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  • 1.
    Aidemark, Jan
    et al.
    Linnaeus University.
    Askenäs, Linda
    Linnaeus University.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Strömberg, Anna
    Linköping University.
    User involvement in the co-design of self-care support systems for heart failure patients2015In: Procedia Computer Science, ISSN 1877-0509, E-ISSN 1877-0509, Vol. 64, p. 118-124Article in journal (Refereed)
    Abstract [en]

    In this paper the nature of user involvement in a co-design process will be explored. The outlines of a research project aiming at developing support systems for self-care inpatients suffering from chronic heart failure will be presented. The project is planned to perform a co-design effort where users (patients and healthcare professionals) will be given the opportunity to influence the development of support systems. We will discuss a number of possibilities and challenges that lie in the design of this kind of project and also some findings from its early stages. This report presents the experiences of users’ input, which are discussed in the context of previous research on benefits of user contributions in systems development.

  • 2.
    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).
    Nygårdh, Annette
    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).
    Patientdelaktighet och medverkan hos vuxna med fysisk ohälsa2018In: Delaktighet och patientmedverkan / [ed] Ann Catrine Eldh, Lund: Studentlitteratur AB, 2018, p. 107-138Chapter in book (Other academic)
  • 3.
    Malm, Dan
    et al.
    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).
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Futurum Academy for Healthcare, Jönköping, Sweden.
    Ebefors, Eva-Marie
    Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Conlon, Lisa
    Futurum Academy for Healthcare, Jönköping, Sweden.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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).
    Reducing the prevalence of catheter-related infections by quality improvement: Six-year follow-up study2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 2, p. 79-87Article in journal (Refereed)
    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.

  • 4.
    Neher, M. S.
    et al.
    Linkoping University, Department of Medical and Health Sciences, Linkoping, Sweden.
    Johansson, P.
    Linkoping University, Department of Cardiology and Department of Social and Welfare studies, Linkoping, Sweden.
    Nilsen, P.
    Linkoping University, Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nygårdh, Annette
    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).
    Exploring implementation issues when introducing a novel internet-based intervention to treat cardiovascular disease-associated mental health issues- the Implement-IT project.2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S52-S53Article in journal (Refereed)
    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.

  • 5.
    Nygårdh, Anette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Interaktiv forskning2009In: Vägval och dilemman i interaktiv forskning: Kurspaper från Bridging the Gaps doktorandkurs Interaktiv forskning 2008 / [ed] Mattias Elg, Boel Andersson Gäre, Linköpings: Linköpings universitet , 2009, p. 19-28Chapter in book (Other academic)
    Abstract [sv]

    Från inledningen: I detta paper är min avsikt att beskriva och diskutera den interaktiva forsk-ningen och hur kunskap kan skapas i denna ansats samt öka förståelsen för hur jag som forskare bör interagera med praktiken för att skapa ett gemen-sam lärande. Jag kommer att utgå från min metoddesign och kritiskt disku-tera huruvida den beskrivna ansatsen kan öka kunskapsbildningen och va-liditeten i min forskning.

  • 6.
    Nygårdh, Anette
    et al.
    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).
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Allemann, H.
    Linköping University, Department of Medical and Health Science, Linköping, Sweden.
    Strömberg, A.
    Linköping University, Department of Medical and Health Science, Linköping, Sweden.
    Aidemark, J.
    Linneaus University, Department of Informatics, Vaxjö, Sweden.
    Fruberg, C.
    Qulturum, Centre for Learning and Innovation in Health Care, Jönköping, Sweden.
    Karlsson, J.-E.
    Ryhov county Hospital, Deparment of Development (Qulturum), Jönköping, Sweden.
    Askenäs, L.
    Linneaus University, Department of Informatics, Växjö, Sweden.
    An experience-based co-design to accomplish person-centered self-care support for elderly persons with heart failure2015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, p. 51-52, article id 139Article in journal (Refereed)
    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.

  • 7.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    A quality improvement project on empowerment in chronic kidney care: an interactive research approach2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    One way of improving health care has been conceptualized as personcentred care. In person-centred care the concept of empowerment is crucial. This thesis aims was to explore the meaning of empowerment from the perspective of persons with chronic kidney disease (CKD) and their family members and to evaluate the outcomes of an improvement intervention (QI) for the persons with CKD. Furthermore, to explore the implementation of an QI for empowerment in the context of chronic kidney care from a professional perspective. The research was based on an interactive approach in which the findings relating to the experiences of empowerment by persons with CKD and their family members in chronic kidney care were used in developing the QI. The methods of data collection were both qualitative and quantitative. In all, 20 persons with CKD (Study I) and 12 family members (Study II) participated in the interviews. In the quasi-experimental evaluation of the QI, 25 individuals took part in the intervention group and 21 persons in the comparison group (Study III). Twelve healthcare professionals participated in the case study of the QI (Study IV). Empowerment in chronic kidney care for the persons with CKD was described in terms of creation of trust and learning through encounters. The family members of the persons with CKD described empowerment as having the strength to assume responsibility. The outcomes of the QI after 2 years showed significantly higher scores for individualized care in the intervention group than in the comparison group. The facilitators in the QI were the healthcare professionals' moving spirit and encouragement from involved persons. As a barrier, the healthcare professionals referred to the limitation of the organization. In conclusion, the individual’s perspective of empowerment is important, both for quality of care and as a facilitator for QI in chronic kidney care.

  • 8.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Wann-Hansson, Christine
    Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Handling a challenging context: experiences of facilitating evidence-based elderly care2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 2, p. 201-210Article in journal (Refereed)
    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.

  • 9.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Wikby, Kerstin
    Linneus University.
    Ahlström, Gerd
    Swedish Institute for Health Sciences, Department of Health Sciences, Lund University.
    Empowerment Intervention in Outpatient Care of Persons with Chronic Kidney Disease Pre-Dialysis2012In: Nephrology Nursing Journal : Journal of The American Nephrology Nurses Association, ISSN 1526-744X, E-ISSN 2163-5390, Vol. 39, no 4, p. 285-294Article in journal (Refereed)
    Abstract [en]

    Empowering interventions can improve person-centered care. A pre- and post-evaluation using interactive research involving two years of empowering interventions was designed to improve quality of care in outpatients with chronic kidney disease who were pre-dialysis. The results showed significantly increased empowerment in the intervention group. Interactive research facilitated the implementation of the empowerment intervention, which may increase sustainability over time.

  • 10.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Wikby, Kerstin
    Ahlström, Gerd
    Facilitators and barriers in the implementation process of an improvement intervention in chronic kidney care: a case studyManuscript (preprint) (Other academic)
  • 11.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Wikby, Kerstin
    Linneus University, Växjö SE- 351 95, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 187, Lund SE-221 00, Sweden.
    The complexity in the implementation process of empowerment-based chronic kidney care: a case study2014In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, no 22, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care.

    Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis.

    Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process.

    Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

  • 12.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Wikby, Kerstin
    Jönköping University, School of Health and Welfare.
    Ahlström, Gerd
    Swedish Institute for Health Sciences (Vårdalinstitutet), Lund University, Lund, Sweden.
    The experience of empowerment in the patient-staff encounter: the patient's perspective2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 5/6, p. 897-904Article in journal (Refereed)
    Abstract [en]

    Aim and objective.  The aim was to explore empowerment within the patient–staff encounter as experienced by out-patients with chronic kidney disease.

    Background.  Empowerment has an important role to play in the patient–staff relationship in the case of patients with a chronic disease. When it comes to patients with chronic kidney disease, there has been little research on empowerment, for which reason interviewing such patients about their experiences of empowerment will provide useful knowledge within the context of out-patient care.

    Design.  A qualitative interview study was chosen to gain an understanding of empowerment from the patient perspective.

    Method.  The study was carried out at an out-patient clinic in Sweden and involved 20 patients with chronic kidney disease. The interviews were subjected to latent content analysis.

    Results.  Five of the seven sub-themes emerging from the analysis represented empowerment: Accessibility according to need, Confirming encounter, Trust in the competence of the healthcare staff, Participation in decision-making, Learning enables better self-management. The other two represented non-empowerment: Meeting with nonchalance, Lack of dialogue and influence. From the seven sub-themes, one comprehensive theme was generated: Creation of trust and learning through encounter.

    Conclusion.  The main finding regarding the central role of the creation of trust and learning through the patient–staff encounter underlines the importance of understanding empowerment from the patient’s perspective.

    Relevance to clinical practice.  Nursing and other healthcare staff need knowledge and understanding of the meaning of empowerment from the patients’ perspective to meet their needs in out-patient care.

  • 13.
    Nygårdh, Annette
    et al.
    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).
    Neher, Margit
    Department of Medical and Health Sciences, 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. ADULT. Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Nilsen, Per
    Department of Medical and Health Sciences, Linköping University, Sweden.
    Johansson, Peter
    Department of Cardiology, University Hospital, Linköping, Sweden.
    Towards internet-based cognitive behavioural therapy for patients with cardiovascular disease and comorbid depression and insomnia?2017In: European Journal of Cardiovascular Nursing, Vol. 16, no 7, p. 565-566Article in journal (Other academic)
  • 14.
    Nygårdh, Annette
    et al.
    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).
    Sherwood, Gwen
    University of North Carolina at Chapel Hill, School of Nursing, United States.
    Sandberg, Therese
    Department of Orthopedics, Värnamo Hospital, Värnamo, Sweden.
    Rehn, Jeanette
    Department of Child Health Care, Värnamo, Sweden.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education2017In: 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)
    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.

  • 15.
    Nygårdh, Annette
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Wikby, Kerstin
    Malm, Dan Anders John
    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.
    Ahlstrom, Gerd
    Empowerment in outpatient care for patients with chronic kidney disease - from the family member's perspective.2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, no 21, p. 2-8Article in journal (Refereed)
    Abstract [en]

    Background: Family members of persons with pre-dialysis chronic kidney disease may experience feelings of vulnerability and insecurity as the disease follows its course. Against this background, the aim of the present study was to explore empowerment in outpatient care as experienced by these family members.

    Methods: An inductive approach for qualitative data analysis was chosen. The study sample comprised 12 family members of pre-dialysis patients at an outpatient kidney clinic. Two interviews with each family member were subjected to content analysis to gain an understanding of empowerment from the family members' perspective.

    Results: Having strength to assume the responsibility was the main theme that emerged from the following five sub-themes: Being an involved participant, Having confirming encounters, Trusting in health-care staff, Comprehending through knowledge, and Feeling left out. Four of these five sub-themes were positive. The fifth subtheme illuminated negative experience, indicating the absence of empowerment.

    Conclusions: Family members' experience of empowerment is dependent on their ability to assume the responsibility for a relative with chronic kidney disease when needed. The findings emphasise the need for a family perspective and the significance of a supportive environment for family members of persons in outpatient care.

  • 16.
    Ulin, Kerstin
    et al.
    Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg.
    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.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    What is known about the benefits of patient-centered care in patients with heart failure2015In: Current Heart Failure Reports, ISSN 1546-9530, E-ISSN 1546-9549, Vol. 12, no 6, p. 350-359Article, review/survey (Refereed)
    Abstract [en]

    Treatment for chronic heart failure (CHF) has improved, and symptom burden has been identified as an important treatment goal. Because patient-centered care may ease the burden, we need to know its benefits for patients with CHF, hence this systematic literature review. We found that one benefit of person-centered care is an increase in quality of life in patients with CHF. Improvements were found in self-care, physical and mental status, health care costs, general uncertainty regarding illness and recovery, patient dignity, treatment, and systems of care. Improvements also were observed in symptom burden, self-efficacy, and quality of life. These findings indicate that person-centered care is a powerful approach to current and future health care. However, because an appropriate tool to measure person-centered care does not yet exist, it will be a challenge to determine whether the goal has been reached from a long-term and patient perspective.

  • 17.
    Wang, Lan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nygårdh, Annette
    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).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, China.
    A health coaching self-management programme to improve physical activity, lung function and quality of life in patients with Chronic Obstructive Pulmonary Disease: a randomized controlled trialManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is the fourth most prevalent cause of death in the world and contributes to higher economic and social burden. Health coaching, which is an approach to support self-management, has proven to be effective in health outcomes for patients with COPD in developed countries. However, no study has evaluated a systematic and structured health-coaching COPD programme to support self-management in China.

    Objectives: To evaluate the effects of a health coaching self-management programme on lung function, physical activity and quality of life in patients with COPD

    Design: A randomised controlled trial in patients with COPD

    Methods: The participants were randomised to either an intervention group (n = 48) or a control group (n = 49) during hospitalisation. The intervention group received usual care combined with a health coaching self-management programme; the control group received only usual care. The intervention programme was performed for six months, and the effects of the intervention were assessed for FEV1%, FVC%, hand grip strength and 1-minute sit-to-stand (STS); and by the Global Physical Activity Questionnaire (GPAQ), Clinical COPD Questionnaire (CCQ) at baseline, 6th week, 6th month and 12th month follow-ups post-discharge.

    Results: Of the 97 patients, 88% completed the 12-month follow-up (94% in the intervention group and 82% in the control group). The interaction effect between time and group (control or intervention) for lung function, physical activity and quality of life showed that the intervention group improved significantly compared to the control group in all measures: FEV1% (P =0.003), FVC% (P = 0.001), GPAQ (P = 0.001), 1-minute STS (P = 0.005) and Grip strength (P<0.001), as well as the CCQ-symptom (P <0.001), CCQ-emotion (P <0.001), CCQ-activity (P<0.001) and CCQ (P <0.001).

    Conclusion: The health coaching self-management programme can improve lung function, physical activity and quality of life in patients with COPD.

  • 18.
    Wang, Lan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Zhao, Yue
    Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. 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).
    Experiences of a health coaching self-management program in patients with COPD: a qualitative content analysis.2018In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 13, p. 1527-1536Article in journal (Refereed)
    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.

  • 19.
    Wang, Lan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nygårdh, Annette
    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).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, China.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of a health coaching self-management programme in patients with Chronic Obstructive Pulmonary Disease on self-management skills and psychological status: a randomized controlled trialManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To evaluate the effects of a health coaching self-management programme intended to improve self-management skills and psychological status for patients with Chronic Obstructive Pulmonary Disease.

    Design: Randomized controlled trial.

    Methods: A randomized controlled study was conducted among patients with COPD. The participants who met the inclusion criteria were randomized to either an intervention group (n=48) or a control group (n=49). The intervention group received the health coaching self-management programme, while the control group received usual care. The programme were performed during six months, and the effects of the intervention were assessed by the COPD Self-management Scale (CSMS) and Hospital anxiety and depression scale (HADS) at baseline, 6th week, 6th month and 12th month post discharge.

    Results: Of the 97 patients, 45 (94%) in the intervention group and 40 (82%) in control group, completed 12-month follow-up. The interaction effect between time and group (control or intervention) showed that the intervention group improved significantly compared to the control group for all five dimensions in self management skills, Symptom management (P<0.001), Daily life management (P<0.001), Emotion management (P<0.001), Information management (P<0.001) and Self-efficacy (P<0.001), as well as psychological status with anxiety (P<0.001) and depression (P<0.001).

    Conclusion: This trial shows that a nurse-led Health Coaching Self-management Programme has the potential to significantly improve the effects on the self management skills, as well as reducing anxiety and depression for patients with COPD.

  • 20.
    Wang, Lan
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nygårdh, Annette
    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).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, p. 61-66Article in journal (Refereed)
    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.

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