lnu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Publications (10 of 18) 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
Show others...
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)2-s2.0-85062951355 (Scopus ID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-08-29Bibliographically approved
Ekstedt, M., Schildmeijer, K., Wennerberg, C., Nilsson, L., Wannheden, C. & Hellström, A. (2019). Enhanced patient activation in cancer care transitions: protocol for a randomized controlled trial of a tailored eectronic health intervention for men with prostate cancer. JMIR Research Protocols, 8(3), 1-13, Article ID e11625.
Open this publication in new window or tab >>Enhanced patient activation in cancer care transitions: protocol for a randomized controlled trial of a tailored eectronic health intervention for men with prostate cancer
Show others...
2019 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 8, no 3, p. 1-13, article id e11625Article in journal (Refereed) Published
Abstract [en]

Background: Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose.

Objective: This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activation, motivation, overall well-being, and health literacy over time in and between groups.

Methods: A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80% power, a sample of 242 men will need to be recruited.

Results: Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020.

Conclusions: With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals.

Place, publisher, year, edition, pages
JMIR Publications, 2019
Keywords
medical informatics, eHealth, mHealth, motivation, patient activation, prostate cancer, self-management
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-81619 (URN)10.2196/11625 (DOI)000462890300001 ()30900999 (PubMedID)2-s2.0-85067901358 (Scopus ID)
Funder
The Kamprad Family Foundation, 2015-0067Swedish Cancer Society, CAN 2017/748Medical Research Council of Southeast Sweden (FORSS), FORSS-657211;FORSS-760131
Available from: 2019-04-03 Created: 2019-04-03 Last updated: 2019-08-29Bibliographically approved
Hanson, E., Hellström, A., Sandvide, Å., Jackson, G. A., MacRae, R., Waugh, A., . . . Tolson, D. (2019). The extended palliative phase of dementia: an integrative literature review. Dementia, 18(1), 108-134
Open this publication in new window or tab >>The extended palliative phase of dementia: an integrative literature review
Show others...
2019 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 18, no 1, p. 108-134Article, review/survey (Refereed) Published
Abstract [en]

This article presents an integrative literature review of the experience of dementia care associated with the extended palliative phase of dementia. The aim was to highlight how dementia is defined in the literature and describe what is known about the symptomatology and management of advanced dementia regarding the needs and preferences of the person with dementia and their family carer/s. There was no consistent definition of advanced dementia. The extended palliative phase was generally synonymous with end-of-life care. Advanced care planning is purported to enable professionals to work together with people with dementia and their families. A lack of understanding of palliative care among frontline practitioners was related to a dearth of educational opportunities in advanced dementia care. There are few robust concepts and theories that embrace living the best life possible during the later stages of dementia. These findings informed our subsequent work around the concept, ‘Dementia Palliare’.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Advanced dementia, Integrative literature review, Palliare, Palliative care
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-61510 (URN)10.1177/1471301216659797 (DOI)000456465500007 ()2-s2.0-85045150247 (Scopus ID)
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2019-08-29Bibliographically approved
Schildmeijer, K., Wannheden, C., Nilsson, L., Frykholm, O., Hellström, A., Flink, M. & Ekstedt, M. (2018). Developing an eHealth Tool to Support Patient Empowerment at Home. In: Adrien Ugon, Daniel Karlsson, Gunnar O. Klein & Anne Moen (Ed.), Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth. Paper presented at MIE2018, Gothenburg, Sweden, April 24-26, 2018 (pp. 925-929). IOS Press, 247
Open this publication in new window or tab >>Developing an eHealth Tool to Support Patient Empowerment at Home
Show others...
2018 (English)In: Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth / [ed] Adrien Ugon, Daniel Karlsson, Gunnar O. Klein & Anne Moen, IOS Press, 2018, Vol. 247, p. 925-929Conference paper, Published paper (Refereed)
Abstract [en]

In previous research we have learned that patients with chronic or complex diseases often experience difficulties when transitioning from hospital care to self-care in their home. We address these difficulties by developing an eHealth tool for patients - ePATH (electronic Patient Activation in Treatment at Home) - intended to empower each patient to manage their individual situation. We have employed a user-centered design process involving both patients and healthcare personnel to specify the content and functionality of ePATH. The system is deployed as a web application with secure login for patients. In this article, we describe the main content and functionality of the system that makes it possible for a patient to manage symptoms development in relation to treatment progression Interactive functionality, e.g., reminders and social support, is included to make the ePATH a useful and informative bridge between patients, next-of-kin and different caregivers. One lesson learned is that it is necessary to incorporate motivational components in the development of an eHealth tool to successfully overcome the "intention-behavior" gap. The self-determination theory of motivation can be used to ensure that important aspects are not missed.

Place, publisher, year, edition, pages
IOS Press, 2018
Series
Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365 ; 247
Keywords
eHealth, patient participation, personalized care, transitions in care, user-centered design
National Category
Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-75584 (URN)10.3233/978-1-61499-852-5-925 (DOI)29678096 (PubMedID)2-s2.0-85046550034 (Scopus ID)9781614998518 (ISBN)9781614998525 (ISBN)
Conference
MIE2018, Gothenburg, Sweden, April 24-26, 2018
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4948
Available from: 2018-07-11 Created: 2018-07-11 Last updated: 2019-08-29Bibliographically 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
Show others...
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: 2019-02-26Bibliographically approved
Tuvesson, H., Hellström, A., Sjöberg, L., Sjölund, B.-M., Nordell, E. & Fagerström, C. (2018). Life weariness and suicidal thoughts in late life: a national study in Sweden. Aging & Mental Health, 22(10), 1365-1371
Open this publication in new window or tab >>Life weariness and suicidal thoughts in late life: a national study in Sweden
Show others...
2018 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 10, p. 1365-1371Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aimed at investigating the point prevalence of life weariness and suicidal thoughts and their relationship with socio-demographic characteristics in a population of older adults in Sweden. Method: Data from 7913 individuals aged 60 years and older were drawn from the Swedish National Study on Aging and Care, a collaborative study in Sweden. Life weariness and suicidal thoughts were measured by one item derived from the Montgomery–Åsberg Depression Rating Scale. A multinomial regression model was used to investigate the relationships of socio-demographic characteristics with life weariness and suicidal thoughts. Results: Living in urban and semi-urban areas, being of advanced age, being divorced and having lower educational levels were related to life weariness. Living in a residential care facility, being widowed or unmarried, being born in a non-Nordic European country and experiencing financial difficulties were related to both life weariness and suicidal thoughts. Sex was found to be unrelated to either life weariness or suicidal thoughts. Conclusion: This study found that several socio-demographic variables were associated with life weariness and suicidal thoughts among older adults. Specific attention to older individuals with these characteristics may be warranted as they might be more vulnerable to life weariness and suicidal thoughts.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Life weariness, National study, Older adults, Socio-demographics, Suicidal thoughts
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-68201 (URN)10.1080/13607863.2017.1348484 (DOI)000455491500017 ()28685600 (PubMedID)2-s2.0-85021985390 (Scopus ID)
Available from: 2017-08-17 Created: 2017-10-04 Last updated: 2019-02-26Bibliographically approved
Hvalic-Touzery, S., Skela-Savic, B., Macrae, R., Jack-Waugh, A., Tolson, D., Hellström, A., . . . Pesjak, K. (2018). The provision of accredited higher education on dementia in six European countries: An exploratory study. Nurse Education Today, 60, 161-169
Open this publication in new window or tab >>The provision of accredited higher education on dementia in six European countries: An exploratory study
Show others...
2018 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 60, p. 161-169Article in journal (Refereed) Published
Abstract [en]

Background: The World Health Organization has identified developing the knowledge and skills of healthcare professionals who are involved in dementia care as a priority. Most healthcare professionals lack the necessary knowledge, skills and understanding to provide high quality dementia care. While dementia education amongst most UK university health and social care programmes is inconsistent, we know little about the provision of dementia education in European universities. Objectives: To examine the provision of accredited higher education on dementia in European countries, to illustrate that it is highly variable despite universities being the major provider of education for healthcare professionals internationally. Design: An exploratory research design was used. Settings: The providers of higher education undergraduate and postgraduate programmes in the Czech Republic, Portugal, Scotland, Slovenia, Spain, Sweden. Participants: Higher Education Institutions who provide undergraduate and postgraduate education in the fields of nursing, medicine, psychology, social work, physiotherapy, occupational therapy, and gerontology in six European countries. Methods: The data was collected using a structured questionnaire. Researchers in each country conducted an internet-based search using the websites of Higher Education Institutions to identify existing accredited dementia education. Results: These searches revealed a lack of dementia education in undergraduate health and social care study programmes. Three of the six countries offered postgraduate study programmes on dementia. There was a significant variation amongst the countries in relation to the provision of dementia education at undergraduate, postgraduate and doctoral levels. Conclusions: Dementia is a global challenge and educating and upskilling the workforce is a policy imperative. To deliver the best dementia care, investment in interprofessional evidence-based education is required if we are to respond effectively and compassionately to the needs of people living with dementia and their families. Higher Education Institutions have an important role to play in equipping health and social care professionals with the knowledge, skills and understanding to respond to this imperative.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Dementia, Undergraduate education, Postgraduate education, Europe, Dementia Palliare
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-69791 (URN)10.1016/j.nedt.2017.10.010 (DOI)000418972700025 ()29132018 (PubMedID)2-s2.0-85033368681 (Scopus ID)
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2019-08-29Bibliographically approved
Hellström, A., Hagell, P., Broström, A., Ulander, M. & Årestedt, K. (2017). Initial psychometric testing of the sleep condition indicator in a swedish context. Sleep Medicine, 40, E129-E130
Open this publication in new window or tab >>Initial psychometric testing of the sleep condition indicator in a swedish context
Show others...
2017 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 40, p. E129-E130Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2017
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-78415 (URN)10.1016/j.sleep.2017.11.379 (DOI)000444558902379 ()
Available from: 2018-10-22 Created: 2018-10-22 Last updated: 2019-02-26Bibliographically approved
Selan, S., Hellström, A. & Fagerström, C. (2016). Impact of nutritional status and sleep quality on hospital utilisation in the oldest old with heart failure. The Journal of Nutrition, Health & Aging, 20(2), 170-177
Open this publication in new window or tab >>Impact of nutritional status and sleep quality on hospital utilisation in the oldest old with heart failure
2016 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 20, no 2, p. 170-177Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF). Design: Single-centred longitudinal observational study. Setting: South-eastern Sweden. Participants: 90 elderly (80+) with objectively verified HF. Measurements: Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n= 90) and at a three-year follow-up (n= 41). Data on hospital utilisation during the three years following the HF diagnosis were also collected. Results: Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period. Conclusion: In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
80+, Heart failure, Hospital utilisation, Nutritional status, Sleep quality
National Category
Nursing
Research subject
Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-51870 (URN)10.1007/s12603-015-0594-9 (DOI)000374701200011 ()26812513 (PubMedID)2-s2.0-84957838844 (Scopus ID)
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2019-02-26Bibliographically approved
Hellström, A., Nilsson, C., Nilsson, A. & Fagerström, C. (2016). Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance. BMC Geriatrics, 16, Article ID 25.
Open this publication in new window or tab >>Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance
2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 25Article in journal (Refereed) Published
Abstract [en]

Background: Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. Methods: The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9 % were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. Results: We found the prevalence of pain intensity >= 5 on the NRS to be 34.8 % in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8 % of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venousarterial ulcers increased the risk of sleep disturbances, as did higher pain scores. Conclusions: The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met. National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed.

Keywords
Leg ulcers, Older people, Pain, Sleep disturbances
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-49718 (URN)10.1186/s12877-016-0198-1 (DOI)000368459400002 ()26797291 (PubMedID)2-s2.0-84959494529 (Scopus ID)
Available from: 2016-02-12 Created: 2016-02-12 Last updated: 2019-02-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8398-9552

Search in DiVA

Show all publications