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  • 1. Hjelm, Carina
    et al.
    Strömberg, Anna
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Broström, Anders
    Association between sleep-disordered breathing, sleep-wake pattern, and cognitive impairment among patients with chronic heart failure2013In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 15, no 5, p. 496-504Article in journal (Refereed)
    Abstract [en]

    Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoeahypopnoea index (AHI) 15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68 male, median age 72 years, 58 NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI 15). The SDB group had significantly higher saturation time below 90, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition. The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.

  • 2. Jaarsma, Tiny
    et al.
    Årestedt, Kristofer
    University of Kalmar, School of Human Sciences.
    Mårtensson, Jan
    Dracup, Kathleen
    Strömberg, Anna
    The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument2009In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 11, no 1, p. 99-105Article in journal (Refereed)
    Abstract [en]

    Aims Improved self-care is the goal of many heart failure (HF) management programmes. The 12-item European Heart Failure Self-Care Behaviour Scale (EHFScB scale) was developed and tested to measure patient self-care behaviours. It is now available in 14 languages. The aim of this study was to further determine reliability and validity of the EHFScB scale.                  

    Methods and results Data from 2592 HF patients (mean age 73 years, 63% male) from six countries were analysed. Internal consistency was determined by Cronbach’s alpha. Validity was established by (1) interviews with HF experts and with HF patients; (2) item analysis; (3) confirmatory factor analysis; and (4) analysing the relationship between the EHFScB scale and scales measuring quality of life and adherence. Internal consistency of the 12-item scale was 0.77 (0.71–0.85). After factor analyses and critical evaluation of both psychometric properties and content of separate items, a nine-item version was further evaluated. The reliability estimates for the total nine-item scale (EHFScB-9) was satisfactory (0.80) and Cronbach’s alpha varied between 0.68 and 0.87 in the different countries. One reliable subscale was defined (consulting behaviour) with a Cronbach’s alpha of 0.85. The EHFScB-9 measures a different construct than quality of life (r = 0.18) and adherence (r = 0.37).                  

    Conclusion The 12-item EHFScB scale was revised into the nine-item EHFScB-9, which can be used as an internally consistent and valid instrument to measure HF-related self-care behaviour.

  • 3.
    Klompstra, L.
    et al.
    Linköping University, Sweden.
    Strömberg, A.
    Linköping University, Sweden.
    Askenäs, Linda
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Aidemark, Jan
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Jaarsma, T.
    Linköping University, Sweden.
    Collaborating with a patient organisation to implement a physical activity intervention2019In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 21, p. 468-468Article in journal (Other academic)
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