
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:hj:diva-34655 (URN)10.1093/geront/gnw162.692 (DOI)
Conference
The Gerontological Society of America's 69th Annual Scientific Meeting, New Orleans, November 16-20, 2016.
Note

Supplement: New Lens on Aging: Changing Attitudes, Expanding Possibilities

Available from: 2017-01-10 Created: 2017-01-10 Last updated: 2018-01-13Bibliographically approved
Wibring, K., Herlitz, J., Christensson, L., Lingman, M. & Bång, A. (2016). Prehospital factors associated with an acute life-threatening condition in non-traumatic chest pain patients - A systematic review. International Journal of Cardiology, 219, 373-379
Open this publication in new window or tab >>Prehospital factors associated with an acute life-threatening condition in non-traumatic chest pain patients - A systematic review
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 219, p. 373-379Article in journal (Refereed) Published
Abstract [en]

Background: Chest pain is a common symptom among patients contacting the emergency medical services (EMS). Risk stratification of these patients is warranted before arrival in hospital, regarding likelihood of an acute life-threatening condition (LTC).

Aim: To identify factors associated with an increased risk of acute LTC among patients who call the EMS due to non-traumatic chest pain.

Methods: Several databases were searched for relevant articles. Identified articles were quality-assessed using the Scottish Intercollegiate Guidelines Network checklists. Extracted data was analysed using a semi-quantitative synthesis evaluating the level of evidence of each identified factor.

Results: In total, 10 of 1245 identified studies were included. These studies provided strong evidence for an increased risk of an acute LTC with increasing age, male gender, elevated heart rate, low systolic blood pressure and ST elevation or ST depression on a 12-lead ECG. The level of evidence regarding the history of myocardial infarction, angina pectoris or presence of a Q wave or a Left Bundle Branch Block on the ECG was moderate. The evidence was inconclusive regarding dyspnoea, cold sweat/paleness, nausea/vomiting, history of chronic heart failure, smoking, Right Bundle Branch Block or T-inversions on the ECG.

Conclusions: Factors reflecting age, gender, myocardial ischemia and a compromised cardiovascular system predicted an increased risk of an acute life-threatening condition in the prehospital setting in cases of acute chest pain. These factors may form the basis for prehospital risk stratification in acute chest pain.

Keywords
Acute coronary syndrome, Chest pain, Emergency medical services, Prehospital, Risk assessment
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:hj:diva-31251 (URN)10.1016/j.ijcard.2016.06.066 (DOI)000380817400064 ()27352210 (PubMedID)2-s2.0-84976329676 (Scopus ID)
External cooperation:
Available from: 2016-08-15 Created: 2016-08-15 Last updated: 2017-11-28Bibliographically approved
Norberg, G., Sundström, B. W., Christensson, L., Nyström, M. & Herlitz, J. (2015). Swedish emergency medical services' identification of potential candidates for primary healthcare: Retrospective patient record study. Scandinavian Journal of Primary Health Care, 33(4), 311-317
Open this publication in new window or tab >>Swedish emergency medical services' identification of potential candidates for primary healthcare: Retrospective patient record study
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2015 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 33, no 4, p. 311-317Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate patients who called the emergency medical services (EMS) for primary healthcare (PHC) problems.

Design: A retrospective and exploratory patient record study from an EMS perspective, comparing two groups: those who were potential candidates for PHC and those who were not. All data were gathered from EMS and hospital records.

Settings: The study was completed at the EMS and five hospital areas in the western region of Sweden.Subjects: The patients (n=3001) who called the EMS in 2011. Data were missing for 10%.

Main outcome measures: The frequency and the clinical characteristics of the patients who called the EMS and were actually potential candidates for PHC.

Results: Of a total of 2703 patients, a group of 426 (16%) were assessed as potential candidates for PHC and could thus be treated at a level of care other than the emergency department. Patients who were classified as suitable for PHC were found at all priority levels and within all symptom groups, but were younger and healthier than the other group.

Conclusion: Numerous patients seeking help from the EMS do not end up at the most appropriate level in the healthcare system.

Implications: In the EMS, guidelines are needed to enable pre-hospital emergency nurses to assess and triage patients to the most appropriate level of healthcare.

Keywords
Assessment, emergency medical services, exploratory, general practice, pre-hospital emergency nurse, primary healthcare, triage, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-29102 (URN)10.3109/02813432.2015.1114347 (DOI)000366742400013 ()26635215 (PubMedID)2-s2.0-84949234110 (Scopus ID)
Available from: 2016-01-15 Created: 2016-01-15 Last updated: 2017-11-30Bibliographically approved
Haraldsson, L., Christensson, L., Conlon, L. & Henricson, M. (2015). The experiences of ICU patients during follow-up sessions: A qualitative study. Intensive & Critical Care Nursing, 31(4), 223-231
Open this publication in new window or tab >>The experiences of ICU patients during follow-up sessions: A qualitative study
2015 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 4, p. 223-231Article in journal (Refereed) Published
Abstract [en]

Objective

Evidence supports the recommendation for follow-up session(s) for patients after discharge from an intensive care unit (ICU). The aim of these follow-up sessions is to allow patients to express and discuss their experiences and problems following their time in an ICU. To optimise the knowledge gained from the follow-up session experience, it is necessary to describe how patients experience these sessions. The aim of this study was to describe how ICU-patients, experience a follow-up session.

Design/setting

This study adopted a qualitative design utilising semi-structured interviews, and which examined the experiences of seven men and five women. Qualitative content analysis was utilised.

Findings

The participants stated that the information gained from these sessions, which had previously seemed unclear to some of them, was, on the whole, now clarified and confirmed. A discernible difference was found between participants who were cared for on a general ward and those who were cared for on a rehabilitation ward and also were offered a meeting with a counsellor, following discharge their from the ICU. The findings also indicated that participants who were not offered psychosocial support showed a greater need for a follow-up session.

Conclusion

This study has highlighted the need for increasing collaboration between intensive care staff and staff in other units to provide support to this patient group in order to reduce their suffering post intensive care experience.

Keywords
content analysis; Follow-up; Intensive care; Memories
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-26398 (URN)10.1016/j.iccn.2015.01.002 (DOI)000361146200005 ()25724102 (PubMedID)2-s2.0-84939256055 (Scopus ID)
Available from: 2015-04-30 Created: 2015-04-30 Last updated: 2017-12-04Bibliographically approved
Johansson, L., Björklund, A., Sidenvall, B. & Christensson, L. (2014). Spouses' experiences of mealtimes with a partner suffering from dementia. The journal of aging research & clinical practice, 3(4), 237-244
Open this publication in new window or tab >>Spouses' experiences of mealtimes with a partner suffering from dementia
2014 (English)In: The journal of aging research & clinical practice, ISSN 2273-421X, Vol. 3, no 4, p. 237-244Article in journal (Refereed) Published
Abstract [en]

Background: As difficulties in performing daily activities occur among persons with dementia, their spouses are also affected. This is also true for mealtimes, yet there is a lack of knowledge and research into how couples manage this situation at home. Objective: The aim of the study was to explore and describe spouses’ experiences of mealtimes in couples in which one partner has dementia. Design, Setting and Participants: Ten spouses were interviewed in their home in respect to their experiences regarding mealtimes when living with a partner diagnosed with dementia. To identify themes across the data set, thematic analysis was conducted. Results: One major theme, Recognizing and managing the range of mealtime change, was identified and showed that depending on where the families were in the dementia process their experienced varied. As progression occurred in the partners disease, routines, responsibilities and relationships were affected within the couple. Strategies the participants used tomanage mealtimes at home regarding these problems were highlighted such as getting support from social services, but also strategies they had learnt by themselves. Conclusion: These results generate an insight into what couples face, and their needs for support. Spouses experiences varied which indicates that it is important that support is based on individual needs. Hence, nursing staff should continuously pay attention to couples mealtime situation. Further it increases staff´s knowledge regarding possible solutions on how to involve persons with dementia in mealtime activities and maintain their nutritional intake.

Keywords
Dementia, mealtimes, qualitative research, spouses.
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-25349 (URN)10.14283/jarcp.2014.41 (DOI)
Available from: 2014-12-17 Created: 2014-12-17 Last updated: 2015-10-23Bibliographically approved
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