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Publications (10 of 131) Show all publications
Danielsson, M., Nilsen, P., Rutberg, H. & Årestedt, K. (2018). A National Study of Patient Safety Culture in Hospitals in Sweden. Journal of patient safety
Open this publication in new window or tab >>A National Study of Patient Safety Culture in Hospitals in Sweden
2018 (English)In: Journal of patient safety, ISSN 1549-8417, E-ISSN 1549-8425Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Using the Hospital Survey on Patient Culture, our aim was to investigate the patient safety culture in all Swedish hospitals and to compare the culture among managers, physicians, registered nurses, and enrolled nurses and to identify factors associated with high overall patient safety.

METHODS: The study used a correlational design based on cross-sectional surveys from health care practitioners in Swedish health care (N = 23,781). We analyzed the associations between overall patient safety (outcome variable) and 12 culture dimensions and 5 background characteristics (explanatory variables). Simple logistic regression analyses were conducted to determine the bivariate association between each explanatory variable and the outcome variable. The explanatory variables were entered to determine the multivariate associations between the variables and the outcome variable.

RESULTS: The highest rated culture dimensions were "teamwork within units" and "nonpunitive response to error," and the lowest rated dimensions were "management support for patient safety" and "staffing." The multivariate analysis showed that long professional experience (>15 years) was associated with increased probability for high overall patient safety. Compared with general wards, the probability for high overall patient safety was higher for emergency care but lower for psychiatric care. The probability for high overall patient safety was higher for both enrolled nurses and physicians compared with managers.

CONCLUSIONS: The safety culture dimensions of the Hospital Survey on Patient Culture contributed far more to overall patient safety than the background characteristics, suggesting that these dimensions are very important in efforts to improve the overall patient safety culture.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:lnu:diva-74271 (URN)10.1097/PTS.0000000000000369 (DOI)28234728 (PubMedID)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-12-06
Alvariza, A., Holm, M., Benkel, I., Norinder, M., Ewing, G., Grande, G., . . . Årestedt, K. (2018). A person-centred approach in nursing: Validity and reliability of the Carer Support Needs Assessment Tool. European Journal of Oncology Nursing, 35, 1-8
Open this publication in new window or tab >>A person-centred approach in nursing: Validity and reliability of the Carer Support Needs Assessment Tool
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2018 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 35, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Purpose: The Carer Support Needs Assessment Tool (CSNAT) was developed for use among family caregivers in palliative care for assessment of their support needs. The purpose of this study was to translate and evaluate the validity and reliability of the CSNAT in a sample of Swedish family caregivers and nurses in a palliative care context. Methods: Data for this validation study was collected during 2016 in the context of palliative home care in two larger Swedish cities. The study was conducted in three stages to reach conceptual, semantic, operational and measurement equivalence between the original UK version and the Swedish version. Stage I consisted of translation to Swedish. In Stage II, cognitive interviews were performed with 8 family caregivers and 10 nurses. Data were analyzed based on relevance, clarity and sensitivity. In Stage III, the CSNAT and related self-rating measures (caregiver burden, preparedness for caregiving and quality of life) were completed by 118 family caregivers. Data quality, construct validity and test-retest reliability were evaluated. Results: The CSNAT items were considered relevant and useful to identify areas of support needs. The Swedish CSNAT showed sound psychometric properties with satisfactory data quality and few problems with missing data across items (1.8%-6.1%). All items except one correlated as expected (rho > 0.3) with caregiver burden, supporting construct validity. All items had satisfactory test-retest reliability (kappa w = 0.45-0.75). Conclusions: This study further adds to the validity of the CSNAT and shows in addition that it is reliable and stable for use among family caregivers in palliative care.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Instrument development, Family caregivers, Nursing, Palliative care, Reliability, Validity
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77496 (URN)10.1016/j.ejon.2018.04.005 (DOI)000441490600001 ()30057075 (PubMedID)
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Ewertzon, M., Alvariza, A., Winnberg, E., Leksell, J., Andershed, B., Goliath, I., . . . Årestedt, K. (2018). Adaptation and evaluation of the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care. Journal of Advanced Nursing, 74(8), 1839-1850
Open this publication in new window or tab >>Adaptation and evaluation of the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care
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2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 8, p. 1839-1850Article in journal (Refereed) Published
Abstract [en]

AimTo adapt the Family Involvement and Alienation Questionnaire (FIAQ) for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability. BackgroundInvolvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed. DesignA psychometric evaluation study, with a cross-sectional design. MethodThe content validity of the FIAQ was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used. ResultsThe content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the FIAQ (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability. ConclusionThe study provides evidence that the FIAQ (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
care of older people, diabetes care, family involvement, instrument development, nursing, palliative care, psychiatric care, psychometric testing, reliability, validity
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77387 (URN)10.1111/jan.13579 (DOI)000438722300010 ()29603762 (PubMedID)
Available from: 2018-08-30 Created: 2018-08-30 Last updated: 2018-08-30Bibliographically approved
Lundberg, T., Forinder, U., Olsson, M., Furst, C. J., Årestedt, K. & Alvariza, A. (2018). Bereavement stressors and psychosocial well-being of young adults following the loss of a parent A cross-sectional survey. European Journal of Oncology Nursing, 35, 33-38
Open this publication in new window or tab >>Bereavement stressors and psychosocial well-being of young adults following the loss of a parent A cross-sectional survey
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2018 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 35, p. 33-38Article in journal (Refereed) Published
Abstract [en]

Purpose: The knowledge about young adults who have lost a parent to cancer is limited, and to reach a broader understanding about this group, this study used the Dual Process Model of Coping with Bereavement (Stroebe and Schut, 1999) as a theoretical framework. The purpose of this study was to describe loss- and restoration oriented bereavement stressors and psychosocial wellbeing of young adults following the loss of a parent to cancer. Mathod: This survey used baseline data from a longitudinal study. Young adults, aged 16-28 years, who lost a parent to cancer more than two months earlier and agreed to participate in support groups held at three palliative care services in Sweden, responded to a comprehensive theory-based study-specific questionnaire. Results: Altogether, 77 young adults (64 women and 13 men) answered the questionnaire an average of five-to eight months after the loss. Twenty percent (n = 15) had not been aware of their parent's impending death at all or only knew a few hours before the death, and 65% (n = 50) did not expect the death when it occurred. The young adults reported low self-esteem (n = 58, 76%), mild to severe anxiety (n = 55, 74%), mild to severe depression (n = 23, 31%) and low life satisfaction. Conclusion: Young adults reported overall poor psychosocial wellbeing following bereavement. The unexpectedness and unawareness of the parent's imminent death, i.e., loss-oriented bereavement stressors, might influence psychosocial wellbeing. Despite these reports, restoration-oriented stressors, such as support from family and friends, helped them to cope with the loss.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Bereavement, Cancer, Palliative care, Parental death, Psychosocial, Young adult
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77497 (URN)10.1016/j.ejon.2018.05.004 (DOI)000441490600005 ()30057081 (PubMedID)
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Andreae, C., Stromberg, A., Chung, M. L., Hjelm, C. & Årestedt, K. (2018). Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure. Journal of Cardiovascular Nursing, 33(2), E15-E20
Open this publication in new window or tab >>Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
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2018 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 2, p. E15-E20Article in journal (Refereed) Published
Abstract [en]

Background: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status. Objective: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association. Methods: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status. Results: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001). Conclusions: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
appetite, association, depression, health status, heart failure, nutritional status
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-77412 (URN)10.1097/JCN.0000000000000428 (DOI)000440241700003 ()28574973 (PubMedID)
Available from: 2018-08-29 Created: 2018-08-29 Last updated: 2018-08-29Bibliographically approved
Bremer, A., Kowalczyk, E., Årestedt, K. & Wireklint Sundström, B. (2018). Emergency Medical Services physicians’ perceptions of ambulance nurses’ responsibility for referring patients to primary care and self-care - a Swedish national survey. Paper presented at EMS2018, Copenhagen, Denmark, April 16-18, 2018. BMJ Open, 8(Suppl 1), A6-A6
Open this publication in new window or tab >>Emergency Medical Services physicians’ perceptions of ambulance nurses’ responsibility for referring patients to primary care and self-care - a Swedish national survey
2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no Suppl 1, p. A6-A6Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Based on guidelines developed by EMS physicians, registered nurses in the Swedish ambulance services sometimes by-pass the emergency department and refer non-urgent patients to primary care and self-care. However, these referrals are associated with problems that may jeopardize patient safety and patient participation.

Aim: To identify the EMS physicians’ perceptions of ambulance nurses’ responsibilities and prerequisites to refer patients to primary care and self-care.

Methods: A national survey of all EMS physicians (n=51) using study specific questions with close-ended and open response options, analysed with descriptive statistics and thematic analysis.

Results: The response rate was 78% (n=40). The majority of the physicians (95%) perceived that nurses should be able to refer patients to primary care and self-care. One fourth (25%) perceived specialist nurses in ambulance care as the most appropriate professionals. The majority of the physicians (65%) perceived that referral to primary care maintain patient safety, whereas fewer (50%) assessed the referral as safe for the patient. All perceived that feedback should be given to nurses when the referral was incorrect. The majority perceived it important to extend the nurses’ authority to refer to primary care (63%) and self-care (55%).

Conclusion: There is no consensus among the EMS physicians regarding responsibilities and conditions for nurses’ referral of patients. Registered nurses with basic education are expected to be able to refer, while there is varying opinion regarding requirements of specialist trained ambulance nurses to refer patients. Professional experience as a nurse is perceived more important than formal education.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
EMS physicians, Ambulance nurses, Competence, Referral, Responsibility, Patient safety, National survey
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-73097 (URN)10.1136/bmjopen-2018-EMS.16 (DOI)
Conference
EMS2018, Copenhagen, Denmark, April 16-18, 2018
Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-11-15Bibliographically approved
Hjelm, C., Hellström, A., Broström, A., Bremer, A. & Årestedt, K. (2018). Exploring sleep disturbances in cardiac arrest survivors: a phenomenographic interview study from registered nurses’ perspective. Paper presented at The Congress of the European Resuscitation Council, Bologna, Italy, September 20-22, 2018. Resuscitation, 130(s1), e129-e129
Open this publication in new window or tab >>Exploring sleep disturbances in cardiac arrest survivors: a phenomenographic interview study from registered nurses’ perspective
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e129-e129Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Sleep disturbances, Cardiac arrest, Phenomenographic, Registered nurses
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-77923 (URN)10.1016/j.resuscitation.2018.07.276 (DOI)
Conference
The Congress of the European Resuscitation Council, Bologna, Italy, September 20-22, 2018
Note

Part of special issue: RESUSCITATION 2018 - New technologies in resuscitation: Abstracts

Available from: 2018-09-20 Created: 2018-09-20 Last updated: 2018-10-30Bibliographically approved
Hedberg, B., Malm, D., Karlsson, J.-E., Årestedt, K. & Broström, A. (2018). Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation. European Journal of Cardiovascular Nursing, 17(5), 446-455
Open this publication in new window or tab >>Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation
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2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 5, p. 446-455Article in journal (Refereed) Published
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.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Atrial fibrillation, decision making, patient-based outcome measure, risk communication
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-74137 (URN)10.1177/1474515117741891 (DOI)000433529700008 ()29135285 (PubMedID)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-07-12Bibliographically approved
Israelsson, J., Thylén, I., Strömberg, A., Bremer, A. & Årestedt, K. (2018). Factors associated with health status and psychological distress among cardiac arrest survivors treated with an implantable cardioverter-defibrillator. Paper presented at The Congress of the European Resuscitation Council, 20th – 22th September. Bologna, Italy.. Resuscitation, 130(s1), e85
Open this publication in new window or tab >>Factors associated with health status and psychological distress among cardiac arrest survivors treated with an implantable cardioverter-defibrillator
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e85-Article in journal, Meeting abstract (Refereed) Published
Keywords
Health-related quality of life, Health status, Psychological distress, Cardiac arrest, Implantable cardioverter-defibrillator, Gender
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-77918 (URN)
Conference
The Congress of the European Resuscitation Council, 20th – 22th September. Bologna, Italy.
Available from: 2018-09-20 Created: 2018-09-20 Last updated: 2018-10-22Bibliographically approved
Israelsson, J., Thylén, I., Strömberg, A., Bremer, A. & Årestedt, K. (2018). Factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter-defibrillator. Resuscitation, 132, 78-84
Open this publication in new window or tab >>Factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter-defibrillator
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 132, p. 78-84Article in journal (Refereed) Published
Abstract [en]

Aim

To explore factors associated with health-related quality of life (HRQoL) among cardiac arrest (CA) survivors treated with an implantable cardioverter-defibrillator (ICD) in relation to gender, and to compare their HRQoL with a general population.

Methods

This cross-sectional study included 990 adults treated with an ICD after suffering CA. All participants received a questionnaire including demographics, comorbidities and instruments to measure HRQoL (EQ-5D-3L and HADS), ICD-related concerns (ICDC), perceived control (CAS), and type D personality (DS-14). HRQoL (EQ-5D-3L) was compared to a general Swedish population, matched for age and gender. Linear regression analyses were used to explore factors associated with HRQoL.

Results

The CA survivors reported better HRQoL in EQ index and less pain/discomfort compared to the general population (p < 0.001). In contrast, they reported more problems in mobility and usual activities (p < 0.01). Problems with anxiety and depression were reported by 15.5% and 7.4% respectively. The following factors were independently associated with all aspects of worse HRQoL: being unemployed, suffering more comorbidity, perceiving less control, and having a type D personality. Further, being female and suffering ICD-related concerns were independently associated with worse HRQoL in three of the four final regression models.

Conclusions

This extensive population-based study showed that most CA survivors living with an ICD rate their HRQoL as acceptable. In addition, their HRQoL is similar to a general population. Women reported worse HRQoL compared to men. Several factors associated with HRQoL were identified, and might be used when screening patients for health problems and when developing health promoting interventions.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Health-related quality of life, Health status, Psychological distress, Cardiac arrest, Implantable cardioverter-defibrillator, Gender
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-78034 (URN)10.1016/j.resuscitation.2018.09.002 (DOI)000446854900019 ()30201535 (PubMedID)
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2018-10-24Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-0961-5250

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