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Publications (10 of 141) Show all publications
Hellström, A., Hagell, P., Broström, A., Ulander, M., Luik, A. I., Espie, C. A. & Årestedt, K. (2019). A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data. PLoS ONE, 14(3), Article ID e0213533.
Open this publication in new window or tab >>A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 3, p. -3, article id e0213533Article in journal (Refereed) Published
Abstract [en]

Background Insomnia symptoms are common among young adults and affect about 5% to 26% of 19 to 34-year-olds. In addition, insomnia is associated with poor mental health and may affect daily performance. In research, as well as in clinical practice, sleep questionnaires are used to screen for and diagnose insomnia. However, most questionnaires are not developed according to current DSM-5 diagnostic criteria. An exception is the recently developed Sleep Condition Indicator (SCI), an eight-item scale screening for insomnia. Aim The aim of this study was to perform a Classical Test Theory (CTT) based psychometric evaluation of the SCI in a sample of Swedish university students, by taking the ordinal nature of item level data into account. Methods The SCI was translated into Swedish and distributed online to undergraduate students at three Swedish universities, within programs of health, psychology, science or economy. Of 3673 invited students, 634 (mean age 26.9 years; SD = 7.4) completed the questionnaire that, in addition to the SCI, comprised other scales on sleep, stress, lifestyle and students' study environment. Data were analyzed according to CTT investigating data completeness, item homogeneity and unidimensionality. Results Polychoric based explorative factor analysis suggested unidimensionality of the SCI, and internal consistency was good (Cronbach's alpha, 0.91; ordinal alpha, 0.94). SCI scores correlated with the Insomnia Severity Index (-0.88) as well as with sleep quality (-0.85) and perceived stress (-0.50), supporting external construct validity. Conclusions These observations support the integrity of the of the SCI. The SCI demonstrates sound CTT-based psychometric properties, supporting its use as an insomnia screening tool.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Other Health Sciences Psychology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-81402 (URN)10.1371/journal.pone.0213533 (DOI)000461166300038 ()30870454 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-03-29Bibliographically approved
Danielsson, M., Nilsen, P., Rutberg, H. & Årestedt, K. (2019). 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
2019 (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, 2019
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: 2019-03-11
Holm, M., Årestedt, K. & Alvariza, A. (2019). Associations between Predeath and Postdeath Grief in Family Caregivers in Palliative Home Care. Journal of Palliative Medicine
Open this publication in new window or tab >>Associations between Predeath and Postdeath Grief in Family Caregivers in Palliative Home Care
2019 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Family caregivers in palliative care may be placed in a complicated emotional situation wherein they suffer the risk of grief reactions both pre- and postbereavement and may also experience symptoms of anxiety and depression. Objective: The aim of this study was to investigate (1) associations between predeath grief and postdeath grief and (2) whether these are moderated by symptoms of anxiety and depression. Design: This was a prospective correlational study. Linear regression analysis in three blocks was used to investigate associations between pre- and postdeath grief and moderation effects of anxiety and depression. Postdeath grief was used as the outcome variable and predeath grief was used as the explanatory variable in block I. The moderator variables, symptoms of anxiety, and symptoms of depression were added as covariates in block II. A multiplicative interaction term between predeath grief and anxiety/depression was added to the model in block III. Setting/Subjects: Data were collected at 10 facilities specialized in palliative home care where health care professionals provided advanced care to patients with various diagnoses in their own homes. Measurements: The anticipatory grief scale and the Texas Revised Inventory of Grief were used to measure pre- and postdeath grief, respectively. To measure symptoms of anxiety and depression, the Hospital Anxiety and Depression scale was used. Results: A total of 128 family caregivers were included. Significant associations were found between predeath grief and postdeath grief and this association remained when controlled against symptoms of anxiety or depression. We found no moderation effect of anxiety or depression on the association between pre- and postdeath grief. Conclusions: In conclusion, grief before and after an expected death can be regarded as parts of the same grief process. Hence, knowing the intensity of predeath grief could be a way to predict the levels of postdeath grief.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2019
Keywords
family caregivers, grief, palliative care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-87066 (URN)10.1089/jpm.2019.0026 (DOI)000475716700001 ()31225778 (PubMedID)
Available from: 2019-08-01 Created: 2019-08-01 Last updated: 2019-08-01
Ericsson, C., Skagerström, J., Schildmeijer, K., Årestedt, K., Anders, B., Pakpour, A. & Per, N. (2019). Can patients contribute to safer care in meetings with health care professionals?: a cross-sectional survey of patient perceptions and beliefs. BMJ Quality and Safety, 28(8), 657-666
Open this publication in new window or tab >>Can patients contribute to safer care in meetings with health care professionals?: a cross-sectional survey of patient perceptions and beliefs
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2019 (English)In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 28, no 8, p. 657-666Article in journal (Refereed) Published
Abstract [en]

Objectives To investigate patients’ perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings.

Design Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics.

Setting The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017.

Participants Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units).

Main outcome measures Patients’ perceptions of meetings with physicians and nurses, beliefs concerning patients’ contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years.

Results Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years.

Conclusions Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-82217 (URN)10.1136/bmjqs-2018-008524 (DOI)
Available from: 2019-04-25 Created: 2019-04-25 Last updated: 2019-08-09Bibliographically approved
Waldréus, N., Jaarsma, T., Ivarsson, B., Strömberg, A., Årestedt, K. & Kjellström, B. (2019). Development and validation of a questionnaire to measure patient's experiences of health care in pulmonary arterial hypertension outpatient clinics. Heart, Lung and Circulation, 28(7), 1074-1081
Open this publication in new window or tab >>Development and validation of a questionnaire to measure patient's experiences of health care in pulmonary arterial hypertension outpatient clinics
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2019 (English)In: Heart, Lung and Circulation, ISSN 1443-9506, E-ISSN 1444-2892, Vol. 28, no 7, p. 1074-1081Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Measuring the patients' experience of care at an outpatient clinic can provide feedback about the quality of health care and if needed, can be support for quality improvements. To date, there is no patient reported experience measurement (PREM) developed targeting patients at the pulmonary arterial hypertension (PAH) outpatient clinics. Therefore, the aim was to develop and evaluate the psychometric properties of a PREM scale to be used for patients at PAH-outpatient clinics.

METHODS: The development and psychometric evaluation of the PREM for patients at PAH outpatient clinics followed two stages: (I) development of the PAH Clinic PREM (PAHC-PREM) scale based on interviews with patients; and (II) psychometric evaluation of the PAHC-PREM scale including data quality, factor structure (construct validity), criterion validity and internal consistency.

RESULTS: A sample of 156 patients at PAH outpatient clinics completed the PAHC-PREM scale (median age 69 years, 57% women). Unidimensionality of the PAHC-PREM scale was supported by parallel analysis. A single factor explained 67% of the variance. Inter-item and item-total correlations were satisfactory (0.46-0.88 and 0.64-0.91, respectively). Internal consistency reliability with ordinal coefficient alpha was good (0.93).

CONCLUSIONS: The PAHC-PREM scale was demonstrated to have good psychometric properties and is now ready to be used to measure quality of health care experience from patients at PAH-outpatient clinics.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Chronic disease, Patient reported experience measurement, Pulmonary arterial hypertension, Quality of health care
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-82984 (URN)10.1016/j.hlc.2018.07.011 (DOI)000470117200017 ()30139595 (PubMedID)
Available from: 2019-05-23 Created: 2019-05-23 Last updated: 2019-06-25Bibliographically approved
Lin, C.-Y., Imani, V., Broström, A., Årestedt, K., Pakpouro, A. H. & Griffiths, M. D. (2019). Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents. Frontiers in Psychology, 10, Article ID 149.
Open this publication in new window or tab >>Evaluating the Psychometric Properties of the 7-Item Persian Game Addiction Scale for Iranian Adolescents
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2019 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 10, article id 149Article in journal (Refereed) Published
Abstract [en]

The 7-item Gaming Addiction Scale (GAS) is a brief instrument based on DSM criteria to assess gaming addiction. Although the psychometric properties of the GAS have been tested using classical test theory, its psychometric properties have never been tested using modern test theory (e.g., Rasch analysis). The present study used a large adolescent sample in Iran to test the psychometric properties of the Persian GAS through both classical test and modern test theories. Adolescents (n = 4442; mean age = 15.3 years; 50.3% males) were recruited from Qazvin, Iran. In addition to the GAS, all of them completed the following instruments: the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and a generic quality of life instrument. Two weeks later, all participants completed the GAS again. Confirmatory factor analysis (CFA) and Rasch analysis were used to test the unidimensionality of the GAS. Pearson correlation coefficients were used to test the test-retest reliability, and a regression model was used to test the criterion-related validity of the GAS. Both CFA and Rasch analysis supported the unidimensionality of the GAS. Pearson correlations coefficients showed satisfactory test-retest reliability of the GAS (r = 0.78 to 0.86), and the regression model demonstrated the criterion-related validity of the GAS (beta = 0.31 with IGDS-SF9; 0.41 with PSQI). Based on the results, the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
adolescent gaming, confirmatory factor analysis, gaming addiction, online addiction, Rasch model
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-80775 (URN)10.3389/fpsyg.2019.00149 (DOI)000457845600002 ()
Available from: 2019-02-22 Created: 2019-02-22 Last updated: 2019-02-22Bibliographically approved
Bremer, A., Dahné, T., Stureson, L., Årestedt, K. & Thylén, I. (2019). Lived experiences of surviving in‐hospital cardiac arrest. Scandinavian Journal of Caring Sciences, 33(1), 156-164
Open this publication in new window or tab >>Lived experiences of surviving in‐hospital cardiac arrest
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2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 1, p. 156-164Article in journal (Refereed) Published
Abstract [en]

Background

Out‐of‐hospital cardiac arrest survivors suffer from psychological distress and cognitive impairments. They experience existential insecurity and vulnerability and are striving to return to a life in which well‐being and the meaning of life have partly changed. However, research highlighting the experiences of in‐hospital cardiac arrest survivors is lacking. This means that evidence for postresuscitation care has largely been extrapolated from studies on out‐of‐hospital cardiac arrest survivors, without considering potential group differences. Studies investigating survivors’ experiences of an in‐hospital cardiac arrest are therefore needed.

Aim

To illuminate meanings of people's lived experiences of surviving an in‐hospital cardiac arrest.

Design

An explorative, phenomenological hermeneutic method to illuminate meanings of lived experiences.

Method

Participants were identified through the Swedish national register of cardiopulmonary resuscitation and recruited from two hospitals. A purposive sample of eight participants, 53–99 years old, who survived an in‐hospital cardiac arrest 1–3 years earlier, was interviewed.

Findings

The survivors were striving to live in everyday life and striving for security. The struggle to reach a new identity meant an existence between restlessness and a peace of mind, searching for emotional well‐being and bodily abilities. The search for existential wholeness meant a quest for understanding and explanation of the fragmented cardiac arrest event and its existential consequences. The transition from hospital to home meant a transition from care and protection to uncertainty and vulnerability with feelings of abandonment, which called for a search for security and belonging, away from isolation and loneliness.

Conclusion

Surviving an in‐hospital cardiac arrest can be further understood by means of the concept of hospital‐to‐home transition. Following hospital discharge, patients felt vulnerable and abandoned when pending between denial and acceptance of the ‘new’ life. Hence, the healthcare system should play a significant role when it comes to facilitate cardiac arrest survivors’ security during hospital‐to‐home transition.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Cardiac arrest, Hospitals, Lived experiences, Nursing, Phenomenological hermeneutics
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-78359 (URN)10.1111/scs.12616 (DOI)000462154100016 ()30329171 (PubMedID)
Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2019-04-11Bibliographically approved
Eriksson, K., Årestedt, K., Broström, A. & Wikström, L. (2019). Nausea intensity as a reflector of early physical recovery after surgery. Journal of Advanced Nursing, 75(5), 989-999
Open this publication in new window or tab >>Nausea intensity as a reflector of early physical recovery after surgery
2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 989-999Article in journal (Refereed) Published
Abstract [en]

Aim To compare different levels of self-rated average nausea intensity with early physical recovery and determine if nausea can reflect recovery in patients undergoing general or orthopaedic surgery. Background Nausea has been found to influence postoperative physical recovery. Despite the incidence of nausea in postoperative care, there is a knowledge gap about the possibility of using average nausea intensity to reflect recovery, motivating further investigation. Design An observational design with repeated measures. Methods General and orthopaedic patients answered a questionnaire (October 2012-January 2015) about nausea and impact on recovery on postoperative days 1 (N = 479) and 2 (N = 441). Questions about average nausea intensity at rest and during activity were answered based on the Numeric Rating Scale (NRS) (0-10). Impact on recovery was evaluated using three dimensions from the postoperative recovery profile tool. Results About one-fifth of the patients reported nausea intensity as moderate to severe on days 1 and 2. Nausea intensity was associated with eight of nine aspects of recovery on postoperative day 1. Nausea intensity on day 1 also reflected four of nine aspects of recovery on day 2. About reflecting physical recovery, the association was strongest between nausea intensity and appetite changes. Conclusions As postoperative nausea is common, regular assessments by healthcare professionals are needed. Assessment of nausea is of importance since it reflects physical recovery. This also shows the importance of treating nausea without delay. Using the NRS to measure nausea intensity is a simple method that is easy to use in clinic.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
nausea, numeric rating scale, nursing, physical recovery, postoperative care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-82534 (URN)10.1111/jan.13893 (DOI)000465107000008 ()30375009 (PubMedID)
Available from: 2019-05-14 Created: 2019-05-14 Last updated: 2019-05-14Bibliographically approved
Holm, M., Alvariza, A., Furst, C.-J., Ohlen, J. & Årestedt, K. (2019). Psychometric evaluation of the anticipatory grief scale in a sample of family caregivers in the context of palliative care. Health and Quality of Life Outcomes, 17, 1-11, Article ID 42.
Open this publication in new window or tab >>Psychometric evaluation of the anticipatory grief scale in a sample of family caregivers in the context of palliative care
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2019 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, p. 1-11, article id 42Article in journal (Refereed) Published
Abstract [en]

IntroductionIn palliative care, family caregivers are often faced with experiences of grief in anticipation of the loss of a close person. An instrument designed to measure this form of grief is the Anticipatory Grief Scale, which includes 27 items and has been used in several studies in various contexts. However, the instrument has not been validated.AimThe aim was to evaluate the psychometric properties, focusing on the factor structure, of the Anticipatory Grief Scale in a sample of family caregivers in palliative care.MethodsThe study had a cross-sectional design. Data were collected from an intervention study in palliative home care that took place between 2013 and 2014. In total, 270 family caregivers in palliative care completed a baseline questionnaire, including the Anticipatory Grief Scale. The factor structure of the scale was evaluated using exploratory factor analysis.ResultsThe initial factor analysis suggested a four-factor solution, but, due to weak communalities, extensive crossloadings, and item inconsistencies, the model was problematic. Further analysis supported that the scale should be reduced to 13 items and two factors. The two subscales captured the behavioral and emotional reactions of grief in family caregivers in palliative care and were named Behavioral reactions and Emotional reactions. This modified version will hereafter be named AGS-13.ConclusionsThis validation study of the Anticipatory Grief Scale resulted in a revised two-factor model, AGS-13, that appears to be promising for use in palliative care but needs to be tested further.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Anticipatory grief, Palliative care, Family caregivers, Instrument development, Factor analysis, Nursing
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-81223 (URN)10.1186/s12955-019-1110-4 (DOI)000460443300001 ()30837000 (PubMedID)
Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2019-03-21Bibliographically approved
Andreae, C., Årestedt, K., Evangelista, L. & Strömberg, A. (2019). The relationship between physical activity and appetite in patients with heart failure: A prospective observational study. European Journal of Cardiovascular Nursing, 18(5), 410-417
Open this publication in new window or tab >>The relationship between physical activity and appetite in patients with heart failure: A prospective observational study
2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 5, p. 410-417Article in journal (Refereed) Published
Abstract [en]

Introduction: Physical activity and appetite are important components for maintaining health. Yet, the association between physical activity and appetite in heart failure (HF) populations is not completely understood. The aim of the present study was to investigate the relationship between physical activity, functional capacity, and appetite in patients with HF. Methods: This was a prospective observational study. In total, 186 patients diagnosed with HF, New York Heart Association (NYHA) class II-IV (mean age 70.7, 30% female), were included. Physical activity was measured using a multi-sensor actigraph for seven days and with a self-reported numeric rating scale. Physical capacity was measured by the six-minute walk test. Appetite was measured using the Council on Nutrition Appetite Questionnaire. Data were collected at inclusion and after 18 months. A series of linear regression analyses, adjusted for age, NYHA class, and B-type natriuretic peptide were conducted. Results: At baseline, higher levels of physical activity and functional capacity were significantly associated with a higher level of appetite in the unadjusted models. In the adjusted models, number of steps (p = 0.019) and the six-minute walk test (p = 0.007) remained significant. At the 18-month follow-up, all physical activity variables and functional capacity were significantly associated with appetite in the unadjusted regression models. In the adjusted models, number of steps (p = 0.001) and metabolic equivalent daily averages (p = 0.040) remained significant. Conclusion: A higher level of physical activity measured by number of steps/day was associated with better self-reported appetite, both at baseline and the 18-month follow-up. Further research is needed to establish causality and explore the intertwined relationship between activity and appetite in patients with HF.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Appetite, heart failure, physical activity
National Category
Cardiac and Cardiovascular Systems Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-85853 (URN)10.1177/1474515119836567 (DOI)000469834300008 ()30866679 (PubMedID)
Available from: 2019-06-25 Created: 2019-06-25 Last updated: 2019-06-25Bibliographically approved
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