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Israelsson, Johan
Publications (10 of 29) Show all publications
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)2-s2.0-85053177117 (Scopus ID)
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2019-08-29Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Petersson, G. & Bath, P. (2018). Factors influencing the quality of vital signs data in electronic health records: a qualitative study. Journal of Clinical Nursing, 27(5-6), 1276-1286
Open this publication in new window or tab >>Factors influencing the quality of vital signs data in electronic health records: a qualitative study
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1276-1286Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To investigate reasons for inadequate documentation of vital signs in an electronic health record.

Background

Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent.

Design

Qualitative study.

Methods

Qualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353-bed hospital.

Results

We identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients’ vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper “workarounds.”

Conclusions

This study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs.

Relevance to clinical practice

Patient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end-users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety.

Place, publisher, year, edition, pages
New Jersey: John Wiley & Sons, 2018
Keywords
Vital signs, patient safety, electronic health records
National Category
Other Medical Sciences not elsewhere specified
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-70319 (URN)10.1111/jocn.14174 (DOI)000428419400087 ()29149483 (PubMedID)2-s2.0-85044258923 (Scopus ID)
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2019-08-29Bibliographically approved
Årestedt, K., Allert, C., Djukanovic, I., Israelsson, J., Schildmeijer, K., Agerström, J., . . . Bremer, A. (2018). Health-related quality of life among in-hospital cardiac arrest survivors in working age. Paper presented at The Congress of the European Resuscitation Council, 20th – 22th September. Bologna, Italy. Resuscitation, 130(s1), Article ID e18.
Open this publication in new window or tab >>Health-related quality of life among in-hospital cardiac arrest survivors in working age
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2018 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, article id e18Article in journal, Meeting abstract (Refereed) Published
Keywords
Health-related quality of life, in-hospital, cardiac arrest, working age, anxiety, depression
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-77900 (URN)10.1016/j.resuscitation.2018.07.342 (DOI)
Conference
The Congress of the European Resuscitation Council, 20th – 22th September. Bologna, Italy
Available from: 2018-09-20 Created: 2018-09-20 Last updated: 2019-08-28Bibliographically approved
Djarv, T., Axelsson, C., Herlitz, J., Stromsoe, A., Israelsson, J. & Claesson, A. (2018). Traumatic cardiac arrest in Sweden 1990-2016: a population-based national cohort study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26, Article ID 30.
Open this publication in new window or tab >>Traumatic cardiac arrest in Sweden 1990-2016: a population-based national cohort study
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2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, article id 30Article in journal (Refereed) Published
Abstract [en]

Background: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA). Methods: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016. The definition of a TCA in the SRCR is a patient who is unresponsive with apnoea where cardiopulmonary resuscitation and/or defibrillation have been initiated and in whom the Emergency Medical Services (EMS, mainly a nurse-based system) reported trauma as the aetiology. Outcome was overall 30-day survival. Descriptive statistics as well as multivariable logistic regression models were used. Results: In all, between 1990 and 2016, 1774 (2.4%) cases had a TCA and 72,547 had a medical CA. Overall 30-day survival gradually increased over the years, and was 3.7% for TCAs compared to 8.2% following a medical CA (p < 0.01). Among TCAs, factors associated with a higher 30-day survival were bystander witnessed and having a shockable initial rhythm (adjusted OR 2.67, 95% C.I. 1.15-6.22 and OR 8.94 95% C.I. 4.27-18.69, respectively). Discussion: Association in registry-based studies do not imply causality but TCA had short time intervals in the chain of survival as well as high rates of bystander-CPR. C onclusion: In a medical CA registry like ours, prevalence of TCAs is low and survival is poor. Registries like ours might not capture the true incidence. However, many individuals do survive and resuscitation in TCAs should not be seen futile.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
TCA, Prevalence, OHCA, Trauma, Resuscitation
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:lnu:diva-76747 (URN)10.1186/s13049-018-0500-7 (DOI)000430636600001 ()29685180 (PubMedID)2-s2.0-85045768123 (Scopus ID)
Available from: 2018-07-10 Created: 2018-07-10 Last updated: 2019-08-29Bibliographically approved
Stevenson-Ågren, J., Israelsson, J., Nilsson, G., Petersson, G. & Bath, P. A. (2018). Vital sign documentation in electronic records: the development of workarounds. Health Informatics Journal, 24(2), 206-215
Open this publication in new window or tab >>Vital sign documentation in electronic records: the development of workarounds
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2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 206-215Article in journal (Refereed) Published
Abstract [en]

Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
electronic health records, healthcare professionals, patient safety, vital signs, workarounds
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Information Systems
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-55697 (URN)10.1177/1460458216663024 (DOI)000432068300008 ()27542887 (PubMedID)
Available from: 2016-08-22 Created: 2016-08-22 Last updated: 2019-03-05Bibliographically approved
Al-Dury, N., Rawshani, A., Israelsson, J., Strömsöe, A., Aune, S., Agerström, J., . . . Herlitz, J. (2017). Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age.. American Journal of Emergency Medicine, 35(12), 1839-1844
Open this publication in new window or tab >>Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age.
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2017 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 35, no 12, p. 1839-1844Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age.

METHODS: Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49years), middle-aged (50-64years) and older (65years and above). Comparisons between men and women were age adjusted.

RESULTS: The mean age was 72.7years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors.

CONCLUSION: When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Cardiac arrest, Cardiopulmonary resuscitation
National Category
Cardiac and Cardiovascular Systems
Research subject
Natural Science, Medicine
Identifiers
urn:nbn:se:lnu:diva-72702 (URN)10.1016/j.ajem.2017.06.012 (DOI)000417337100009 ()28624147 (PubMedID)2-s2.0-85020765621 (Scopus ID)
Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2019-08-29Bibliographically approved
Israelsson, J., Thylén, I., Strömberg, A., Bremer, A. & Årestedt, K. (2017). Factors associated with health status and psychological distress among cardiac arrest (CA) survivors living with an implantable cardioverter-defibrillator (ICD). In: : . Paper presented at 3rd International Symposium on Post Cardiac Arrest Care, Lund, Sweden, September 4-5, 2017.
Open this publication in new window or tab >>Factors associated with health status and psychological distress among cardiac arrest (CA) survivors living with an implantable cardioverter-defibrillator (ICD)
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2017 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Background: The aim was to explore factors associated with health status and psychological distress among ICD-implanted CA survivors.  

Materials and methods: This cross-sectional study included all eligible adult ICD-implanted CA survivors in the Swedish ICD and Pacemaker Registry, 2011-2012. Health status and psychological distress were measured with the EQ-5D-5L (EQ index & EQ VAS) and the Hospital Anxiety and Depression Scale (HADS) respectively. Linear regression analyses were used to explore associations between explanatory- and outcome variables.

Results: In total, 990 patients (22% women) with a median age of 68 (q1-q3=60-74) were included. Time since the CA varied between 6 months to 23 years. The median values for EQ index and EQ VAS were 0.85 (q1-q3=0.73-1.00) and 80 (q1-q3=69-90) respectively. Gender, comorbidity, receiving ICD-shock/-s, perceived control and personality were independently associated with health status. The final models explained 25% (EQ index) and 30% (EQ VAS) of the total variance (according to the R2 values). The median values for HADS Anxiety and HADS Depression were 3 (q1-q3=1-6) and 2 (q1-q3=1-4) respectively. Age, gender, comorbidity, living alone, ICD-related concerns, perceived control and personality were independently associated with psychological distress. The final models explained 51% (HADS Anxiety) and 44% (HADS Depression) of the total variance.

Conclusion: Age, gender, living alone, comorbidity, receiving ICD-shock/-s, ICD-related concerns, perceived control and personality were associated with health status and/or psychological distress. These results contribute to a better understanding of the life situation among CA survivors, and may be important to develop individualized post CA care. 

Keywords
Health status, Psychological distress, Cardiac arrest, survivors, Implantable cardioverter-defibrillator
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-68014 (URN)
Conference
3rd International Symposium on Post Cardiac Arrest Care, Lund, Sweden, September 4-5, 2017
Available from: 2017-09-18 Created: 2017-09-18 Last updated: 2018-05-17Bibliographically approved
Israelsson, J., Bremer, A., Herlitz, J., Axelsson, Å. B., Cronberg, T., Djärv, T., . . . Årestedt, K. (2017). Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender. Resuscitation, 114, 27-33
Open this publication in new window or tab >>Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
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2017 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, p. 27-33Article in journal (Refereed) Published
Abstract [en]

AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.

METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).

RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p&lt;0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p&lt;0.001) and symptoms of depression (p&lt;0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.

CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
medication adherence, reasons, attitudes, gender, anxiety symptoms, depression symptoms, Cardiac and Cardiovascular Systems, Kardiologi, Health Sciences, Hälsovetenskaper
National Category
Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-62745 (URN)10.1016/j.resuscitation.2017.02.006 (DOI)000402487800021 ()28216089 (PubMedID)2-s2.0-85014407099 (Scopus ID)
Available from: 2017-05-03 Created: 2017-05-03 Last updated: 2019-08-29Bibliographically approved
Årestedt, K., Sawatsky, R., Israelsson, J., Herlitz, J., Lilja, G., Cronberg, T. & Bremer, A. (2017). Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors. In: : . Paper presented at EuroHeartCare 2017, Jönköping, Sweden, May 18-20, 2017.
Open this publication in new window or tab >>Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors
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2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: The Hospital Anxiety and Depression scale (HAD) is commonly used to assess emotional distress in different group of patients. Despite emotional distress is common in sudden cardiac arrest survivors (SCA), HAD have not to our best knowledge been psychometrically evaluated in this patient group.

Purpose: The aim was to evaluate the psychometric properties of the HAD, with focus on factor structure, internal consistency and differential item functioning (DIF) for sex and age, in SCA survivors.

Methods: Data from the national Swedish Register of Cardiopulmonary Resuscitation were used, including HAD ratings from in-hospital cardiac arrest survivors, collected 3-12 months after resuscitation. Confirmatory factor analysis (CFA) was used to evaluate the hypothesized two factor structure for Anxiety and Depression, respectively. Ordinal version of Cronbach’s alpha was calculated to evaluate internal consistency reliability of the two factors. Multiple indicator multiple causes CFA models (MIMIC) were used to detect presence of DIF.

Results: The sample consisted of 604 in-hospital cardiac arrest survivors (mean age 69.4±12.6), 384 men and 220 women. The suggested two-factor model was confirmed after item 7 was allowed to cross-load on Depression. The internal consistency was satisfactory for both Anxiety (.92) and Depression (.91). No DIF for sex and age was demonstrated.

Conclusion: This study shows that the HAD Anxiety and Depression subscales are unidimensional. Both scales can also be used to make invariant comparisons between groups of different sex and age. Therefore, HAD can be used to assess psychological distress (anxiety and depression) in SCA survivors.

Keywords
Cardiac arrest, Patients, Psychometric evaluation, Hospital Anxiety and Depression scale
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-64383 (URN)
Conference
EuroHeartCare 2017, Jönköping, Sweden, May 18-20, 2017
Available from: 2017-05-25 Created: 2017-05-25 Last updated: 2019-08-28Bibliographically approved
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