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Fagerström, Cecilia, Docent
Biography [swe]

livsvillkor, hälsa och livskvalitet bland äldre. Ehälsolösningar i samband med kroniska sjukdomar. Personcentrerad vård

 

Publications (10 of 58) Show all publications
Wickström, H. L., Oien, R. F., Fagerström, C., Anderberg, P., Jakobsson, U. & Midlov, P. J. (2018). Comparing video consultation with inperson assessment for Swedish patients with hard-to-heal ulcers: registry-based studies of healing time and of waiting time. BMJ Open, 8(2), Article ID e017623.
Open this publication in new window or tab >>Comparing video consultation with inperson assessment for Swedish patients with hard-to-heal ulcers: registry-based studies of healing time and of waiting time
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 2, article id e017623Article in journal (Refereed) Published
Abstract [en]

Objectives To investigate differences in ulcer healing time and waiting time between video consultation and inperson assessment for patients with hard-to-heal ulcers. Setting Patients treated at Blekinge Wound Healing Centre, a primary care centre covering the whole of Blekinge county (150 000 inhabitants), were compared with patients registered and treated according to the Registry of Ulcer Treatment, a Swedish national web-based quality registry. Participants In the study for analysing ulcer healing time, the study group consisted of 100 patients diagnosed through video consultation between October 2014 and September 2016. The control group for analysing healing time consisted of 1888 patients diagnosed through inperson assessment during the same period. In the study for analysing waiting time, the same study group (n=100) was compared with 100 patients diagnosed through inperson assessment. Primary and secondary outcome measures Differences in ulcer healing time were analysed using the log-rank test. Differences in waiting time were analysed using the Mann-Whitney U test. Results Median healing time was 59 days (95% CI 40 to 78) in the study group and 82 days (95% CI 75 to 89) in the control group (P<0.001). Median waiting time was 25 days (range: 1-83 days) in the study group and 32 days (range: 3-294 days) for patients diagnosed through inperson assessment (P=0.017). There were no significant differences between the study group and the control group regarding age, gender or ulcer size. Conclusions Healing time and waiting time were significantly shorter for patients diagnosed through video consultation compared with those diagnosed through inperson assessment.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2018
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-76895 (URN)10.1136/bmjopen-2017-017623 (DOI)000433129800102 ()29449288 (PubMedID)
Available from: 2018-07-17 Created: 2018-07-17 Last updated: 2018-07-17Bibliographically 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
Open this publication in new window or tab >>Life weariness and suicidal thoughts in late life: a national study in Sweden
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2018 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915Article in journal (Refereed) Epub ahead of print
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.

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)28685600 (PubMedID)2-s2.0-85021985390 (Scopus ID)
Available from: 2017-08-17 Created: 2017-10-04 Last updated: 2018-03-29
Karlsson, S., Hallberg, I. R., Midlöv, P. & Fagerström, C. (2017). Antipsychotic medication in relation to national directives in people with dementia in Sweden. In: Program Abstracts from the 21st International Association of Gerontology and Geriatrics (IAGG) World Congress: . Paper presented at The 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, San Francisco, USA, July 23-27, 2017 (pp. 348-349). Washington, DC: The Gerontological Society of America
Open this publication in new window or tab >>Antipsychotic medication in relation to national directives in people with dementia in Sweden
2017 (English)In: Program Abstracts from the 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, Washington, DC: The Gerontological Society of America , 2017, p. 348-349Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care as reported in the most recent empirical studies on the topic, and to relate these trends to directives and recommendations from national authorities.

The study included two scoping review studies and two empirical studies. The scoping studies reviewed published data in electronic databases as well as Swedish recommendations and directives in the field.

During the past decade, recommendations have been developed regarding antipsychotic medication in Sweden. These recommendations were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend towards a decrease in antipsychotic use has been seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.4% in 2001 to 11.5% in 2007, for older people in general as well as for older people with dementia. Among older people with dementia, 10% were utilizing antipsychotic medication, with no difference between those cared for at home and those in nursing homes.

Directives from Swedish national authorities seem to have had an impact on antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while other psychotropic medication has increased. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.

Place, publisher, year, edition, pages
Washington, DC: The Gerontological Society of America, 2017
Series
Innovation in Aging, E-ISSN 2399-5300 ; Vol 1, Suppl 1
Keywords
Dementia, Antipsychotic medication, Drug utilization, Directive
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-71984 (URN)10.1093/geroni/igx004.1276 (DOI)
Conference
The 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, San Francisco, USA, July 23-27, 2017
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-05-11Bibliographically approved
Lindberg, C., Fagerström, C., Willman, A. & Sivberg, B. (2017). Befriending everyday life when bringing technology into the private sphere. Qualitative Health Research, 27(6), 843-854
Open this publication in new window or tab >>Befriending everyday life when bringing technology into the private sphere
2017 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, no 6, p. 843-854Article in journal (Refereed) Published
Abstract [en]

We present the findings of our phenomenological interview study concerning the meaning of being an autonomous person while dependent on advanced medical technology at home. This was elucidated in the participants' narratives as befriending everyday life when bringing technology into the private sphere. We discovered four constituents of the phenomenon: befriending the lived body, depending on good relationships, keeping the home as a private sphere, and managing time. The most important finding was the overall position of the lived body by means of the illness limiting the control over one's life. We found that the participants wanted to be involved in and have influence over their care to be able to enjoy autonomy. We therefore stress the importance of bringing the patients into the care process as chronic illness will be a part of their everyday life for a long time to come, hence challenging patient autonomy.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Advanced home care, Autonomy, Decision making, Ethics, Giorgi, Interviews, Phenomenology, Qualitative, Technology, Medical
National Category
Nursing
Identifiers
urn:nbn:se:lnu:diva-71990 (URN)10.1177/1049732315627428 (DOI)000400198000008 ()
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-05-02Bibliographically approved
Marcinowicz, L., Jamiołkowski, J., Gugnowski, Z., Strandberg, E. L., Fagerström, C. & Pawlikowska, T. (2017). Evaluation of the trust in physician scale (TIPS) of primary health care patients in north-east Poland: a preliminary study. Family Medicine and Primary Care Review, 19(1), 39-43
Open this publication in new window or tab >>Evaluation of the trust in physician scale (TIPS) of primary health care patients in north-east Poland: a preliminary study
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2017 (English)In: Family Medicine and Primary Care Review, ISSN 1734-3402, E-ISSN 2449-8580, Vol. 19, no 1, p. 39-43Article in journal (Refereed) Published
Abstract [en]

Background. Trust is a complex concept, difficult to study, but very important in a patient-family physician relationship. One of the measures used to assess interpersonal trust is a scale developed by Anderson & Dedrick entitled the Trust in Physician Scale (TI PS).

Objectives. The aim of the study was to assess the TI PS properties in relation to the age, gender, and health status of primary health care patients consulting family doctors and trainees in north-east Poland.

Material and methods. A cross-sectional study using the TI PS was conducted in primary health care units in north-east Poland. 120 patients (60 who came to see family doctors, and 60 who came to see trainees) were asked to participate in the survey.

Results. The Trust in Physician Scale has good reliability in primary care patients in north-east Poland (Cronbach’s alpha coefficient was 0.90). Patients displayed statistically significant greater trust in family doctors than in trainees. A negative correlation was found between age and the trust scale (r = -0.30; p = 0.005); the younger the respondent, the higher trust in the physician, and conversely, a positive correlation between self-assessment of health and the trust scale (r = 0.3; p = 0.003).

Conclusions. The Polish translation of the TI PS instrument performed well in terms of acceptability in the family medicine environment. It can be used to differentiate between the level of trust in family doctors and in trainees. A relation between age, sex, education level and self-assessment of health needs to be confirmed using a larger sample.

Place, publisher, year, edition, pages
Continuo Publisher, 2017
Keywords
Patient trust, Doctor–patient relationship, The Trust in Physician Scale, Questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:lnu:diva-71995 (URN)10.5114/fmpcr.2017.65089 (DOI)000398934500008 ()2-s2.0-85016439210 (Scopus ID)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-05-02Bibliographically approved
Fagerström, C., Wranker, L. S., Kabir, Z. N. & Sternäng, O. (2017). Everyday health among older people: a comparison between two countries with variant life conditions. Journal of Aging Research, Article ID 2720942.
Open this publication in new window or tab >>Everyday health among older people: a comparison between two countries with variant life conditions
2017 (English)In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, article id 2720942Article in journal (Refereed) Published
Abstract [en]

This study described health factors of importance for everyday health, such as pain, tiredness, and sleeping problems, in a cross-national context. Data for persons 60+ years were obtained from the Poverty and Health in Aging study, Bangladesh, and the Swedish National Study on Aging and Care-Blekinge. The strongest associations with everyday health in Sweden were found for pain and tiredness, while in Bangladesh they were financial status, tiredness, and sleeping problems. As similarities were found regarding the associations of tiredness on everyday health, tiredness may be a universal predictor of everyday health in older adults irrespective of country context.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:lnu:diva-71965 (URN)10.1155/2017/2720942 (DOI)28875042 (PubMedID)2-s2.0-85028308831 (Scopus ID)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-04-11Bibliographically approved
Wimo, A., Elmstål, S., Fratiglioni, L., Sjölund, B.-M., Sköldunger, A., Fagerström, C., . . . Lagergren, M. (2017). Formal and informal care of community-living older people: a population-based study from the Swedish National study on Aging and Care. The Journal of Nutrition, Health & Aging, 21(1), 17-24
Open this publication in new window or tab >>Formal and informal care of community-living older people: a population-based study from the Swedish National study on Aging and Care
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2017 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 1, p. 17-24Article in journal (Refereed) Published
Abstract [en]

Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC).

Design: Cross-sectional, population based cohort.

Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County.

Participants: 3,338 persons ≥72 years.

Measurements: Patterns and amounts of informal and formal care by cognition and area of residence.

Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole.

Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Social support, Informal care, Cognitive impairment, Residential area
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:lnu:diva-72005 (URN)10.1007/s12603-016-0747-5 (DOI)000394347000003 ()2-s2.0-84969983766 (Scopus ID)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-05-02Bibliographically approved
Wennstig, M. & Fagerström, C. (2017). Levnadsberättelser i Blekinges särskilda boende för äldre. Landstinget Blekinge
Open this publication in new window or tab >>Levnadsberättelser i Blekinges särskilda boende för äldre
2017 (Swedish)Report (Other academic)
Abstract [sv]

BakgrundDemenssjukdom och liknande tillstånd innebär att en person efterhand får allt svårare att delge information om sig själv och sitt liv. En dokumenterad levnadsberättelse kan för dessa personer utgöra ett av de viktiga redskapen för att få en personcentrerad vård och omsorg. Eftersom det i Blekinge fanns en osäkerhet kring levnadsberättelsens användning i särskilt boende beslutades att genomföra en kartläggning i länet. Syftet med undersökningen var att kartlägga förekomsten av levnadsberättelser i särskilt boende, graden av ifyllnad och vissa kvalitetsmått i befintliga levnadsberättelser. Syftet var även att beskriva undersköterskors uppfattning kring användandet av levnadsberättelsen i deras dagliga arbete.

MetodUndersökningen bestod av två delar; en personalenkät till 701 undersköterskor samt en granskning av 77 enheter med totalt 873 brukare. Resultatet presenteras i form av beskrivande statistik och kommentarer. I analysen har även samband undersökts.

ResultatResultatet visade att 38 % av brukarna i särskilt boende har en dokumenterad levnadsberättelse. I de fall det finns en tydlig rutin för levnadsberättelsen används den i högre grad som ett arbetsredskap i vård och omsorg. En klar majoritet (94 %) av undersköterskorna i undersökningen anser att levnadsberättelsen skulle kunna användas mer i vardagen. Rutiner på boendet kring ifyllandet av levnadsberättelsen, användning av levnadsberättelsen i arbetsgruppen och användning av levnadsberättelsen som underlag för genomförandeplanen visar sig ha samband med hur den enskilda undersköterskan fyller i och använder sig av levnadsberättelsen i vården och omsorgen kring den äldre som bor på boendet

SlutsatsEnbart en tredjedel av brukarna i denna undersökning har en dokumenterad levnadsberättelse, samtidigt som nästan all personal anser att den skulle kunna användas mer i samband med brukarens vård och omsorg. Den relativt låga implementeringen av levnadsberättelsen tillskrivs bristen av rutiner på arbetsplatsen. Eftersom levnadsberättelsen kan ha stor betydelse för den enskilde personens vård och omsorg i vardagen, anser vi att det är angeläget att den implementeras i högre grad i Blekinges särskilda boenden. I vidare studier skulle det vara värdefullt att undersöka levnadsberättelsens effekter på den enskildes hälsa, men framförallt, undersöka orsaker till det låga användandet presenterad i denna rapport och testa olika arbetssätt ämnade att öka levnadsberättelsens användande i särskilda boende samt säkerställa inflyttningsprocessen.

Place, publisher, year, edition, pages
Landstinget Blekinge, 2017
Series
Rapporter / Blekinge Kompetenscentrum ; 2017:1
National Category
Health Sciences Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-72236 (URN)978-91-86711-91-7 (ISBN)
Available from: 2018-04-05 Created: 2018-04-05 Last updated: 2018-05-11Bibliographically approved
Christiansen, L., Fagerström, C. & Nilsson, L. (2017). Nurses' use and perception of an information and communication technology system for improving coordination during hospital discharges: a survey in Swedish primary healthcare. Computers, Informatics, Nursing, 35(7), 358-363
Open this publication in new window or tab >>Nurses' use and perception of an information and communication technology system for improving coordination during hospital discharges: a survey in Swedish primary healthcare
2017 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 35, no 7, p. 358-363Article in journal (Refereed) Published
Abstract [en]

To facilitate communications between care levels and improve coordination during hospital discharges, there is great potential in using information and communication technology systems, because they can significantly help to deter unnecessary readmissions. However, there is still a lack of knowledge about how often nurses use information and communication technology and the indicators related to its use. The aims of this study were to describe the indicators related to nurses' use of an information and communication technology system for collaboration between care levels and to estimate whether the level of use can be related to nurses' perceptions of the information and communication technology system's contribution to improve coordination during hospital discharges. A quantitative survey of 37 nurses from 11 primary healthcare centers was performed in a county in southern Sweden. The data were analyzed using descriptive and comparative analyses. The results showed that perceptions concerning the information and communication technology system's usability and time consumption differed between nurses who used the system and those who did not. Simultaneously, the nurses were rather unaware of the ability of the information and communication technology system to improve coordination during patient discharges.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
Keywords
ICT, Information, Nursing, Primary healthcare, Usability
National Category
Nursing
Identifiers
urn:nbn:se:lnu:diva-71943 (URN)10.1097/CIN.0000000000000335 (DOI)000405288100007 ()28679125 (PubMedID)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-04-23Bibliographically approved
Naseer, M. & Fagerström, C. (2017). Psychometric properties of the Subjective-Objective Malnutrition Risk Assessment (SOMRA) in a study of Swedish people aged ≥ 60 years. JARCP - The Journal of Aging Research & Clinical Practice, 6, 32-39
Open this publication in new window or tab >>Psychometric properties of the Subjective-Objective Malnutrition Risk Assessment (SOMRA) in a study of Swedish people aged ≥ 60 years
2017 (English)In: JARCP - The Journal of Aging Research & Clinical Practice, ISSN 2273-421X, Vol. 6, p. 32-39Article in journal (Refereed) Published
Abstract [en]

Objective: This study aimed to investigate the risk of malnutrition and to evaluate the psychometric properties of the Subjective-Objective Malnutrition Risk Assessment (SOMRA), SOMRA cut-offs and Swedish-Guidelines on Malnutrition Risk Assessment (SGMRA) for Swedish people aged ≥ 60 years.

Setting: This study included both older people living at home and those in special housing.

Participants: 1222 of the 1402 subjects aged ≥ 60 years who had participated in the baseline survey (2001–2003) as part of the ongoing National Study on Aging and Care-Blekinge (SNAC-B) were included because they had provided complete information on Mini-Nutritional Assessment (MNA).

Measurements: The risk of malnutrition was estimated by the SOMRA, MNA, and SGMRA. To measure concurrent validity, the Receiver Operating Characteristics (ROC) curve, Cohen’s kappa (κ) and Spearman’s rank correlation coefficient rho (rs) were used. Youden’s index (J) was computed to assess the optimal cut-off on SOMRA. Cronbach’s alpha (α) was used to test reliability.

Results: The risks of malnutrition measured by SOMRA, MNA and SGMRA were 6.5%, 8.6% and 20.9%, respectively. The risk was higher among older people living in special housing compared to those at home (p < 0.05). Different optimal cut-offs on SOMRA were observed for residents living at home (≥ 1) and those in special housing (≥ 3). Compared to SGMRA, the SOMRA and SOMRA cut-off ≥ 3 gave higher values for J (0.68, 0.81, and 0.84, respectively), κ (0.59, 0.77, and 0.84, respectively) and rs (0.64, 0.78, and 0.84, respectively) for the older people in special housing. The reliability for SOMRA was α = 0.71.

Conclusion: The risk of malnutrition was higher among older people in special housing than among those living at home. For the people in special housing, the SOMRA and SOMRA cut-off ≥ 3 showed higher concurrent validity with MNA compared to the SGMRA, but not for older people living at home. SOMRA includes six items, takes less time to implement and is composed of both subjective and anthropometric measurements; therefore, it is suitable for use in special housing and/or clinical settings to identify the risk of malnutrition or the need for nutritional support.

Place, publisher, year, edition, pages
Serdi Publisher, 2017
National Category
Gerontology, specialising in Medical and Health Sciences
Research subject
Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-72105 (URN)10.14283/jarcp.2016.125 (DOI)
Available from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-04-19Bibliographically approved
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