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  • 1.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Factors affecting in-hospital sleep-wake pattern in octogenarians during the early postoperative phase after transcutaneous aortic valve replacement2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S53-S53Article in journal (Refereed)
    Abstract [en]

    Background: Octogenarian patients are an increasing group admitted for advanced cardiac treatment. Little is known about factors disturbing their sleep-wake pattern in the early postoperative phase after transcutaneous aortic valve replacement (TAVI), as current knowledge is based upon studies on younger age groups treated for surgical aortic valve replacement.

    Aim: To determine factors affecting the in-hospital sleep wake pattern in octogenarian patients after TAVI.

    Methods: This is a prospective cohort study in a tertiary university hospital. Inclusion criteria were age > 80 years with severe aortic stenosis accepted for TAVI. Actigraphy was used to identify sleep-wake pattern (sleep time night and sleep time day), and the Minimal Insomnia Symptom Scale (MISS) to measure self-reported insomnia daily during the first five postoperative days. Charlson`s comorbidity index was used as a measure of comorbidities and the Visual Analog Scale (VAS) to rate pain severity. Information regarding duration of anesthesia, blood transfusion and parenteral administration of morphine equivalents were derived from the patients’ medical journals. Multiple regression analysis was used to test associations between variables.

    Results: In all, 65 patients (41 women) were included. Mean age was 85 years (SD 2.8). No significant associations were found between age, comorbidities, blood transfusion and morphine equivalents and sleep. Gender was significantly associated with sleep time night and sleep efficiency as men had shortest duration of sleep from the third to the fifth postoperative night (p < .001, and adjusted R2=.230 to .283). Duration of anesthesia had a significant association with sleep time night and sleep efficiency from the third to the fifth postoperative night (p=.013 to p < .001, and adjusted R2=.230 to .283), where longer duration gave less total sleep and lower sleep efficiency. VAS score correlated with wake time night the third night, where a higher VAS score gave more wake time (p=.006 and adjusted R2 .236).

    Conclusion: Male gender, longer duration of perioperative anesthesia and postoperative pain were associated with disturbances in the postoperative sleep-wake pattern in octogenarian patients in the early postoperative phase after TAVI. This knowledge is important and relevant and should have implications in improving patient care.

  • 2.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Faculty of Health and Social Science, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway .
    Factors associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after surgical aortic valve replacement2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S63-S64Article in journal (Refereed)
    Abstract [en]

    Background: Disturbances of the sleep-wake pattern are known phenomenon in the postoperative phase after aortic valve replacement (SAVR) that have negative impact on the morbidity, quality of life and mortality. Octogenarian patients are an increasing group admitted for cardiac surgery, however knowledge is based on younger patients.

    Aims: To determine factors associated with disturbances in postoperative sleep-wake pattern in octogenarian patients after SAVR.

    Methods: A prospective cohort study of octogenarian patients in a single center university hospital. Inclusion criteria were age > 80 years, severe aortic stenosis, accepted for SAVR. Actigraphy was used to identify the sleep-wake pattern (sleep-time, sleep efficiency and wake time night and sleep- and wake-time day) for the five first postoperative days, and the sleep questionnaires Minimal Insomnia Symptom scale (MISS) to measure the selfreported insomnia at baseline and daily for the five first postoperative days. 

    Charlsons comorbidity index was used to score comorbidities and the Visual Analog Scale (VAS), was used to rate pain severity. The patients’ medical journals were used to record duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusions and parenteral administration of morphine equivalents. Multiple regression analysis was used to test associations between variables.

    Results: In all, 78 patients were included (40 women). Mean age was 82 years (SD 2.0). For the sleep-wake pattern first to fifth postoperative night, mean sleep-time night was 330-370 minutes (SD 32-124). Mean sleep efficiency was 68-77% (SD 21-26). Mean sleep-time day was 545-712 minutes (SD 146-169). Mean insomnia score was 1,8-5,3 (SD 2,6-3,8). On the first postoperative night the pain VAS score correlated with wake time night, where a higher VAS indicated more wake time (p=.014, adjusted R2=.213). No other variable; age, gender, duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusion or morphine equivalents showed significant association with the sleep-wake pattern or insomnia.

    Conclusion: Postoperative pain was associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after SAVR. This indicates that pain management may be inadequate for patients after SAVR. More research on this issue is needed to establish data needed to improve treatment and care.

  • 3.
    Amofah, Hege A.
    et al.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Bjorvatn, Bjørn
    Norwegian Competence Centre for Sleep Disorders, Bergen, Norway.
    Haaverstad, Rune
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Hufthammer, Karl Ove
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Kuiper, Karel K. J.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Ranhoff, Anette H.
    Department of Clinical Science, University of Bergen, Norway.
    Norekvål, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 2, p. 168-177Article in journal (Refereed)
    Abstract [en]

    Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.

    Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep–wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.

    Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep–wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.

    Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).

    Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep–wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.

  • 4.
    Arenhall, Eva
    et al.
    Orebro Universitet, Department of Cardiology, Orebro, Sweden.
    Eriksson, Mats
    Uddevalla Hospital, Department of Pediatrics, Uddevalla, Sweden.
    Nilsson, Ulrica
    Orebro Universitet, School of Health Sciences, Orebro, Sweden.
    Steinke, Elaine E.
    Wichita State University, School of Nursing, Wichita, United States.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Decreased sexual function in partners after patients’ first-time myocardial infarction2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953Article in journal (Refereed)
    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. 

  • 5. Arenhall, Eva
    et al.
    Kristofferzon, Marja-Leena
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Malm, Dan
    Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nilsson, Ulrica
    The male partners' experiences of the intimate relationships after a first myocardial infarction2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 2, p. 108-114Article in journal (Refereed)
    Abstract [en]

    Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.

    Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.

    Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis.

    Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.

    Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders.

  • 6.
    Astin, Felicity
    et al.
    University of Salford.
    Carroll, Diane
    Massachusetts General Hosital,.
    De Geest, Sabina
    Kathlieke Universiteit Leuven.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Education for nurses working in cardiovascular care: A European survey2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 6, p. 532-540Article in journal (Refereed)
    Abstract [en]

    Background: Nurses represent the largest sector of the workforce caring for people with cardiovascular disease in Europe. Little is known about the post-registration education provided to nurses working within this specialty. The aim of this descriptive cross sectional survey was to describe the structure, content, teaching, learning, assessment and evaluation methods used in post-registration cardiovascular nurse education programmes in Europe.

    Method: A 24-item researcher generated electronic questionnaire was sent to nurse representatives from 23 European countries. Items included questions about cardiovascular registered nurse education programmes.

    Results: Forty-nine respondents from 17 European countries completed questionnaires. Respondents were typically female (74%) and educated at Masters (50%) or doctoral (39%) level. Fifty-one percent of the cardiovascular nursing education programmes were offered by universities either at bachelor or masters level. The most frequently reported programme content included cardiac arrhythmias (93%), heart failure (85%) and ischaemic heart disease (83%). The most common teaching mode was face-to-face lectures (85%) and/or seminars (77%). A variety of assessment methods were used with an exam or knowledge test being the most frequent. Programme evaluation was typically conducted through student feedback (95%).

    Conclusion: There is variability in the content, teaching, learning and evaluation methods in post-registration cardiovascular nurse education programmes in Europe. Cardiovascular nurse education would be strengthened with a stronger focus upon content that reflects current health challenges faced in Europe. A broader view of cardiovascular disease to include stroke and peripheral vascular disease is recommended with greater emphasis on prevention, rehabilitation and the impact of health inequalities.

  • 7. Axelsson, Åsa B
    et al.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Moons, Philip
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Scholte op Reimer, Wilma
    Smith, Karen
    Strömberg, Anna
    Thompson, David R
    Norekvål, Tone M
    European cardiovascular nurses' experiences of and attitudes towards having family members present in the resuscitation room2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 1, p. 15-23Article in journal (Refereed)
  • 8. Berben, L
    et al.
    Bogert, L
    Leventhal, ME
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Jaarsma, T
    Norekvål, TM
    Smith, K
    Strömberg, A
    Thompson, DR
    De Geest, S
    Which interventions are used by healthcare professionals to enhance medication adherence in cardiovascular patients?: A survey of current clinical practice2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 1, p. 14-21Article in journal (Refereed)
    Abstract [en]

    Background Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice.

    Aim To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions.

    Method A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management.

    Results Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence.

    Conclusion Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.

  • 9.
    Bergman, Eva
    et al.
    Department of Internal Medicine, Division of Cardiology, County Hospital Ryhov, Jönköping, Sweden .
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Ljungqvist, Birgit
    Jönköping University, School of Health and Welfare.
    Karlsson, Jan-Erik
    Department of Medicine and Health Sciences, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Berterö, Carina
    Department of Medicine and Health Sciences, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Karlsson, Jan-Erik
    Department of Internal Medicine, Division of Cardiology, County Hospital Ryhov, Jönköping, Sweden.
    Meaningfulness is not the most important component for changes in sense of coherence2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 3, p. 331-338Article in journal (Refereed)
    Abstract [en]

    Background Sense of coherence is a theoretical construct which is used to measure the degree to which a person finds the world comprehensible, manageable and meaningful.

    Aim The main aim of the present study was to assess the hypothesis of Antonovsky that meaningfulness is the most crucial component in sense of coherence. The second aim was to explore the importance of its components and factors at baseline on sense of coherence changes and if the findings can be used in cardiac rehabilitation.

    Methods One hundred patients, who suffered a primary myocardial infarction were followed during two years. The instruments used were; sense of coherence questionnaire-13, 12-item short-form health survey questionnaire, the Seattle Angina Questionnaire and Health Curve.

    Results Thirty-nine percent of the participants fulfilled Antonovsky's hypothesis. Comprehensibility and the baseline factors of smoking, alcohol use, marital status and disease perception proved to be of importance for sense of coherence changes over time.

    Conclusion The hypothesis that meaningfulness is the most crucial component in sense of coherence is rejected for patients with primary myocardial infarction. Comprehensibility is more important than meaningfulness for changes in sense of coherence. Nurses therefore have an important task to increase comprehensibility and sense of coherence by providing information and knowledge about myocardial infarction and lifestyle changes at an early stage. The information should be given in an individualized and easily understandable way from a salutogenic perspective, which means to identify and work with factors that can contribute to preserving and promoting health.

  • 10. Bergman, Eva
    et al.
    Årestedt, Kristofer
    County Hospital Ryhov.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Karlsson, Jan-Erik
    County Hospital Ryhov.
    Malm, Dan Anders John
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction: a long-term follow-up study2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 3, p. 276-283Article in journal (Refereed)
    Abstract [en]

    Background: After being through a myocardial infarction (MI), a severe recovery period ensues for the patient. Long-term follow-ups are helpful, but what this should include differs between patients. Today there is no established approach to identify needs for support after an MI.

    Aim: The aim was to describe sense of coherence (SOC) over time in relation to sex, as well as further SOC in relation to quality of life (QoL) and treatment satisfaction in patients with an MI. Methods. This study had an observational and longitudinal design and followed 18 women and 60 men with an acute MI for 49–67 months after the onset of MI. Instruments used were the SOC-13 and the Seattle Angina Questionnaire.

    Results: Women scored lower SOC than men. A main effect of time was shown for comprehensibility which increased significantly from baseline to the long-term follow-up. Women increased from a lower level to an equal level as men at the long-term follow-up. The total SOC was significantly associated with QoL and treatment satisfaction.

    Conclusion: High comprehensibility and high SOC give the patient a better basis to handle life after MI. Thus, healthcare professionals should keep in mind that SOC and especially comprehensibility have meaning for the patient’s ability to handle her or his recovery. Healthcare professionals need to together with the patient identify and work with lifestyle factors that contribute to increased comprehensibility about the disease, which gives the patient the foundation to preserve and promote her or his health both in the short and long term.

  • 11. Bolse, K
    et al.
    Flemme, I
    Ivarsson, A
    Jinhage, BM
    Carroll, D
    Edvardsson, N
    Hamilton, GA
    Fridlund, Bengt
    Högskolan i Halmstad.
    Life situation related to the ICD implantation: self-reported uncertainty and satisfaction in Swedish and US samples2002In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, no 4, p. 243-251Article in journal (Refereed)
  • 12. Broström, A
    et al.
    Johansson, P
    Albers, J
    Wiberg, J
    Svanborg , E
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    6-month CPAP-treatment in a young male patient with severe obstructive sleep apnoea syndrome: a case study from the couple's perspective.2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 2, p. 103-112Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Obstructive sleep apnoea syndrome (OSAS) is independently associated with an increased risk for hypertension and cardiovascular disease. Continuous positive airway pressure (CPAP) can reduce mortality and morbidity, but low compliance rates are seen. AIM: To explore and describe the experiences of CPAP-treatment in a young male patient with severe OSAS during a 6-month period from the couple's perspective. METHODS AND THE CASE: A single case study with a phenomenographic approach was employed. Diagnostic procedures of OSAS and initiation of treatment with Auto-CPAP, humidifier and a nasal mask were performed during 4 visits. Conceptions were collected at 4 different occasions during the 6-month period (before, and 2 weeks, 3 months, and 6 months after treatment initiation) by means of interviews with a 33-year old male patient and his female partner. FINDINGS: Totally 17 different structural aspects were found to fluctuate during the 6-month period in relation to; influence of stressors, social reactions and adaptation to increase compliance. CONCLUSION: An increased knowledge about the influence of stressors, the social reactions, and the adaptation can help healthcare personnel to identify and better understand concerns of other patients and spouses during different time phases of the initial 6-month period of CPAP-treatment.

  • 13.
    Broström, Anders
    et al.
    Linköping University.
    Johansson, Peter
    Linköping University.
    Sleep disturbances in patients with chronic heart failure and their holistic consequences-what different care actions can be implemented?2005In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, no 3, p. 183-197Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sleep disturbances are prevalent among elderly, especially among those with chronic heart failure (CHF) and can affect all dimensions of quality of life (QOL) negatively.

    AIM: To describe the most common causes leading to sleep disturbances in patients with CHF, their consequences from a holistic perspective and different care actions that can be implemented.

    METHODS: MEDLINE and CINAHL databases were searched from 1989 to July 2004.

    FINDINGS: Sleep disordered breathing (SDB), and insomnia were the most common causes for sleep disturbances and occurs in 45--82% (SDB) and one-third (insomnia) of all patients with CHF. SDB cause a disturbed sleep structure with frequent awakenings, as well as several adverse effects on the cardiovascular system causing increased morbidity and mortality. Insomnia, caused by anxiety, an unknown life situation in relation to the debut of CHF, or symptoms/deteriorations of CHF can lead to negative effects on all aspects of QOL, as well as daytime sleepiness.

    CONCLUSION: The high prevalence of sleep disturbances and their holistic consequences should be taken into account when nurses asses and plan the care for patients with CHF. Randomized studies with large sample sizes evaluating non-pharmacological nursing interventions that improve sleep are needed.

  • 14.
    Broström, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sunnergren, Ola
    Linköping University.
    Nilsen, Per
    Linköping University.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, Martin
    Linköping University.
    Svanborg, Eva
    Linköping University.
    Gender differences in respiratory disturbance, sleep and daytime sleepiness in hypertensive patients with different degrees of obesity2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 2, p. 140-149Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Hypertension (HT) and obesity have both been linked to obstructive sleep apnoea (OSA). Difficulties have been described in identifying patients with OSA in primary care, causing low referral rates to sleep clinics. Increased knowledge about gender-specific characteristics and symptoms may help to identify patients. AIM: The aim was to describe gender differences regarding undiagnosed OSA, self-rated sleep, insomnia and daytime sleepiness in middle-aged primary care patients with HT and different degrees of obesity. METHODS: A cross-sectional design was used and 394 patients (52.5% women), mean age 57.8 years (SD 6.7 years), with HT (BP >140/90 mmHg) were included. Clinical examinations, respiratory recordings and self-rated scales regarding OSA symptoms, sleep, insomnia and daytime sleepiness were used. Body mass index (BMI) was classified according to the criteria from the National Institutes of Health. RESULTS: Pre-obesity and obesity classes I and II were seen among 53%, 26% and 8% of the men and 37%, 19% and 14% of the women, respectively. Occurrence of mild, moderate and severe OSA increased significantly across the BMI classes for both genders (p<0.01). Ninety percent of the men and 80% of the women in obesity class II had OSA. Insomnia was prevalent in obese patients. Other clinical variables did not differ between BMI classes or genders. CONCLUSION: The occurrence of overweight/obesity and OSA was high among both genders. A high BMI might be a convenient clinical marker for healthcare personnel to identify hypertensive patients with possible OSA in need of further evaluation and treatment.

  • 15.
    Cider, Åsa
    et al.
    Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ. ADULT.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ. ADULT.
    Strömberg, Anna
    Linkoping Univ, S-58183 Linkoping, Sweden.
    Pihl, Emma
    Halmstad Univ, Halmstad, Sweden.
    Response to 'Exercise programmes and quality of life in the elderly: important facts'2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 1, p. 128-128Article in journal (Other academic)
  • 16.
    Dalteg, Tomas
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Benzein, Eva
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Cardiac Disease and its Consequences on the Partner Relationship: a Systematic Review2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 3, p. 140-149Article in journal (Refereed)
    Abstract [en]

    Introduction

    Cardiac disease is a chronic illness that has extensive impact on patients and their partners. No previous review has been made on how the partner relationship is affected following cardiac disease. The review limited itself to the main cardiac disease of myocardial ischemia, arrhythmia and heart failure.

    Aim

    The aim of this review was to identify how the partner relationship is affected following cardiac disease after hospital discharge.

    Method

    CINAHL, PubMed and PsycINFO were searched from 1999 to 2009. Quality assessment of included articles was made using the Joanna Briggs Institute Reviewers' Manual. A total of 20 articles were included.

    Results

    Five themes identified how the partner relationship is affected following cardiac disease, namely: overprotection, communication deficiency, sexual concerns, changes in domestic roles, and adjustment to illness. Patients reported feeling overprotected by their spouses which occasionally served as a fertile ground for arguments or conflicts. Most couples experienced some implications concerning their sexual life following cardiac disease, though in various degrees. Both patients and partners seemed to experience communication deficiency concerning emotions within their relationship following the event. Most couples experienced a shift in roles and responsibilities within their partner relationship. Even though most couples experienced great distress following being afflicted with cardiac disease they reported that the disease had brought them closer together.

    Conclusion

    The review found that though couples found the cardiac event distressful they conformed and adjusted their relationship to the new situation.

  • 17.
    Dalteg, Tomas
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Sandgren, Anna
    Linnaeus University, The Center for Collaborative Palliative Care, Vaxjo, Sweden.
    Benzein, Eva
    Linnaeus University, The Center for Collaborative Palliative Care, Vaxjo, Sweden.
    The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S41-S41, article id 116Article in journal (Refereed)
    Abstract [en]

    Background: Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple’s illness beliefs play an important role in convalescence and illness management, and no previous studies have examined illness beliefs in couples living with AF.

    Purpose: To explore illness beliefs in couples where one spouse has atrial fibrillation.

    Methods: Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with AF.

    Results: The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief “Theheart is a representation of life,” two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief “Change is an integral part of life,” two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief “Adaptation is fundamental in life,” two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.

    Conclusion: Couples’ interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.

  • 18. De Geest, Sabina
    et al.
    Fridlund, Bengt
    Lunds universitet.
    Heikkilä, Johanna
    Jaarsma, Tiny
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Moons, Philip
    Scholte op Reimer, Wilma
    Smith, Karen
    Stewart, Simon
    Strömberg, Anna
    Thompson, David
    A survey of coronary risk factors in a cohort of cardiac nurses from Europe: do nurses practise what they preach?2002In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, no 1, p. 57-60Article in journal (Refereed)
  • 19.
    Eide, L. S. P.
    et al.
    Bergen University College, Faculty of Health and Social Sciences, Bergen, Norway.
    Ranhoff, A. H.
    Haraldsplass Diakonale Hospital, Kavli Research Center for Geriatrics and Dementia, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Haaverstad, R.
    Haukeland University Hospital, Department of Heart Disease, Bergen, Norway.
    Hufthammer, K. O.
    Haukeland University Hospital, Centre for Clinical Research, Bergen, Norway.
    Lauck, S.
    St Paul’s Hospital, Centre for Heart Valve Innovation, Vancouver, Canada.
    Norekval, T. M.
    Bergen University College, Faculty of Health and Social Sciences, Bergen, Norway.
    Urinary catheter use and delirium after aortic valve therapy2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S3-S4Article in journal (Refereed)
    Abstract [en]

    Background: Indwelling urinary catheters (IUC) are valuable devices that help to control and monitor urine output under and after invasive procedures. However, adverse outcomes might arise following use of IUC, and several studies show that IUC can be a risk factor for postoperative delirium. Delirium is an acute and fluctuating change in attention and cognition that might lead to extended hospital stay, and more morbidity and mortality. The association between delirium and the duration of IUC use in octogenarians after Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Implantation (TAVI) remains to be established.

    Purpose: To determine if the duration of IUC use after SAVR or TAVI predicts the development of delirium in older people.

    Methods: This is a prospective cohort study of octogenarian patients (N=136) in a tertiary university hospital. Inclusion criteria: ⩾80 years, severe aortic stenosis, and elective TAVI or SAVR. Exclusion criteria: Inability to speak Norwegian or declined consent to participate in the study. The Mini-Mental State examination was used to evaluate global cognitive function at baseline. The Confusion Assessment Method allowed the identification of delirium during five postoperative days. The duration of IUC use was collected from patients’ medical records. The predictive effect of IUC in the development of delirium was examined using multiple regression.

    Results: The majority (57%) of patients was female, and 46% received TAVI. Patients in the TAVI group were older (85 vs. 82 years-old, P<0.001), had more comorbidities (2.5 vs.1.8, P=0.001) and higher logistic EuroSCORE (19.6 vs. 9.4,P<0.001). Delirium was present in 66% of patients treated with SAVR vs. 44% of those receiving TAVI. The average duration of IUC use in SAVR patients with delirium was 66 hours (SD=29) compared to 59 hours (SD=27) in those without delirium (P=0.307), and in TAVI patients with delirium was 58 hours (SD=38) compared to 32 hours (SD=15) for those without delirium (P=0.001). Multivariate regression analysis shows that lower cognitive function (P=0.040), type of aortic valve treatment (P=0.043) and longer of IUC use (P=0.002) predicted the development of delirium.

    Conclusion: In octogenarian patients undergoing aortic valve treatment, the duration of IUC use can predict delirium. Further research is needed to mitigate the risks of delirium in patients undergoing aortic valve treatment.

  • 20.
    Ekblad, Helena
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Rönning, Helen
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Patients' well-being: experience and actions in their preventing and handling of atrial fibrillation2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 2, p. 132-139Article in journal (Refereed)
    Abstract [en]

    Background: Atrial fibrillation (AF) influences the lives of patients in the form of worsened well-being. Patients’ own experience of and how to handle AF is rarely investigated. These are important aspects for healthcare services to understand in order to support the well-being of patients with AF.

    Aim: To explore and describe critical incidents in which patients experience how AF affects their well-being and what actions they take to prevent and handle it.

    Design and methods: An explorative, descriptive design based on the critical incident technique (CIT) was used. Interviews were conducted with 25 patients (16 men and 9 women) with AF in a healthcare area in southern Sweden.

    Results: Patients experienced discomfort and limitations in daily life. The actions they took were self-care related actions and healthcare related actions.

    Conclusion: AF affects well-being when it is uncomfortable and leads to pronounced limitations in daily life with the patients trying to maintain or restore well-being through adapting and developing strategies for self-care. Patients base the handling of AF on their personal experience.

  • 21.
    Elfström, Maria
    et al.
    Jönköping University, School of Health and Welfare. ENT Clinic, Ryhov County Hospital.
    Karlsson, Susanne
    Jönköping University, School of Health and Welfare. ENT Clinic, Ryhov County Hospital.
    Nielsen, Per
    Division of Health and Society, Department of Medical and Health Sciences, Linköping University, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Svanberg, Eva
    Department of Clinical Neurophysiology, University Hospital, Linköping, and Institution of Clinical and Experimental Medicine, Linköping University, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Decisive Situations Affecting Partners' Support to Continuous Positive Airway Pressure-Treated Patients With Obstructive Sleep Apnea Syndrome: A Critical Incident Technique Analysis of the Initial Treatment Phase2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 27, no 3, p. 228-239Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND RESEARCH OBJECTIVE: Effective treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) can reduce morbidity and mortality, but adherence rates are low. The partner has an important role in supporting the patient, but this role may be adversely affected by difficulties during the early phase of the CPAP initiation. The aim of this study was to explore and describe decisive situations affecting partners' support to patients with OSAS and how the partners manage these situations during the initial phase of CPAP treatment.

    SUBJECTS AND METHODS: A qualitative descriptive design using critical incident technique was used. A total of 542 decisive situations affecting partners' support and 222 situations describing managing were collected by means of interviews with 25 strategically selected partners of patients with CPAP treated OSAS.

    RESULTS: Adverse effects, limited effect, practical and psychosocial problems, limited presence, and inappropriate initiation emerged as negative influences on the partners' support. A well-functioning treatment, improvements, high motivation, and receiving support from others were identified as positive influences on the partners' support. The partner managed the situations by letting the patient handle the CPAP treatment by himself/herself, by handling the treatment together with the patient, or taking over the handling of CPAP treatment.

    CONCLUSION: Increased knowledge about the different situations that affect the partners' support negatively or positively and how these situations are managed by partners can be used in educational situations involving both patients and partners during CPAP initiation.

  • 22.
    Fridlund, Bengt
    Växjö universitet.
    10 challenges in supervision of doctoral students2005In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, no 2, p. 97-98Article in journal (Refereed)
  • 23.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Cardiovascular nursing: holistic outlooks in 21st century Europe2003In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 2, no 1, p. 1-2Article in journal (Refereed)
  • 24.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Healthy sexual life after a cardiac event: What do we know and what do we do now?2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 3, p. 159-160Article in journal (Refereed)
  • 25.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nursing interventions: when are they the rule rather than the exception?2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 4, p. 253-254Article in journal (Other (popular science, discussion, etc.))
  • 26.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    The dissertation book: Should it be a monograph or a compilation thesis?2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, p. 144-145Article in journal (Other academic)
  • 27.
    Fridlund, Bengt
    Högskolan i Halmstad.
    The role of the nurse in cardiac rehabilitation programmes2002In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, no 1, p. 15-18Article in journal (Refereed)
  • 28.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Time for proper support for the next of kin of a patient who has suffered a cardiac event2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 3, p. 138-139Article in journal (Refereed)
  • 29.
    Fridlund, Bengt
    Växjö universitet.
    Writing a scientific manuscript: Some formal and informal proposals2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 3, p. 185-187Article in journal (Refereed)
  • 30.
    Fridlund, Bengt
    et al.
    Växjö universitet.
    Hildebrandt, L
    Hildingh, C
    Lidell, E
    Status and trends in Swedish dissertations in the area of cardiovascular nursing2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 1, p. 72-76Article in journal (Refereed)
  • 31.
    Fridlund, Bengt
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Cardiovascular nursing in RN and higher education in Swedish universities: a national survey.2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 3, p. 255-259Article in journal (Refereed)
  • 32.
    Fålun, Nina
    et al.
    Department of Heart Disease, Haukeland University Hospital, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Heart Disease, Haukeland University Hospital, Norway.
    Schaufel, Margrethe A.
    Department of Heart Disease, Haukeland University Hospital, Norway.
    Schei, Edvin
    Department of Global Public Health and Primary Care, University of Bergen, Norway.
    Norekvål, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Norway.
    Patients’ goals, resources, and barriers to future change: A qualitative study of patient reflections at hospital discharge after myocardial infarction2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 495-503Article in journal (Refereed)
    Abstract [en]

    Background: Myocardial infarction (MI) patients may find it challenging to adhere to lifestyle advice and medications. Understanding motivational factors and barriers to change is crucial. However, empirical evidence on patients’ ability to effect lifestyle changes at the time of discharge is limited.

    Aim: The aim of this study was to identify at the time of hospital discharge the goals, resources, and barriers to future change in MI patients.

    Methods: We conducted a qualitative interview study with a purposive sample of 20 MI patients (eight women) in a cardiac department at a university hospital in Norway. All interviews were conducted before hospital discharge, transcribed verbatim, and analysed using qualitative content analysis.

    Findings: Three themes suggested that, at the time of discharge, patients’ views of their MI were complex and diverse. Patients were motivated to change their lifestyle and contemplated taking their life in new directions, adopting a change of life perspective. Frequently, patients struggled to understand the context of living with an MI, manage symptoms, and understand the precipitating causes of MI. There were also patients who wanted to maintain their present lifestyle and live as normal as possible. They just wanted to keep going.

    Conclusions and implications: There is a need for a different approach to communicating with MI patients at the time of discharge. Person-centred care that allows personal narratives to emerge may enable health-care professionals to offer more individualised guidance to MI patients that will help them cope with the everyday challenges they experience after discharge.

  • 33.
    Gardner, Benjamin
    et al.
    Department of Epidemiology and Public Health, University College London, UK.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nilsen, Per
    Department of Health and Society, Linköping University, Sweden.
    Hrubos Ström, Harald
    Department of Otopharyngeology, Akershus University Hospital, Norway.
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Skagerström, Janna
    Department of Health and Society, Linköping University, Sweden.
    Johansson, Peter
    Department of Cardiology, Linköping University Hospital, Sweden.
    From 'does it work?' to 'what makes it work?': The importance of making assumptions explicit when designing and evaluating behavioural interventions2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 4, p. 292-294Article in journal (Refereed)
  • 34.
    Gullvag, M.
    et al.
    St Olavs Hospital, Department of Cardiology, Trondheim, Norway.
    Gjeilo, K. H.
    St Olavs Hospital, Department of Cardiology, Trondheim, Norway.
    Falun, N.
    Haukeland University Hospital, Department of Heart Disease, Bergen, Norway.
    Norekval, T. M.
    Haukeland University Hospital, Department of Heart Disease, Bergen, Norway.
    Mo, R.
    St Olavs Hospital, Department of Cardiology, Trondheim, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sleepless nights and sleepy days - a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep disordered breathing2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S57-S58Article in journal (Refereed)
    Abstract [en]

    Background: Sleep disordered breathing (SDB) is a pathologic, nocturnal breathing pattern present in at least 50% of patients with chronic heart failure (CHF). SDB is categorized as central or obstructive, and both are associated with worsened prognosis, affects physical and mental capacity and influences quality of life. Knowledge of how SDB is experienced by patients with CHF is limited, and has not previously been addressed in qualitative studies.

    Purpose: The aim of this study was to explore the experiences of patients with CHF and newly verified and untreated SDB.

    Methods: The study used an inductive descriptive design, collecting data through semi-structured interviews analysed with qualitative content analysis. Twelve participants (9 men and 3 women, mean age 62 (range 41-80)) diagnosed with CHF and a newly objectively verified (i.e., by polygraphy) SDB (6 obstructive, 5 central and 1 mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals.

    Results: The participants’ descriptions fell into five categories: Sleep disruption causing troublesome nights: Disruptive nights with sleep onset latency, frequent arousals and early morning awakenings caused frustration and a longing for a night of uninterrupted sleep. Daily life challenges due to daytime sleepiness: Excessive tiredness led to a need for sleep during the day, overactivity to avoid tiredness, extra care when operating a vehicle, and a feeling that concentration and memory were impaired. Involvement of a partner: The partners were described as being more affected by the sleep apnea than the participants, and it was apparent that the apneas caused fear and worry for the partners. Self-care strategies: Use of a dark, quiet and well-ventilated bedroom and avoidance of actions that could impair sleep; i.e. daytime naps, coffee, or heavy meals before bedtime were described. Some participants discussed their  sleep problems with their GP, but experienced that the problems were not examined in detail and sleep medication was a common, however unwanted, solution. Awareness of SDB: Some participants were relieved as the finding of the SDB finally gave an explanation to their problems, while others were surprised by the result.

    Conclusion: Patients with CHF and SDB experienced that sleep disturbances influenced their daily life. Raised awareness on sleep is needed for these patients. Possible underlying causes for disruptive sleep, such as SDB, should be identified in order to establish proper treatment strategies and follow-up care for the individual. Future studies on both medical and nursing strategies to improve sleep for patients with CHF and SDB are needed, and intervention studies should be prioritized.

  • 35.
    Hedberg, Berith
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Malm, Dan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Karlsson, J. E. K.
    Ryhov County Hospital, Jonkoping, Sweden, Department of Medicine, Jonkoping, Sweden.
    Arestedt, K. A.
    Ryhov County Hospital, Jonkoping, Sweden, Department of Medicine, Jonkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Ryhov County Hospital, Jonkoping, Sweden, Department of Medicine, Jonkoping, Sweden.
    Factors associated with involvement in risk communication and confidence in shared decision making among patients with atrial fibrillation.2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S74-S75Article in journal (Refereed)
    Abstract [en]

    Background: Atrial fibrillation (AF) is a highly prevalent arrhythmia. Effective communication of risks (e.g., risk for stroke) and benefits to patients (e.g., treatment with oral anticoagulants) is crucial for shared decision making. Knowledge about how patients experience confidence and satisfaction in communication in relation to their health status is limited.

    Aim: The aim was to explore factors associated with involvement in risk communication and confidence in shared decision making among patients with AF.

    Method: A cross-sectional design was used and 322 patients (39 % women), mean age 67 years (SD 10.3 years) with AF were included at four hospitals in Sweden. Clinical examinations and self-rating scales for risk communication (COMRADE), uncertainty in illness (MUIS-C), depressive symptoms (HADS), mastery of daily life (MDL), as well as physical and mental health (SF-36) were used to collect data after a follow-up visit at the outpatient clinic 3 months post an AF episode.

    Results: Paroxysmal, persistent and permanent AF occurred among 32%, 34% and 7% of the patients, respectively. Patients whom had undergone DC-conversion (53%) and had anticoagulants (37%). Seven percent had been treated by a percutan ablation. Heart failure (15%) and ischemic heart disease (12%) were the most common co-morbidities. CHA2DS2-VASc >2 were seen among 62% of the patients. Overall, multiple regression analyses showed that uncertainty in illness and mastery of daily life were significantly associated with confidence in decisions and uncertainty in illness and hypertension were significantly associated with satisfaction in communication. Higher uncertainty in illness and poorer mastery of daily life were associated with poor confidence in decisions. Higher uncertainty in illness and occurrence of hypertension were associated with poor satisfaction in communication. Clinical AF variables (i.e.,symptom or treatment related) or depressive symptoms were not significantly associated with satisfaction in communication or confidence in decisions in the multiple regression analysis. The final models explained 29% and 30% of the variance in confidence in decision making and satisfaction in communication.

    Conclusion: In this cross-sectional study, including patients with AF, confidence in decision making and satisfaction in communication are associated with uncertainty in illness, mastery of daily life and hypertension.

  • 36.
    Hedberg, Berith
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Futurum, Region Jönköpings län.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Ryhov County Hospital, Region Jönköpings län Jönköping, Sweden.
    Karlsson, Jan-Erik
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Internal Medicine, Department of Medical and Health Sciences, Linköping University, Sweden.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Sweden.
    Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 5, p. 446-455Article in journal (Refereed)
    Abstract [en]

    Background:

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

    Aim:

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

    Methods:

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

    Results:

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

    Conclusion:

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

  • 37. Hildingh, C
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    A 3-year follow-up of participation in peer support groups after a cardiac event2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 4, p. 315-320Article in journal (Refereed)
  • 38.
    Hjelmfors, A-L
    et al.
    Linkoping University, Department of Social and Welfare Studies, Linkoping, Sweden.
    Sandgren, A. S.
    Linnaeus University, Department of Healthc and Caring Sciences, Kalmar, Sweden.
    Stromberg, A. S.
    Linkoping University, Department of Medical and Health Sciences, Linkoping, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Jaarsma, T. J.
    Linkoping University, Department of Social and Welfare Studies, Linkoping, Sweden.
    Friedrichsen, M. F.
    Linkoping University, Department of Social and Welfare Studies, Linkoping, Sweden.
    Patient perspectives of prognosis communication2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S65-S66Article in journal (Refereed)
    Abstract [en]

    Background: Several studies describe that patients with heart failure (HF) find it important to discuss prognosis and that they want to be informed about the expectations about the illness progression. However, little is known about their actual preferences for professional communication about prognosis.

    Purpose: to explore patient’s perspectives regarding communication with health care professionals about the HF prognosis.

    Methods: 15 patients participated in focus group interviews and a further 9 patients completed individual semi-structured interviews. The patients (75% men, 52-87 years of age) were in NYHA I-III, and were not diagnosed with any other major life threatening disease. Data was analysed using thematic analysis to identify and interpret patterns in the data.

    Results: One overarching theme was identified: “The tension between hoping for the best and preparing for the worst” with three sub-themes. Ignorance is bliss. Describes how patients preferred to avoid thinking about the HF prognosis because they did not want to lose hope for the future. They lived one day at the time, focusing on here and now, wanting to forget about the illness altogether. Patients also preferred to decide themselves whether they wanted to talk about the prognosis with professionals or not. Nothing but the truth. Describes how patients wanted to know the objective and absolute truth about their illness and its’ prognosis and were afraid to live under false expectations. The truth about their prognosis was that they might die because of their illness. Even though the truth may hurt, they believed that knowing the truth was necessary to live as good as possible. Good news only. Patients described that they knew that HF was a chronic illness but they were ambivalent in their approach towards discussing prognosis. They wanted to know the truth about their prognosis, but at the same time they did not want to know anything since they fear they might hear something they do not want to, as this may hurt. They only wanted to receive “good” and positive information from the professionals, since they perceived such information to be something that they can benefit from.

    Conclusions: This study shows that patients have different preferences for communication about prognosis and uses different approaches in order to cope living with a serious condition such as heart failure. Professionals need to respect the strategies a patient uses, and be ready to support the patient according to their needs, preferences and life situation.

  • 39.
    Hjelmfors, Lisa
    et al.
    Linköpings universitet.
    Strömberg, Anna
    Linköpings universitet.
    Friedrichsén, Maria
    Vrinnevi sjukhus.
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
    Jaarsma, Tiny
    Linköpings universitet.
    Communicating prognosis and end-of-life care to heart failure patients: a survey of heart failure nurses' perspectives2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 2, p. 152-161Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many heart failure (HF) patients have palliative care needs, but communication about prognosis and end-of-life care is lacking. HF nurses can play an important role in such communication, but their views on this have rarely been sought.

    AIMS: This study aims to describe HF nurses' perspectives on, and daily practice regarding, discussing prognosis and end-of-life care with HF patients in outpatient care. It further aims to explore barriers, facilitators and related factors for discussing these issues.

    METHODS: A national survey including nurses from outpatient clinics and primary health care centres was performed. Data was collected using a questionnaire on communication with HF patients about prognosis and end-of-life care.

    RESULTS: In total, 111 (82%) of the HF nurses completed the questionnaire. Most of them reported that physicians should have the main responsibility for discussing prognosis (69%) and end-of-life care (67%). Most nurses felt knowledgeable to have these discussions, but 91% reported a need for further training in at least one of the areas. Barriers for communication about prognosis and end-of-life care included the unpredictable trajectory of HF, patients' comorbidities and the opinion that patients in NYHA class II-III are not in the end-of-life.

    CONCLUSION: Although HF nurses feel competent discussing prognosis and end-of-life care with the HF patient, they are hesitant to have these conversations. This might be partly explained by the fact that they consider the physician to be responsible for such conversations, and by perceived barriers to communication. This implies a need for clinical policy and education for HF nurses to expand their knowledge and awareness of the patients' possible needs for palliative care.

  • 40.
    Holst, Marie
    et al.
    Jönköping University.
    Willenheimer, Ronnie
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lindholm, Maud
    Strömberg, Anna
    Telephone follow-up of self-care behaviour after a single session education of patients with heart failure in primary health care2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 2, p. 153-159Article in journal (Other academic)
  • 41.
    Iversen, C.
    et al.
    Uppsala University, Department of Sociology, Uppsala, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping University Hospital, Department of Clinical Neurophysiology, Linkoping, Sweden.
    ‘No problems when you drive?’ nurses balancing conflicting roles as coaches and state agents when they ask sleepy patients about traffic risk2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S85-S85Article in journal (Refereed)
    Abstract [en]

    Background: Communication in traffic risk assessment is an understudied area in nursing research. Specifically, no research exists of how clinicians formulate their risk assessment questions in actual practice. Because obstructive sleep apnea (OSA) is associated with an increased risk of traffic accidents, traffic safety authorities demand adherent Continuous Positive Airway Pressure (CPAP) use. Nurses have a key role in both treatment initiation and traffic risk assessment. They act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by asking OSA patients about drowsy driving.

    Aim: We examined how nurses and OSA patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations.

    Methods: We studied the actual practice of risk assessment questioning in 19 video-recorded initial CPAP treatment consultations with nurses and recently diagnosed OSA patients. To explicate the details of the interactions, we used conversation analysis.

    Results: Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if OSA patients have not previously indicated problems in relation to general daytime sleepiness. Accordingly, by taking a stance to daytime sleepiness prior to the risk question, patients influence how nurses phrase questions about traffic risk. In this sense, traffic risk assessment questioning is coconstructed between nurses and patients.

    Conclusion: It poses a safety problem when nurses, by accepting OSA patients’ prior stance when asking about traffic risk, orient to relationship building rather than task focus. To clarify the difference between their potentially conflicting roles, nurses can refer to legislation when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. However, our study suggests that there is a need to develop legislation to acknowledge different clinicians’responsibilities in traffic risk assessment. Furthermore, guidelines and risk assessment tools should be developed to help clinicians manage their different roles with regard to coaching CPAP treatment and assessing traffic risk.Traffic risk assessment is communicatively sensitive but clinically important, as obstructive sleep apnea is a highly prevalent and increasing problem causing excessive sleepiness.

  • 42. Jaarsma, T
    et al.
    Strömberg, A
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    De Geest, S
    Mårtensson, J
    Moons, P
    Norekval, TM
    Smith, K
    Steinke, E
    Thompson, DR
    Sexual counselling of cardiac patients: nurses´ perception of practice, responsibility and confidence2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 1, p. 24-29Article in journal (Refereed)
    Abstract [en]

    Background: Cardiac patients may experience problems with sexual activity as a result of their disease, medications or anxiety and nurses play an important role in sexual counselling. We studied the practice, responsibility and confidence of cardiac nurses in the sexual counselling of these patients.

    Method: An adapted version of the nurses' survey of sexual counselling of MI patients was administered during a scientific meeting of the Council on Cardiovascular Nursing and Allied Professionals within the European Society of Cardiology.

    Results: Most of the 157 cardiovascular nurses (87%) who completed the survey felt responsible to discuss sexual concerns with their clients, especially when patients initiated a discussion. However in practice, most respondents rarely addressed sexual issues. The items that nurses reported to counsel patients were closely related to the cardiac disease, symptoms and medications and seldom more sensitive subjects (e.g. foreplay, positions). Nurses estimated that their patients could be upset (67%), embarrassed (72%) or anxious (68%) if they were asked about sexual concerns. One-fifth of the nurses felt they had insufficient knowledge and 40% sometimes hesitated to discuss sexual concerns with clients because they might not know how to answer questions. Additional education on sexuality was significantly related to being more comfortable and active in sexual counselling.

    Conclusion: Although cardiac nurses feel responsible and not anxious discussing patients' sexual concerns, these issues are not often discussed in daily practice. Nurses might need more knowledge and specific practical training in providing information on sexual concerns and sexual counselling to cardiac patients.

  • 43.
    Jaarsma, Tiny
    et al.
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Deaton, Christi
    School of Nursing, Midwifery & Social Work, Central Manchester University Hospitals NHS Foundation Trust, UK.
    Fitzsimmons, Donna
    Belfast Health and Social Care Trust, UK.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hardig, Bjarne M.
    Physio-Control Sweden/Jolife AB, Sweden.
    Mahrer-Imhof, Romy
    Institute of Nursing, Zurich University of Applied Sciences, Switzerland.
    Moons, Philip
    Department of Public Health and Primary Care, University of Leuven, Belgium.
    Noureddine, Samar
    Hariri School of Nursing, American University of Beirut, Lebanon.
    O'Donnell, Sharon
    School of Nursing and Midwifery, University of Dublin, Ireland.
    Pedersen, Susanne S.
    Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
    Stewart, Simon
    National Health and Medical Research Council (NHMRC) Centre of Research Excellence to Reduce Inequality in Heart Disease & Preventative Health, Baker IDI Heart and Diabetes Institute, Australia.
    Strömberg, Anna
    Department of Medicine and Health Sciences, Linköping University, Sweden.
    Thompson, David R.
    Cardiovascular Research Centre, Australian Catholic University, Australia.
    Tokem, Yasemin
    İzmir Katip Çelebi Üniversitesi, Turkey.
    Kjellström, Barbro
    Department of Medicine, Karolinska Institutet, Sweden on behalf of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology.
    Research in cardiovascular care: A position statement of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 1, p. 9-21Article in journal (Refereed)
    Abstract [en]

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined with the increasing opportunities and challenges in multidisciplinary research, the Science Committee of the Council on Cardiovascular Nursing and Allied Professionals (CCNAP) recognised the need for a position statement to guide researchers, policymakers and funding bodies to contribute to the advancement of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given.

  • 44. Jaarsma, Tiny
    et al.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Strömberg, Anna
    Thompson, David R
    The European Journal Of Cardiovascular Nursing Endorses the CONSORT statement and extension2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, no 8, p. 235-236Article in journal (Other (popular science, discussion, etc.))
  • 45. Jaarsma, Tiny
    et al.
    Stewart, Simon
    De Geest, Sabina
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Heikkilä, Johanna
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Moons, Philip
    Op Reimer, Wilma Scholte
    Smith, Karen
    Strömberg, Anna
    Thompson, David R
    A survey of coronary risk factors and B-type natriuretic peptide concentrations in cardiac nurses from Europe: do nurses still practice what they preach?2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 1, p. 3-6Article in journal (Refereed)
  • 46. Jaarsma, Tiny
    et al.
    Strömberg, Anna
    De Geest, Sabina
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Heikkila, Johanna
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Moons, Philip
    Scholte op Reimer, Wilma
    Smith, Karen
    Stewart, Simon
    Thompson, David
    Heart failure management programmes in Europe2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 3, p. 197-205Article in journal (Refereed)
  • 47.
    Jaarsma, Tiny
    et al.
    Linköpings Universitet.
    Strömberg, Anna
    Linköpings Universitet.
    Årestedt, Kristofer
    Linneuniversitetet, Kalmar.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Kärner, Anita
    Linköpings universitet.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Moons, Philip
    Centre for Health Services and Nursing Research, Katholieke Universiteit, Leuven, Belgium .
    Thylen, Ingela
    Linköpings universitet.
    Thompson, David
    Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia .
    A good manuscript review for the European Journal of Cardiovascular Nursing2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 2, p. 102-103Article in journal (Other academic)
  • 48.
    Johansson, Peter
    et al.
    Linköping University.
    Arestedt, Kristoffer
    Linköping University.
    Alehagen, Urban
    Linköping University.
    Svanborg, Eva
    Linköping University.
    Dahlström, Ulf
    Linköping University.
    Broström, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Sleep disordered breathing, insomnia, and health related quality of life: a comparison between age and gender matched elderly with heart failure or without cardiovascular disease2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 2, p. 108-117Article in journal (Refereed)
    Abstract [en]

    AIMS: The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL).

    METHODS: Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36).

    RESULTS: The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, p<0.001). Moderate/severe SDB was found in 42% of those with HF vs. 8% in those without CVD (p=0.001). Those with HF had more difficulties maintaining sleep (DMS) (72% vs. 50%, p=0.05) and excessive daytime sleepiness (EDS) (25% vs. 8%, p=0.05) and scored worse Hr-QoL in five of eight SF-36 domains. In regression analysis SDB had no association to Hr-QoL. DMS associated to the physical-, and non restorative sleep to the mental domain of Hr-QoL. SDB had no correlations to insomnia or EDS.

    CONCLUSIONS: SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly.

  • 49.
    Johansson, Peter
    et al.
    Linköping University Hospital.
    Broström, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Sleep disturbances — a significant problem for cardiovascular nurses in practice and/or research?2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 2, p. 75-76Article in journal (Refereed)
  • 50.
    Johansson, Peter
    et al.
    Linköping University.
    Broström, Anders
    Linköping University.
    Dahlström, Ulf
    Linköping University.
    Alehagen, Urban
    Linköping University.
    Global perceived health and health-related quality of life in elderly primary care patients with symptoms of heart failure2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 4, p. 269-276Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim was to examine whether a single question about global perceived health (GPH) is associated with the domains of health-related quality of life (HR-QoL) as assessed by the SF-36, and whether the scores in these domains differ from the different scores of the GPH in relation to left ventricular ejection fraction (LVEF).

    METHOD: The study included 412 elderly outpatients with symptoms of heart failure (HF). Echocardiography was used to determine their LVEF, and GPH was assessed by the first question on the SF-36.

    RESULTS: The correlations between GPH and the different domains in SF-36 ranged from 0.33 to 0.64 in patients with LVEF>or=50% and was between 0.29 and 0.59 in patients with LVEF<40%. Regression analyses revealed GPH to be the strongest predictor of HR-QoL. Patients with LVEF<40% rating poor GPH differed significantly (p<0.05) from those with good or moderate GPH in six of the eight HR-QoL domains.

    CONCLUSION: One question about GPH gives a good general description of HR-QoL and may therefore be used as a simple tool to assess HR-QoL in elderly outpatients with clinical symptoms of HF.

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