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  • 1.
    Al-Dury, Nooraldeen
    et al.
    University of Gothenburg.
    Rawshani, Araz
    University of Gothenburg.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital;Linköping university.
    Strömsöe, Anneli
    School of Health, Care and Social Welfare, Västerås.
    Aune, Solveig
    Sahlgrenska University Hospital.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Karlsson, Thomas
    University of Gothenburg.
    Ravn-Fischer, Annica
    University of Gothenburg;Sahlgrenska University Hospital.
    Herlitz, Johan
    University of Gothenburg;Sahlgrenska University Hospital;University of Borås, Borås.
    Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age.2017In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 35, no 12, p. 1839-1844Article in journal (Refereed)
    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.

  • 2.
    Djarv, T.
    et al.
    Karolinska University Hospital;Karolinska Institutet.
    Axelsson, C.
    University College of Borås.
    Herlitz, J.
    Karolinska Institutet;University College of Borås.
    Stromsoe, A.
    Mälardalen University.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital;Linköping University.
    Claesson, A.
    Karolinska Institutet;University College of Borås.
    Traumatic cardiac arrest in Sweden 1990-2016: a population-based national cohort study2018In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, article id 30Article in journal (Refereed)
    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.

  • 3.
    Israelsson, Johan
    et al.
    Kalmar County Hospital.
    Bremer, Anders
    University of Borås.
    Axelsson, Åsa
    University of Gothenburg.
    Cronberg, Tobias
    Lund University.
    Djärv, Therese
    Karolinska Institutet.
    Herlitz, Johan
    University of Borås.
    Kristofferzon, Marja-Leena
    University of Gävle.
    Larsson, Ing-Marie
    Uppsala University.
    Lilja, Gisela
    Lund University.
    Sunnerhagen, Katarina S
    University of Gothenburg.
    Wallin, Ewa
    Uppsala University.
    Ågren, Susanna
    Linköping University.
    Åkerman, Eva
    Skane University Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Neurologic outcome, health-related quality of life, anxiety and symptoms of depression among in-hospital cardiac arrest survivors2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no S1, p. 101-101Article in journal (Refereed)
    Abstract [en]

    Purpose: Most cardiac arrest research has focused on survival in an out-of-hospital context. The knowledge of health and quality of life is sparse, especially regarding in-hospital cardiac arrest (IHCA) survivors. The aim of the current study was therefore to describe neurologic outcome, health-related quality of life (HRQoL), anxiety and symptoms of depression among IHCA survivors.

    Materials and methods: This study has a cross-sectional design. Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including two questions about activities in daily life and mental/intellectual recovery, the EQ-5D-5L and the Hospital Anxiety and Depression Scale (HADS). In addition, Cerebral Performance Category (CPC)-scoring is performed.

    Results: Between the 11th of June 2013 and the 7th of May 2015, 488 IHCA survivors with a mean age of 69 ± 13 were included. A majority were men (62%), had a cerebral function of CPC 1 (87%) and no need of assistance from other people in daily life (71%). A large proportion had not made a complete mental/intellectual recovery (27%). Pain/discomfort was the dimension in EQ-5D-5L where most survivors reported problems (64%), while least problems were reported in the dimension self-care (24%). The individual variations of present health state (EQ-VAS) were substantial (range 0–100), with a mean value of 66 ± 22. Anxiety and symptoms of depression were reported by 16% and 15% respectively.

    Conclusions: Although the majority of the IHCA survivors reported good neurologic outcome, satisfactory HRQoL, no anxiety or symptoms of depression, the results indicate major individual differences, with a substantial group reporting serious problems. Our findings stress the importance of structured post resuscitation care and follow-up, in order to identify and support those in need.

  • 4.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    Bremer, Anders
    University of Borås ; Kalmar County Hospital.
    Herlitz, Johan
    University of Borås.
    Axelsson, Åsa B.
    University of Gothenburg.
    Cronberg, Tobias
    Lund University.
    Djärv, Therese
    Karolinska Institutet ; Karolinska University Hospital.
    Kristofferzon, Marja-Leena
    University of Gävle ; Uppsala University.
    Larsson, Ing-Marie
    Uppsala University.
    Lilja, Gisela
    Lund University .
    Sunnerhagen, Katharina S.
    University of Gothenburg.
    Wallin, Ewa
    Uppsala University.
    Ågren, Susanna
    Linköping University ; County Council of Östergötland.
    Åkerman, Eva
    Skåne University Hospital ; Karolinska Institutet.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Bräcke University College ; Kalmar County Hospital.
    Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, p. 27-33Article in journal (Refereed)
    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.

  • 5.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Bremer, Anders
    University of Borås.
    Herlitz, Johan
    University of Borås.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Health status and psychological distress among in-hospital cardiac arrest survivors in relation to sex2016In: Presented at EuroHeart, Dubrovnik, Croatia, June 14-15, 2015, 2016, Vol. 134Conference paper (Refereed)
    Abstract [en]

    Introduction: Previous studies have demonstrated differences in characteristics and outcome between men and women in cardiac arrest (CA) populations. However, most studies have focused only on survival outcome. Knowledge about patient reported health and psychological distress among CA survivors is sparse, in particular among those suffering in-hospital cardiac arrest (IHCA). The aim was to describe health status and psychological distress among IHCA survivors in relation to sex. Methods: This national register study presents follow-up data of IHCA survivors from 64% of the eligible hospitals in Sweden. A questionnaire was sent to the survivors, 3-6 months post CA, including measures of health status (EQ-5D) and psychological distress (HADS). Results: Between 2013 and 2015, 594 IHCA survivors were included. Women reported more problems in all dimensions of EQ-5D, except for Self-care. They also had worse health status (EQ-index) (0.75 vs 0.79, p&lt;0.001). The median value for EQ-VAS was 70 (q1-q3=50-80), significantly lower for women compared to men (65 vs 75, p&lt;0.001). A majority reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (median 3 vs 2, p&lt;0.001) and symptoms of depression (median 3 vs 2, p&lt;0.001) compared to men. Being women was significantly associated with lower health status and more psychological distress in the regression models. No interaction effects for sex and age were found. Conclusions: Although the majority of the survivors reported acceptable health status and no psychological distress, a substantial group reported serious 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. All IHCA survivors should be screened for health problems during the post cardiac arrest follow-up, and offered support when needed.

  • 6.
    Israelsson, Johan
    et al.
    Kalmar County Hospital.
    Bremer, Anders
    University of Borås.
    Herlitz, Johan
    University of Borås.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Health-related quality of life among in-hospital cardiacarrest survivors2015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no 1 suppl, article id 174Article in journal (Refereed)
    Abstract [en]

    Purpose: A cardiac arrest can cause brain injury with cognitive dysfunctions, emotional reactions and negative effects on activities in daily life. However, most research has focused on survival and the knowledge about health-related quality of life (HRQoL) among survivors is limited. In addition, almost all studies are performed in an out-of-hospital context. The aim of the current study was therefore to describe HRQoL among in-hospital cardiac arrest (IHCA) survivors.

    Methods: This study has a cross-sectional design. In collaboration with the Swedish national register for cardiopulmonary resuscitation, data was collected 3-6 months after resuscitation by using a questionnaire including EuroQol-5 dimension (EQ-5D), the Hospital Anxiety and Depression Scale (HADS) and single questions on activities in daily life and mental/intellectual recovery. In addition, the Cerebral Performance Category (CPC) was scored.

    Results: In total, 286 IHCA survivors with a mean age of 67±12 were included. A majority of the survivors were men (65%), had a cerebral function of CPC 1 (88%) and had no need of assistance from other people in daily life (70%). A large proportion of the survivors had not made a complete mental and/or intellectual recovery (34%), causing problems in daily life for 65% of them. Pain was the dimension in EQ-5D where most survivors reported problems of some degree (64%). Problems within the dimensions anxiety/depression and mobility were reported by more than half of the survivors (53% vs. 51%). In the dimensions personal care and activities in daily life problems were reported by less than half of the survivors (24% vs. 49%). The individual variations of present health measured by the EQ-VAS were substantial (range 0-100), with a mean value of 67±22. Symptoms of anxiety and depression (measured by HADS) were reported by 15% and 16% respectively.

    Conclusions: Although the majority of the IHCA survivors reported satisfactory HRQoL, the results indicate major individual differences, with a substantial group reporting serious problems. Our findings stress the importance of assessing HRQoL among IHCA survivors and the need of follow-up and structured post cardiac arrest care.

  • 7.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    Lilja, Gisela
    Lund University ; Skåne University Hospital.
    Bremer, Anders
    University of Borås ; Kalmar County Hospital.
    Stevenson-Ågren, Jean
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages. University of Sheffield.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Post cardiac arrest care and follow-up in Sweden: a national web-survey2016In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Recent decades have shown major improvements in survival rates after cardiac arrest. However, few interventions have been tested in order to improve the care for survivors and their family members. In many countries, including Sweden, national guidelines for post cardiac arrest care and follow-up programs are not available and current practice has not previously been investigated. The aim of this survey was therefore to describe current post cardiac arrest care and follow-up in Sweden.

    Methods: An internet based questionnaire was sent to the resuscitation coordinators at all Swedish emergency hospitals (n = 74) and 59 answers were received. Quantitative data were analysed with descriptive statistics and free text responses were analysed using manifest content analysis.

    Results: Almost half of the hospitals in Sweden (n = 27, 46 %) have local guidelines for post cardiac arrest care and follow-up. However, 39 % of them reported that these guidelines were not always applied. The most common routine is a follow-up visit at a cardiac reception unit. If the need for neurological or psychological support are discovered the routines are not explicit. In addition, family members are not always included in the follow-up.

    Conclusions: Although efforts are already made to improve post cardiac arrest care and follow-up, many hospitals need to focus more on this part of cardiac arrest treatment. In addition, evidence-based national guidelines will have to be developed and implemented in order to achieve a more uniform care and follow-up for survivors and their family members. This national survey highlights this need, and might be helpful in the implementation of such guidelines.

  • 8.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital.
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Strömberg, Anna
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings Universitet, Ersta Sköndal University College.
    Is there a difference in survival between men and women suffering in-hospital cardiac arrest?2014In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, no 6, p. 510-515Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival. Background: Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted. Methods: This registry study included 286 CAs. To investigate if sex was associated with survival, logistic regression analyses were performed. Results: The proportion of CA with a resuscitation attempt compared to CA without resuscitation was higher among men. There were no associations between sex and survival when controlling for previously known predictors and interaction effects. Conclusions: Sex does not appear to be a predictor for survival among patients suffering CA where resuscitation is attempted. The difference regarding proportion of resuscitation attempts requires more attention. It is important to consider possible interaction effects when studying the sex perspective. (C) 2014 Elsevier Inc. All rights reserved.

  • 9.
    Israelsson, Johan
    et al.
    Linköping University.
    Thylén, Ingela
    Linköping University.
    Strömberg, Anna
    Linköping University.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Factors associated with health status and psychological distress among cardiac arrest (CA) survivors living with an implantable cardioverter-defibrillator (ICD)2017Conference paper (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. 

  • 10.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Department of Cardiology, Kalmar County Council, Kalmar ; Linköping University.
    Thylén, Ingela
    Linköping University.
    Strömberg, Anna
    Linköping University.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Division of Emergency Medical Services, Kalmar County Council, Kalmar.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. The Research Section, Kalmar County Council, Kalmar.
    Factors associated with health status and psychological distress among cardiac arrest survivors treated with an implantable cardioverter-defibrillator2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e85-Article in journal (Refereed)
  • 11.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Sensitivity and specificity of two different automated external defibrillators2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 120, p. 108-112Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs). Methods: Three investigators reviewed 2938 rhythm analyses performed by AEDs in 240 consecutive patients (median age 72, q1-q3 = 62-83) who had suffered cardiac arrest between January 2011 and March 2015. Two different AEDs were used (AED A n = 105, AED B n = 135) in-hospital (n = 91) and out-of-hospital (n = 149). Results: Among 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n = 135) of shockable episodes (sensitivity 91.2 vs 100%, p < 0.01). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (specificity 98.9 vs 95.9, p < 0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n = 40, 63.5%), while 9 (81.8%) were caused by external artifacts (AED B, n = 23, 36.5%). Conclusions: There were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using. (C) 2017 Elsevier B.V. All rights reserved.

  • 12.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resusscitation2017In: Paper presented at the 2nd International Nursing Conference (Nursing-2017), Barcelona, Spain, November 1-3, 2017, Madridge , 2017Conference paper (Other academic)
  • 13.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    von Wangenheim, Burkard
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions and complaince by healthcare professionals with real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation2017In: 2nd International Nursing Conference, November 1-3, 2017, Barcelona, Spain, 2017Conference paper (Other academic)
  • 14.
    Semark, Birgitta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions during CPR-comparison between manual and automatic review2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Supplement 1, p. 66-66, article id AP058Article in journal (Refereed)
  • 15.
    Semark, Birgitta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Linköping University ; Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 453-457Article in journal (Refereed)
    Abstract [en]

    Introduction: A high quality of chest compressions, e.g. sufficient depth (5-6 cm) and rate (100-120 per min), has been associated with survival. The patient's underlay affects chest compression depth. Depth and rate can be assessed by feedback systems to guide rescuers during cardiopulmonary resuscitation. Aim: The purpose of this study was to describe the quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation. Method: An observational descriptive study was performed including 63 cardiac arrest events with a resuscitation attempt. Data files were recorded by Zoll AED Pro, and reviewed by RescueNet Code Review software. The events were analysed according to depth, rate, quality of chest compressions and underlay. Results: Across events, 12.7% (median) of the compressions had a depth of 5-6 cm. Compression depth of >6 cm was measured in 70.1% (median). The underlay could be identified from the electronic patient records in 54 events. The median compression depth was 4.5 cm (floor) and 6.7 cm (mattress). Across events, 57.5% (median) of the compressions were performed with a median frequency of 100-120 compressions/min and the most common problem was a compression rate of <100 (median=22.3%). Conclusions: Chest compression quality was poor according to the feedback system. However, the distribution of compression depth with regard to underlay points towards overestimation of depth when treating patients on a mattress. Audiovisual feedback devices ought to be further developed. Healthcare professionals need to be aware of the strengths and weaknesses of their devices.

  • 16.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Sheffield.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bath, Peter
    University of Sheffield, UK.
    Documentation of vital signs in electronic records: the development of workarounds2015In: Health informatics for enhancing health and well-being: Proceedings of the seventeenth International Symposium for Health Information Management Research, York, UK 24-26 June 2015 / [ed] P. Bath, H. Spring, &, B Sen, B, 2015Conference paper (Refereed)
    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.

  • 17.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. University of Sheffield, UK.
    Israelsson, Johan
    Kalmar County Hospital.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bath, Peter
    University of Sheffield, UK.
    Dokumentation av vitalparametrar i datorjournaler: En risk för patientsäkerheten?2014In: VITALIS - Nordens ledande eHälsomöte: Vetenskapliga papers presenterade vid Vitalis konferens, Svenska Mässan, Göteborg, 8-10 april 2014, Göteborg: Göteborgs universitet, 2014Conference paper (Other academic)
    Abstract [sv]

    Tidig upptäckt och snabb hantering av riskpatienter har betraktats som det ’första steget i kedjan till överlevnad’ i hjärtlungräddning (HLR)[1]. Patienter uppvisar ofta tecken på försämring av kliniskt tillstånd under perioden före oväntad hjärtstopp [2]. För att förbättra identifieringen av försämring i kliniskt tillstånd hos patienter har många varianter på system för snabb respons införts med fokus på mätning, rapportering och hantering av patienter med avvikande vitalparametrar [3]. Datorjournaler journaler används allt mer inom vården för i stort sett all dokumentation. Däremot är kunskapen begränsad kring betydelsen av dokumentationen i datorjournalen för att upptäcka försämring av patienternas kliniska tillstånd. Syftet med denna studie var att undersöka dokumentationen av vitala parametrar i datorjournalen för sjukhusvårdade patienter, som efter inläggning drabbats av oväntat hjärtstopp.

  • 18.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Sheffield, UK.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bath, Peter
    University of Sheffield, UK.
    Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest2016In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 22, no 1, p. 21-33Article in journal (Refereed)
    Abstract [en]

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPACTM Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. 

  • 19.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. University of Sheffield, UK.
    Israelsson, Johan
    Kalmar County Hospital.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bath, Peter A.
    University of Sheffield, UK.
    Vital sign documentation in electronic records: the development of workarounds2018In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 206-215Article in journal (Refereed)
    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.

  • 20.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. University of Sheffield, UK.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bath, Peter
    University of Sheffield, UK.
    Factors influencing the quality of vital signs data in electronic health records: a qualitative study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1276-1286Article in journal (Refereed)
    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.

  • 21.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. University of Sheffield, UK.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Israelsson, Johan
    Kalmar County Hospital.
    Bath, Peter
    University of Sheffield, UK.
    Reasons for poor vital sign documentation in electronic health records: A qualitative study2017In: European Society of Cardiology Congress, Barcelona, 26-30 August, 2017, 2017Conference paper (Refereed)
  • 22.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Allert, Camilla
    Blekinge Institute of Technology.
    Djukanovic, Ingrid
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Council.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Herlitz, Johan
    University of Borås.
    Årestedt, Liselott
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Health-related quality of life among in-hospital cardiac arrest survivors in working age2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, article id e18Article in journal (Refereed)
  • 23.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. ICare.
    Israelsson, Johan
    Kalmar County Hospital.
    Herlitz, Johan
    University of Borås.
    Bremer, Anders
    University of Borås.
    Psychometric properties of the Hospital Anxiety and Depressionscale in sudden cardiac arrest survivors2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Suppl 1, p. 141-141Article in journal (Refereed)
    Abstract [en]

    Purpose: Emotional distress, in terms of anxiety and depression, is common among patients who survive a sudden cardiac arrest (SCA). The Hospital Anxiety and Depression scale (HAD) is one of the most used instruments to assess emotional distress in SCA survivors. However, it has not to our knowledge been psychometrically tested in this group of patients. The aim was therefore to evaluate the measurement properties of the HAD in SCA survivors.

    Materials and methods: Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including HAD. Data quality was evaluated according to the distribution of item and scale score and missing data patterns. A principal component factor analysis was conducted to explore the factor structure. Internal consistency was evaluated with Cronbach's alpha.

    Results: The sample consisted of 498 in-hospital survivors with a mean age of 69.3 ± 12.6 years. All items demonstrated problems with floor effects. The scale scores for both anxiety and depression deviated significantly from a normal distribution (p < 0.001). The factor analysis reproduced the hypothesized two-factor structure, which explained 59% of the total variance. The factor loadings varied between 0.547 and 0.778 for anxiety and between 0.651 and 0.780 for depression. Cronbach's alpha was 0.874 and 0.875 for anxiety and depression respectively.

    Conclusions: The HAD demonstrated good measurement properties among SCA survivors. Despite problems with floor effects, the two HAD scales, anxiety and depression, seem to be uni-dimensional measures with good internal consistency. Therefore, the HAD can be recommended to assess emotional distress among SCA survivors.

  • 24.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sawatsky, Richard
    Trinity Western University, Canada.
    Israelsson, Johan
    Kalmar County Hospital.
    Herlitz, Johan
    University of Borås.
    Lilja, Gisela
    Lund University.
    Cronberg, Tobias
    Lund University.
    Bremer, Anders
    University of Borås.
    Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors2017Conference paper (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.

  • 25.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sawatzky, R.
    Trinity Western Univ, Canada.
    Israelsson, Johan
    Kalmar County Hospital.
    Herlitz, J.
    University of Borås.
    Lilja, G.
    Lund University.
    Cronberg, T.
    Lund University.
    Bremer, A.
    University of Borås.
    Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S2-S3Article in journal (Other academic)
1 - 25 of 25
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