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Nygårdh, Annette
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Publications (10 of 21) Show all publications
Neher, M., Nygårdh, A., Nilsen, P., Broström, A. & Johansson, P. (2019). Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review. European Journal of Cardiovascular Nursing, 18(5), 346-357
Open this publication in new window or tab >>Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and psychological distress: a scoping review
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 5, p. 346-357Article, review/survey (Refereed) Published
Abstract [en]

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

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

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

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

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

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Implementation, computer-assisted therapy, depression, insomnia, internet, remote consultation
National Category
Cardiac and Cardiovascular Systems Psychiatry
Identifiers
urn:nbn:se:hj:diva-43367 (URN)10.1177/1474515119833251 (DOI)000469834300002 ()30795698 (PubMedID)2-s2.0-85062326670 (Scopus ID)
Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2019-06-20Bibliographically approved
Wang, L., Mårtensson, J., Zhao, Y. & Nygårdh, A. (2018). Experiences of a health coaching self-management program in patients with COPD: a qualitative content analysis.. The International Journal of Chronic Obstructive Pulmonary Disease, 13, 1527-1536
Open this publication in new window or tab >>Experiences of a health coaching self-management program in patients with COPD: a qualitative content analysis.
2018 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 13, p. 1527-1536Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe the experiences of patients with COPD participating in a health coaching self-management program.

Patients and methods: Twenty patients who had participated in a 6-month health coaching self-management program intervention were purposefully selected for a qualitative evaluation of the program using semi-structured interviews. The interviews were analyzed using inductive qualitative content analysis.

Results: Four categories and 13 subcategories emerged describing the participants' experiences of the program. Their experiences were expressed as gaining insight into the importance of knowledge and personal responsibilities in the management of COPD, taking action to maintain a healthy lifestyle, feeling supported by the program, and being hindered by individual and program limitations.

Conclusion: Iterative interactions between patients and health care professionals together with the content of the program are described as important to develop skills to manage COPD. However, in future self-management programs more awareness of individual prerequisites should be considered.

Place, publisher, year, edition, pages
Dove Medical Press, 2018
Keywords
chronic obstructive pulmonary disease, health coaching, qualitative content analysis, self-management
National Category
Respiratory Medicine and Allergy Nursing
Identifiers
urn:nbn:se:hj:diva-41081 (URN)10.2147/COPD.S161410 (DOI)000432048200001 ()29785102 (PubMedID)2-s2.0-85047080588 (Scopus ID)HHJADULTIS, HHJIMPROVEIS (Local ID)HHJADULTIS, HHJIMPROVEIS (Archive number)HHJADULTIS, HHJIMPROVEIS (OAI)
Available from: 2018-07-31 Created: 2018-07-31 Last updated: 2019-03-07Bibliographically approved
Hedberg, B. & Nygårdh, A. (2018). Patientdelaktighet och medverkan hos vuxna med fysisk ohälsa. In: Ann Catrine Eldh (Ed.), Delaktighet och patientmedverkan: (pp. 107-138). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Patientdelaktighet och medverkan hos vuxna med fysisk ohälsa
2018 (Swedish)In: Delaktighet och patientmedverkan / [ed] Ann Catrine Eldh, Lund: Studentlitteratur AB, 2018, p. 107-138Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2018
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-39636 (URN)9789144113296 (ISBN)
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2018-05-31Bibliographically approved
Neher, M. S., Johansson, P., Nilsen, P., Broström, A. & Nygårdh, A. (2017). Exploring implementation issues when introducing a novel internet-based intervention to treat cardiovascular disease-associated mental health issues- the Implement-IT project.. Paper presented at EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden. European Journal of Cardiovascular Nursing, 16(Suppl. 1), S52-S53
Open this publication in new window or tab >>Exploring implementation issues when introducing a novel internet-based intervention to treat cardiovascular disease-associated mental health issues- the Implement-IT project.
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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. S52-S53Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Mental health (MH) problems such as depression and insomnia are prominent among patients with cardiovascular disease (CVD). They are associated with a negative impact on quality of life, higher health care costs and a poorer prognosis. Despite this most patients with CVD will not receive support or treatment for their MH problems. Studies in other patient groups have described internet based cognitive behavioral treatment (I-CBT) as a promising intervention, but I-CBT has not been tested in CVD patients. The I-CBT HEART research project aims specifically to develop and evaluate I-CBT programs for CVD patients with psychological distress. The programs, both of which are in early stages of clinical evaluation, respectively target patients with depressive symptoms and patients with insomnia. Two randomized controlled trials will be carried out, I-CBT for insomnia (HiT-IT) and I-CBT for depression (DOHART). Implementation research has shown overwhelming evidence of the difficulties that are often encountered in the diffusion and dissemination of novel treatments, such as I-CBT for CVD. To smooth the way for future use of a successful intervention in clinical practice, a better knowledge is needed of the factors that may hinder or support implementation in practice.

Purpose: The overall aim of the IMPLEMENT-IT study, a part of the I-CBT HEART project, is to achieve a better understanding of potential future implementation issues by exploring barriers and facilitators from different stakeholder perspectives that may be of importance in future implementation.

Methods: Both qualitative and quantitative data will be collected in conjunction with the RCT studies HiT-IT and DOHART. Interviews with stakeholders at different levels focusing on perceptions of the role of eHealth in traditional healthcare in general, and of the I-CBT HEART intervention in particular. Informants are recruited in groups of healthcare-tasked representatives of political parties at the regional level, local decision-makers in higher healthcare administration, clinical decision-makers, healthcare profe ssionals (providers), as well as patients. Our intention is to measure implementation leadership,empowerment and implementation climate in the clinical contexts, but also to develop valid and reliable instruments to be used in future studies.

Conclusion: Studying factors that may potentially influence the implementation of a novel I-CBT program for treatment of MH problems in CVD patients through a mixed methods approach may assist the design of future implementation strategies in clinical cardiac care.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Cardiac and Cardiovascular Systems Psychiatry
Identifiers
urn:nbn:se:hj:diva-35950 (URN)000401775600091 ()
Conference
EuroHeartCare 2017, 18-20 May 2017, Jönköping, Sweden
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2017-11-21Bibliographically approved
Nygårdh, A., Sherwood, G., Sandberg, T., Rehn, J. & Knutsson, S. (2017). The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education. Nurse Education Today, 59, 110-117, Article ID S0260-6917(17)30207-1.
Open this publication in new window or tab >>The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 59, p. 110-117, article id S0260-6917(17)30207-1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education.

PURPOSE: To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice

METHOD: A quantitative descriptive method was used to analyze assessment tools from 23 universities.

RESULTS AND CONCLUSION: Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Assessment tool, Clinical education, QSEN, Student nurses
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-37619 (URN)10.1016/j.nedt.2017.09.003 (DOI)000416187800020 ()28985548 (PubMedID)2-s2.0-85030680352 (Scopus ID)HHJCHILDIS, HHJKvalitetIS (Local ID)HHJCHILDIS, HHJKvalitetIS (Archive number)HHJCHILDIS, HHJKvalitetIS (OAI)
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2018-01-19Bibliographically approved
Nygårdh, A., Neher, M., Broström, A., Nilsen, P. & Johansson, P. (2017). Towards internet-based cognitive behavioural therapy for patients with cardiovascular disease and comorbid depression and insomnia?. European Journal of Cardiovascular Nursing, 16(7), 565-566
Open this publication in new window or tab >>Towards internet-based cognitive behavioural therapy for patients with cardiovascular disease and comorbid depression and insomnia?
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2017 (English)In: European Journal of Cardiovascular Nursing, Vol. 16, no 7, p. 565-566Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-37665 (URN)10.1177/1474515117704101 (DOI)000412103400002 ()28393545 (PubMedID)2-s2.0-85030231648 (Scopus ID)
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-11-21Bibliographically approved
Nygårdh, A., Ahlström, G. & Wann-Hansson, C. (2016). Handling a challenging context: experiences of facilitating evidence-based elderly care. Journal of Nursing Management, 24(2), 201-210
Open this publication in new window or tab >>Handling a challenging context: experiences of facilitating evidence-based elderly care
2016 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 2, p. 201-210Article in journal (Refereed) Published
Abstract [en]

Aim

To explore improvement facilitators' experiences of handling their commission to implement evidence-based practice in elderly care for frail older persons.

Background

Improvement facilitators were put in place across Sweden in a time-limited project by the government, with one part of the project being to evaluate the model before establishing this facilitation of evidence-based practice in elderly care.

Method

Two focus groups were interviewed twice. Each group comprised three respondents. The interviews were analysed using qualitative content analysis.

Findings

A main theme, ‘Moving forward by adjusting to the circumstances’, described how the improvement facilitators handle their commitment. Five subthemes emerged: identifying barriers, keeping focus, maintaining motivation, building bridges and finding balance.

Conclusion

The improvement facilitators' commitment is ambiguous because of unclear leadership of, and responsibility for the national investment. They have to handle leaders' different approaches and justify the need for evidence-based practice. The improvement facilitators did not reflect on the impact of programme adaptations on evidence-based practice.

Implications for nursing management

The findings emphasise the need for collaboration between the improvement facilitator and the nurse manager. To fully implement evidence-based practice, negotiations with current practitioners for adaptation to local conditions are necessary. Furthermore, the value of improving organisational performance needs to be rigorously communicated throughout the organisation.

Keywords
elderly care; evidence-based practice; facilitators; nurse management; quality register
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-28864 (URN)10.1111/jonm.12300 (DOI)000372022600017 ()25882164 (PubMedID)2-s2.0-84928128896 (Scopus ID)
External cooperation:
Available from: 2016-01-04 Created: 2016-01-04 Last updated: 2017-12-01Bibliographically approved
Malm, D., Rolander, B., Ebefors, E.-M., Conlon, L. & Nygårdh, A. (2016). Reducing the prevalence of catheter-related infections by quality improvement: Six-year follow-up study. Open Journal of Nursing, 6(2), 79-87
Open this publication in new window or tab >>Reducing the prevalence of catheter-related infections by quality improvement: Six-year follow-up study
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2016 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 2, p. 79-87Article in journal (Refereed) Published
Abstract [en]

Background: Peripheral venous catheter (PVC) insertion is a crucial nursing action during life support. Several factors that increase the risk of thrombophlebitis associated with PVCs have been reported. Objective: We wish to evaluate the impact of a quality improvement regarding PVC treatment for patients with coronary heart diseases.

Method: A longitudinal, quantitative observational study was carried out in 2008 and 2013 in a hospital in southern Sweden with 360 consecutive patients suffering from acute chest pain. New routines for PVC treatment were included in the hospital with daily inspection according to a checklist. A structured observation protocol was used to survey the prevalence of thrombophlebitis between 2008 and 2013. Also, we examined the relationship between the location and luminal diameters of PVCs.

Results: The student’s t-test showed significant differences between 2008 and 2013 with respect to luminal diameter of PVCs (p = 0.002), prevalence of thrombophlebitis (p = 0.003) and number of days with PVC left in situ (p < 0.001).

Conclusion: These findings emphasize the value of using systematic daily inspections and checklists to achieve quality and safety in patients with acute chest pain having PVC-based treatment.

Keywords
Bloodstream Infection, Peripheral Venous Catheter, Quality Improvement, Thrombophlebitis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-34665 (URN)10.4236/ojn.2016.62008 (DOI)
Available from: 2017-01-11 Created: 2017-01-11 Last updated: 2017-11-29Bibliographically approved
Wang, L., Nygårdh, A., Zhao, Y. & Mårtensson, J. (2016). Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables. Applied Nursing Research, 32, 61-66
Open this publication in new window or tab >>Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables
2016 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, p. 61-66Article in journal (Refereed) Published
Abstract [en]

PURPOSE: This study aimed to examine the status of self-management in patients with COPD and its associations with sociodemographic and clinical variables.

METHODS: This cross-sectional study included 154 patients with COPD (mean age, 73 years) at four hospitals in Tianjin, China. The COPD Self-Management Scale was used to describe the level of self-management, and its associations with sociodemographic and clinical variables were examined with multiple regression analysis.

RESULTS: More than half of the patients with COPD had a low (30%) or moderate (27%) level of self-management. Self-management was rated highest in management of daily life and lowest in information management. Higher physical activity, higher salary, and lower age affected self-management the most positively.

CONCLUSION: The overall burden of COPD in China is greater than that found in other countries. Healthcare professionals need to improve their understanding of the importance of self-management and specifically focus on increased physical activity targeting patients with poor literacy skills.

Keywords
Self-management; Chronic obstructive pulmonary disease; Sociodemographic variables; Clinical variables
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-34600 (URN)10.1016/j.apnr.2016.05.001 (DOI)000388057100012 ()27969053 (PubMedID)2-s2.0-84969786258 (Scopus ID)HHJIMPROVEIS, HHJADULTIS (Local ID)HHJIMPROVEIS, HHJADULTIS (Archive number)HHJIMPROVEIS, HHJADULTIS (OAI)
Available from: 2017-01-02 Created: 2017-01-02 Last updated: 2019-03-07Bibliographically approved
Nygårdh, A., Mårtensson, J., Allemann, H., Strömberg, A., Aidemark, J., Fruberg, C., . . . Askenäs, L. (2015). An experience-based co-design to accomplish person-centered self-care support for elderly persons with heart failure. Paper presented at EuroHeartCare 2015. European Journal of Cardiovascular Nursing, 14, 51-52, Article ID 139.
Open this publication in new window or tab >>An experience-based co-design to accomplish person-centered self-care support for elderly persons with heart failure
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2015 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, p. 51-52, article id 139Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Self-care refers to activities performed with the intention of improving or restoring health and well-being. A good understanding of the adaptations needed in daily life is a prerequisite to motivate individuals to implement such changes. Facilitating the person with heart-failure’s (HF) understanding of the diagnosis, how to handle symptoms, and when to seek healthcare, is one way of proactive self-care. Previous Information and communication technology (ICT) support has proved to be effective in younger patients, but the development has not been user-driven, i.e. involving references and experiences from the patient, their family members or healthcare professionals and have rarely been implemented in clinical practice. In addition, disregard of the user hands over control and responsibility to the healthcare professionals and misses the patient’s desires and requirements.

Aim: To describe an experience-based co-design of ICT for self-care support in the context of heart failure care

Methods: The steps in the process of developing ICT support programs for self-care were guided by an experienced based co-design methodology including: 1) Workshops regarding self-care needs. 2) Workshops regarding self-care support as a means to cope with the phases of the disease. 3) Workshops to assess the usability of the suggested ideas. 4) Workshops to test the different supports in action. The project involved older persons with HF, their family members, healthcare professionals, IT-developers, informatics, development leaders, and researchers. There was also a quality improvement process involved to improve working routines and communication between the person with HF and the healthcare professionals, which in turn, increases the value of the innovation. Data collection include tape- and video recorded workshops and diary notes supplied by the informants. All data are to be analyzed by content analysis to identify needs, opportunities and challenges of self-care.

Results and conclusion: This design was found to be a useful method for finding and assess usability of person-centered self-care ICT support. To involve users in the development of self-care support has improved the opportunities to realize support needed. Sharing these perspectives increases professionally and organizationally learning in order to accomplish person-centered self-care. Preliminary findings show that ICT will be a part of solving some of the self-care needs described by patients, family member and health care providers and the next step in the project will be to test and adapt these tools.

National Category
Cardiac and Cardiovascular Systems Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hj:diva-34666 (URN)000356411700095 ()
Conference
EuroHeartCare 2015
Note

Moderated Poster Session, Psycho-social & Prevention, Sunday 14 June 2015 – 10:00 – 11:00

Available from: 2017-01-11 Created: 2017-01-11 Last updated: 2019-03-07Bibliographically approved
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