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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 78) 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
Nilsson, L. & Fagerström, C. (2018). Decision-makers and mediators in a home healthcare digitisation process: nurses' experiences of implementation and use of a decision support system. Contemporary Nurse: health care across the lifespan, 54(4-5), 511-521
Open this publication in new window or tab >>Decision-makers and mediators in a home healthcare digitisation process: nurses' experiences of implementation and use of a decision support system
2018 (English)In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 54, no 4-5, p. 511-521Article in journal (Refereed) Published
Abstract [en]

Background: This study focuses on a decision support system (DSS) for home healthcare and the implementation of it.Aim: To describe home healthcare nurses' experiences of the implementation and use of a new DSS, with a focus on how it influences decision making in everyday work practice.Design: A qualitative research design.Methods: Data was collected through three focus group interviews with six home healthcare nurses.The data analysis was drawn from Burnard's method for content analysis.Results: The DSS was experienced as bringing support to decisions, but sometimes incompatible with home healthcare nurses' work practice. Professional understanding and the DSS were sometimes experienced as parallel support systems not assisting work across healthcare organisations.Conclusion: When a DSS is used to transform work of healthcare organisations several aspects should be highlighted. If the organisation does not consider these aspects, nurses may adopt a role as mediator in the implementation process.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
decision support system, health care services, home care services, implementation, nursing care
National Category
Nursing Computer and Information Sciences
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-79190 (URN)10.1080/10376178.2018.1507676 (DOI)000451525700014 ()30099935 (PubMedID)
Available from: 2018-12-13 Created: 2018-12-13 Last updated: 2018-12-13Bibliographically approved
Naseer, M., Dahlberg, L. & Fagerström, C. (2018). Health related quality of life and emergency department visits in adults of age >= 66 years: a prospective cohort study. Health and Quality of Life Outcomes, 16, Article ID 14.
Open this publication in new window or tab >>Health related quality of life and emergency department visits in adults of age >= 66 years: a prospective cohort study
2018 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 16, article id 14Article in journal (Refereed) Published
Abstract [en]

Background: Age increases the risk of emergency department [ED] visits. Health related quality of life (HRQoL) is often estimated as an outcome of ED visits, but it can be a risk factor of ED visits. This study aims to assess the association of HRQoL with time to first ED visit and/or frequent ED use in older adults during four-year period and if this association differs in 66-80 and 80+ age groups. Methods: Data from the Swedish National Study on Aging and Care-Blekinge of wave 2007-2009 was used in combination with electronic health records on ED visits. The analytical sample included 673 participants of age 66 years and older with information on HRQoL. Cox proportional hazard model was used to assess the association between HRQoL and time to first ED visit. Logistic regression analysis was performed to estimate the association of HRQoL with frequent ED use. Results: During the study period, 55.3% of older adults visited the ED and 28.8% had a frequent ED use. Poor physical HRQoL was independently associated with first ED visit both in total sample (p < 0.001) and in 66-80 (p < 0. 001) and 80+ (p = 0.038) age groups. Poor mental HRQoL had no significant association with first ED visit and frequent ED use. Conclusion: Findings suggest that poor physical HRQoL is associated with time to first ED visit in older adults. Therefore, physical HRQoL should be considered while planning interventions on the reduction of ED utilisation in older adults. Explanatory factors of frequent ED use may differ in age groups. Further studies are needed to identify associated factors of frequent ED visits in 80+ group.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Quality of life, Subjective health, Older adults, Care utilisation, Emergency visit
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-77395 (URN)10.1186/s12955-018-0967-y (DOI)000439735900001 ()30041629 (PubMedID)
Available from: 2018-08-29 Created: 2018-08-29 Last updated: 2018-11-01Bibliographically 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
Lindberg, C., Fagerström, C. & Willman, A. (2018). Patient autonomy in a high-tech care context: A theoretical framework. Journal of Clinical Nursing, 27(21-22), 4128-4140
Open this publication in new window or tab >>Patient autonomy in a high-tech care context: A theoretical framework
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 21-22, p. 4128-4140Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesTo synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high-tech care context. BackgroundPutting the somewhat abstract concept of patient autonomy into practice can prove difficult as when it is highlighted in healthcare literature, the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could therefore be considered paradoxical, as in most cases, these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. DesignTheory development. MethodsThe basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. ResultsA theoretical frameworkthe control-partnership-transition frameworkwas delineated disclosing different parts cocreating the prerequisites for patient autonomy in high-tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients were revealed as follows: the strategy of control, the strategy of partnership, the strategy of trust and the strategy of transition. ConclusionsAn extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high-tech care environments. Relevance to clinical practiceThe control-partnership-transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high-tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
autonomy, caring, concept development, high-tech care, metasynthesis, theory development
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-78605 (URN)10.1111/jocn.14562 (DOI)000446561500030 ()29893468 (PubMedID)
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-01Bibliographically approved
Fagerström, C., Elmståhl, S. & Sandin Wranker, L. (2017). A gender perspective on factors affecting quality of life when being a caregiver in old age: findings from the Swedish National Study on Aging and Care (SNAC) study. In: : . Paper presented at European Union Geriatric Medicine Society (EUGMS), Nice, France, September 20-22, 2017.
Open this publication in new window or tab >>A gender perspective on factors affecting quality of life when being a caregiver in old age: findings from the Swedish National Study on Aging and Care (SNAC) study
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing; Health and Caring Sciences, Nursing; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-72346 (URN)
Conference
European Union Geriatric Medicine Society (EUGMS), Nice, France, September 20-22, 2017
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-12-07Bibliographically approved
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: 2018-11-01Bibliographically 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: 2018-11-01Bibliographically approved
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