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  • 101.
    Mattisson, Marie
    et al.
    Linköping University, Sweden.
    Johnson, Christina
    Linköping University, Sweden.
    Börjeson, Sussanne
    Linköping University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Lindberg, Malou
    Linköping University, Sweden.
    Development and content validation of the Telenursing Interaction and Satisfaction Questionnaire (TISQ)2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1213-1222Article in journal (Refereed)
    Abstract [en]

    Background Caller satisfaction with telephone advice nursing (TAN) is generally high, and the interaction is essential. However, a valid questionnaire exploring caller satisfaction in TAN with focus on perceived interaction is lacking. Objective To develop and assess content validity and test-retest reliability of a theoretically anchored questionnaire, the Telenursing Interaction and Satisfaction Questionnaire (TISQ), that explores caller satisfaction in TAN by focusing on perceived interaction between the caller and the telenurse. Methods The study was performed in three stages. First, variables relevant for patient satisfaction in health care were identified through a literature search. Variables were then structured according to the Interaction Model of Client Health Behavior (IMCHB), which provided theoretical guidance. Items relevant for a TAN context were developed through consensus discussions. Then, evaluation and refinement were performed through cognitive interviews with callers and expert ratings of the Content Validity Index (CVI). Finally, test-retest reliability of items was evaluated in a sample of 109 individuals using intraclass correlation coefficients (ICC). Results The TISQ consists of 60 items. Twenty items cover perceived interaction in terms of health information, affective support, decisional control and professional/technical competence. Five items cover satisfaction with interaction and five items overall satisfaction. Remaining items reflect singularity of the caller and descriptive items of the call. The TISQ was found to exhibit good content validity, and test-retest reliability was moderate to good (ICC = 0.39-0.84). Conclusions The items in the TISQ form a comprehensive and theoretically anchored questionnaire with satisfactory content validity and test-retest reliability.

  • 102.
    Melin, Jeanette
    et al.
    University of Gothenburg, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    The Patient Participation in Rehabilitation Questionnaire (PPRQ): psychometric evaluation and revision for use in neurological rehabilitation.2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-8Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the psychometric properties of the Patient Participation in Rehabilitation Questionnaire (PPRQ) in neurological rehabilitation using statistical methods taking the ordinal nature of data into account.

    METHODS: A cross-sectional postal questionnaire study was conducted. In total, 522 patients from a neurological rehabilitation unit completed the 32-item version of the PPRQ. The PPRQ comprises five scales and assesses patients' experiences of participation in their rehabilitation. A confirmatory factor analysis was conducted to evaluate the factor structure according to the hypothetical five-scale model. Internal consistency reliability was evaluated by ordinal α, and test-retest reliability was evaluated by weighted kappa statistics and intraclass correlations (ICC).

    RESULTS: After omitting 12 items, a 20-item version with the five hypothetical scales showed acceptable fit for the PPRQ (RMSEA = 0.067, CFI = 0.983, TLI = 0.979). For each scale, both internal consistency and test-retest reliability were good to excellent (ordinal α = 0.88-0.93, ICC = 0.83-0.90).

    CONCLUSIONS: The revised version of the PPRQ shows sound psychometric properties and is a potential questionnaire for the evaluation of patients' experiences of participation in neurological rehabilitation. The PPRQ can provide insight into central aspects that are crucial for the patients' participation, namely Respect and integrity, Planning and decision-making, Information and knowledge, Motivation and encouragement, and Involvement of family. Implications for Rehabilitation Patient participation in rehabilitation is a multidimensional concept that can be assessed by the revised Patient Participation in Rehabilitation Questionnaire (PPRQ). The revised PPRQ shows sound psychometric properties for persons undergone neurological rehabilitation. The revised PPRQ still covers five central aspects of patient participation: Respect and integrity, Planning and decision-making, Information and knowledge, Motivation and encouragement, and Involvement of family. Assessments with the revised PPRQ can provide insight into the patients' experiences of central aspects that are crucial for participation in their own rehabilitation.

  • 103.
    Möllerberg, Marie-Louise
    et al.
    Skåne University Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kalmar County, Sweden.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Adaptation and psychometric evaluation of the short version of Family Sense of Coherence Scale in a sample of persons with cancer in the palliative stage and their family members2020In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 18, no 1, p. 24-32Article in journal (Refereed)
    Abstract [en]

    Objectives For patients' entire families, it can be challenging to live with cancer during the palliative stage. However, a sense of coherence buffers stress and could help health professionals identify families that require support. Therefore, the short version of the Family Sense of Coherence Scale (FSOC-S) was translated, culturally adapted, and validated in a Swedish sample. Methods Translation and cross-cultural adaptation of the FSOC-S into Swedish was conducted in accordance with the World Health Organization's Process for Translation and Adaptation of Research Instruments guidelines. Participants were recruited from two oncology clinics and two palliative centers in Sweden. Results Content validity was supported by experts (n = 7), persons with cancer (n = 179), and family members (n = 165). Homogeneity among items was satisfactory for persons with cancer and family members (item-total correlations were 0.45-0.70 and 0.55-0.72, respectively) as well as internal consistency (ordinal alpha = 0.91 and 0.91, respectively). Factor analyses supported unidimensionality. FSOC-S correlated (r(s) > 0.3) with hope, anxiety, and symptoms of depression, which supported convergent validity. The test-retest reliability for items ranged between fair and good (k(w) = 0.37-0.61).

  • 104.
    Möllerberg, Marie-Louise
    et al.
    Skåne University Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study2019In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 33, no 10, p. 1310-1318Article in journal (Refereed)
    Abstract [en]

    Background: There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. Aim: To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. Design: An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. Setting/participants: Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. Results: The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. Conclusion: Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.

  • 105.
    Nordström, Erik Blennow
    et al.
    Lund University.
    Lilja, Gisela
    Lund University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Friberg, Hans
    Lund University.
    Nielsen, Niklas
    Lund University.
    Vestberg, Susanna
    Lund University.
    Cronberg, Tobias
    Lund University.
    Validity of the IQCODE-CA: An informant questionnaire on cognitive decline modified for a cardiac arrest population2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 118, p. 8-14Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the psychometric properties of a modified version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), for a cardiac arrest population (IQCODE-CA). Methods: The IQCODE-CA, a 26-item observer-reported questionnaire, was completed by informants, defined as relatives or close friends, of 268 out-of-hospital cardiac arrest (OHCA) survivors who participated in the Target Temperature Management trial in a scheduled follow-up 180 +/- 14 days after OHCA. Survivors completed the Mini Mental State Examination (MMSE), the Rivermead Behavioural Memory Test (RBMT) and the Hospital Anxiety and Depression Scale (HADS). An exploratory factor analysis was performed. Associations between IQCODE-CA results and demographic variables along with other instruments were calculated. Area under the curve (AUC) ratios were evaluated to examine discrimination. Results: The IQCODE-CA measured one factor, global cognitive decline, with high internal consistency (ordinal alpha = 0.95). Age, gender or education did not influence the IQCODE-CA score. Associations with performance-based measures of global cognitive function as well as anxiety and depression ranged from small to moderate (rs = -0.29 to 0.38). AUC ratios ranged from fair to good (0.72-0.81). According to the MMSE and RBMT, the optimal cut-off score to identify cognitive decline on the IQCODE-CA was 3.04. Using this value, 53% of the survivors were under the cut-off. Conclusions: The IQCODE-CA identified a large amount of survivors with possible cognitive problems, making it useful when screening for cognitive decline post-CA. Due to lower AUC ratios than desired, additional performance-based measures should be used to improve the overall screening methodology. (C) 2017 Elsevier B.V. All rights reserved.

  • 106.
    Näsström, Lena
    et al.
    Linköping University.
    Jaarsma, Tiny
    Linköping University.
    Idvall, Ewa
    Malmö University ; Skåne University Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Ersta Sköndal University College.
    Strömberg, Anna
    Linköping University.
    Patient participation in patients with heart failure receiving structured home care: a prospective longitudinal study2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, article id 633Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care. Methods: The study had a prospective pre-post longitudinal design evaluating the influence of structured home care on participation in patients at four different home care units. Patient participation was measured using 3 scales and 1 single item. Self-care behavior, knowledge, symptoms of depression, socio-demographic and clinical characteristics were measured to explore factors associated with patient participation. Repeated measure ANOVA was used to describe change over time, and stepwise regression analyses were used to explore factors associated with patient participation. Results: One hundred patients receiving structured heart failure home care were included. Mean age was 82 years, 38 were women and 80 were in New York Heart Association functional class III. One aspect of participation, received information, showed a significant change over time and had increased at both six and twelve months. Better self-care behavior was associated with all four scales measuring different aspects of participation. Experiencing lower degree of symptoms of depression, having better knowledge, being of male sex, being of lower age, cohabiting and having home help services were associated with one or two of the four scales measuring different aspects of participation. Conclusion: Patients experienced a fairly high level of satisfaction with participation in care at baseline, and there was a significant improvement over time for participation with regard to received information after being admitted to structured home care. Higher level of patient participation was consistently associated with better self-care behavior. This study shows that patient participation may need to be further focused upon, and that the association with self-care may be interesting to target in future interventions.

  • 107.
    Olsson, Yvonne
    et al.
    Lund University, Sweden.
    Claren, Lena
    Lund University, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Sweden;Capio Palliative Care Unit, Sweden;Linköping University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Bräcke University College, Sweden.
    Hagellf, Peter
    Kristianstad University, Sweden.
    Health and Social Service Access Among Family Caregivers of People with Parkinson's Disease2016In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 6, no 3, p. 581-587Article in journal (Refereed)
    Abstract [en]

    Background: Being a family caregiver for a person with Parkinson's disease (PD) can negatively impact health and wellbeing, but it appears less clear to what extent caregivers' health/social service needs are met. Objective: We explored the extent to which PD family caregivers experience sufficient access to health/social services, as compared to age-matched controls; and the associations between this and demographic and health-related variables. Methods: A cross-sectional survey of 66 PD family caregivers and 79 age-matched control subjects including the SF-36 health survey, the Nottingham Health Profile Sleep section (NHP-Sleep), and questions regarding contacts with various health/social related services and whether these were perceived as sufficient. Results: People reporting insufficient access (n = 29) were more often PD family caregivers than controls (83% vs. 37%), did more often have a disease of their own (79% vs. 46%), and reported poorer health according to the SF-36 and the NHP-Sleep. Being a PD family caregiver (OR, 8.90), reporting more pain (OR, 1.02) and having an own disease (OR, 3.46) were independently associated with insufficient health/social service access. Conclusions: Our results imply that those in greatest need for health/social services (i.e., those with poorer health, an own disease, and who are PD family caregivers) are those whose health/social service needs are least met. Larger studies are needed for firmer conclusions and regarding how unmet health/social service needs impacts caregiver health and wellbeing. Health/social service providers should not only focus on patients but also consider their family members' needs.

  • 108.
    Ozanne, Anneli
    et al.
    University of Gothenburg, Sweden;Sahlgrenska University Hospital, Sweden.
    Sawatzky, Richard
    University of Gothenburg, Sweden;Trinity Western Univ, Canada;St Pauls Hosp, Canada.
    Håkanson, Cecilia
    Sophiahemmet University, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Sweden;Dalen Hospital, Sweden.
    Fürst, Carl Johan
    Lund University, Sweden;Region Skåne, Sweden;Lund University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Öhlen, Joakim
    University of Gothenburg, Sweden;Sahlgrenska University Hospital, Sweden.
    Symptom relief during last week of life in neurological diseases2019In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, no 8, p. 1-9, article id e01348Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & Methods Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death. Results The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end-of-life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end-of-life discussions. Conclusions The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person-centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end-of-life conversations.

  • 109. Palmetun Ekbäck, Maria
    et al.
    Lindberg, M.
    Benzein, Eva
    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. Linköpings universitet / Ersta Sköndals högskola.
    Health-Related Quality of Life, Depression and Anxiety Correlate with the Degree of Hirsutism2013In: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 227, no 3, p. 278-284Article in journal (Refereed)
    Abstract [en]

    Background: Hirsutism has a negative impact on women's quality of life. The relation between quality of life, anxiety, depression and the level of hairiness has not been described. Aims: To investigate the correlations between the levels of hairiness, quality of life, anxiety and depression. Methods: 200 patients from Malmo, Orebro and Uppsala, who had been in contact with the clinics for problems with excessive hair growth, were invited to answer a self-administered questionnaire including sociodemographic questions, EQ-5D index score, Dermatology Life Quality Index (DLOI), Hospital Anxiety and Depression Scale (HADS) and Ferriman-Gallwey scale (F-G); of these, 127 women participated in the study. Results: The mean values were: EQ-5D index 0.73 (SD = 0.27), EQ visual analogue scale 61.0 (SD = 22.6), HADS-anxiety 9.5 +/- 5.3 and HADS-depression 6.5 +/- 4.6. The mean DLQI was 11.8 +/- 8.4, indicating a very large effect on patients' lives. All were significantly correlated with the amount of hairiness. Conclusions: Higher levels of hair growth were significantly correlated with a lower level of quality of life and symptoms of both anxiety and depression. (C) 2013 S. Karger AG, Basel

  • 110.
    Persson, Carina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    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.
    Assessing family resources: validation of the Swedish version of the Family Hardiness Index2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, p. 845-855Article in journal (Refereed)
    Abstract [en]

    All families face normative transitions. Some are perceived as stressful and calls for family resources to maintain or restore family well-being. In times of illness, families also need to develop strengths and capabilities to enhance family well-being. The way these are developed is related to family hardiness. Family hardiness is thus seen as a family resource, and the Family Hardiness Index (FHI) was developed to measure family stress resistance and adaptation resources. The index was not available in Swedish and no extensive international psychometric evaluation was found. Therefore, the aim was to translate and validate the Swedish version of the FHI. The study was approved by a Regional Ethical Review Board. Data from 174 Swedish participants, family members to persons with cognitive dysfunctions (n = 95) and nursing students (n = 79) were included. Family members were enrolled in outpatient clinics in primary care and rehabilitation, and nursing students at a nursing school. Psychometric properties were evaluated through calculations of missing data, distributions of item and scale scores, item correlations, Cronbach's alpha, confirmatory factor analyses and correlations with theoretically related constructs. Sample scores had acceptable data quality, internal consistency for the FHI total scale was satisfactory (alpha = 0.86), and construct validity was supported. Our findings cast some doubt on the intended interpretation since confirmatory factor analyses showed that a modified four-subscale version, excluding one subscale, showed best fit. The Control subscale lacked important psychometric properties in terms of homogeneity, internal consistency and construct validity. The sample size was probably sufficiently large for the factor analyses, but the subgroup analyses should be treated with caution. The conclusion is that the Swedish version of the FHI is a promising scale for assessing family hardiness, but more solid evidence for the factor structure in various Swedish and international samples is needed.

  • 111.
    Pucciarelli, Gianluca
    et al.
    Univ Roma Tor Vergata, Italy.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Simeone, Silvio
    Univ Roma Tor Vergata, Italy.
    Bolgeo, Tatiana
    Univ Roma Tor Vergata, Italy.
    Alvaro, Rosaria
    Univ Roma Tor Vergata, Italy.
    Vellone, Ercole
    Univ Roma Tor Vergata, Italy.
    Psychometric characteristics of the WHOQOL-SRPB Scale in a population of stroke survivors and caregivers2020In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Purpose Studies have shown that spirituality plays an important role in enhancing the quality of life of stroke survivors and their caregivers. Spirituality has been associated with positive patient and caregiver outcomes, so a valid, reliable measure of spirituality is important. It has not been tested with stroke survivors and their caregivers, so the aim of this study was to evaluate the validity and reliability of the World Health Organization Quality of Life Spiritual Religious and Personal Belief (WHOQOL-SRPB) scale for stroke survivors and their caregivers. Methods In this cross-sectional study, 414 stroke survivors at 10 rehabilitation hospitals and 244 caregivers completed the WHOQOL-SRPB. The WHOQOL-SRPB's factorial structure was assessed with confirmatory factor analysis (CFA), criterion-related validity was evaluated with the WHOQOL-BREF, and internal consistency reliability was assessed with Cronbach's alpha and ordinal alpha. Results The CFA results supported the hypothesized eight-factor structure. The stroke survivor and the caregiver versions of the model both had excellent fit indices. The factor loadings for the final models were strong: 0.78-0.98 for stroke survivors and caregivers (p < 0.001). The criterion-related validity for the WHOQOL-SRPB showed weak to moderate correlations with all the WHOQOL-BREF dimensions. Both ordinal alpha and Cronbach's alpha had values more than 0.70. Conclusions The WHOQOL-SRPB scale is a valid, reliable instrument for measuring spirituality in stroke survivors and caregivers. Given the importance of spirituality for stroke survivors and caregivers, the WHOQOL-SRPB scale is recommended as an important tool for clinical practice and research.

  • 112.
    Rahmqvist Linnarsson, Josefin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    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 Univ ; Ersta Sköndal Univ Coll.
    Nurses' views of forensic care in emergency departments and their attitudes, and involvement of family members2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 1-2, p. 266-274Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To describe nurses' views of forensic care provided for victims of violence and their families in EDs, to identify factors associated with nurses' attitudes towards families in care and to investigate if these attitudes were associated with the involvement of patients' families in care. Background. Interpersonal violence has serious health consequences for individuals and family members. Emergency departments provide care for victims of violence, and nurses play a key role in forensic care. However, there is limited knowledge of their views and their involvement of family members. Design. A cross-sectional design was used with a sample of all registered nurses (n = 867) in 28 emergency departments in Sweden. Methods. A self-report questionnaire, including the instrument Families' Importance in Nursing Care Nurses' Attitudes, was used to collect data. Descriptive statistics, multiple linear regression and ordinal regression were used to analyse data. Results. Four hundred and fifty-seven nurses completed the questionnaire (53%). Most nurses provided forensic care, but few had specific education for this task. Policy documents and routines existed for specific patient groups. Most nurses involved family members in care although education and policy documents rarely included them. Being a woman, policy documents and own experience of a critically ill family member were associated with a positive attitude towards family. A positive attitude towards family members was associated with involving patients' families in care. Conclusion. Many emergency department nurses provided forensic care without having specific education, and policy documents only concerned women and children. Nurses' positive attitude to family members was not reflected in policies or education. Relevance to clinical practice. These results can inspire clinical forensic care interventions in emergency departments. Educational efforts for nurses and policies for all groups of victims of violence are needed. Emergency departments may need to rethink how family members are included in their organisation.

  • 113.
    Rahmqvist Linnarsson, Josefin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    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.
    Erlingsson, Christen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Preparedness to care for victims of violence and their families in emergency departments2013In: Emergency Medicine Journal, ISSN 1472-0205, E-ISSN 1472-0213, Vol. 30, no 3, p. 198-201Article in journal (Refereed)
    Abstract [en]

    Objective To describe the preparedness to provide care for victims of violence and their families in emergency departments (EDs) in Sweden.

    Methods A web-based questionnaire was sent to all hospital EDs in Sweden (N=66).

    Results A total of 46 out of 66 (70%) heads of EDs completed the questionnaire. The results show that most of the EDs are prepared to care for women and children who are victims of violence. However, there seems to be a lack of preparedness to care for other groups of patients, such as victimised men. Very few EDs have routines to identify victims of violence among patients. Results also indicate that nurses play a key role in the care for victims of violence; however, family members are rarely included in care.

    Conclusions A lack of general preparedness in EDs to care for all victims of violence, regardless of gender and age, can lead to many patients not receiving appropriate care and treatment. To correct this there is a need to implement guidelines and routines about the care for victims of violence. Further research can shed more light on which measures are needed to improve quality of care for these patients and their families.

  • 114. Rovner, Graciela S
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings Universitet.
    Gerdle, Björn
    Börsbo, Björn
    McCracken, Lance M
    Psychometric properties of the 8-item Chronic Pain Acceptance Questionnaire (CPAQ - 8) in a Swedish Chronic Pain Cohort2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 1, p. 73-80Article in journal (Refereed)
    Abstract [en]

    Background: Acceptance and Commitment Therapy for chronic pain has good empirical support. Pain acceptance is most often assessed with the Chronic Pain Acceptance Questionnaire (CPAQ). Recently a shorter 8-item version, the CPAQ-8, was developed. Objectives: To further validate the CPAQ-8 in a Swedish context and to test its sensitivity to treatment effects, an as-yet unknown property of the instrument. Methods: A total of 891 patients completed the CPAQ, along with scales for anxiety and depression (Hospital Anxiety and Depression scale), kinesiophobia (Tampa Scale for Kinesiophobia) and quality of life (Short Form-36). Confirmatory factor analyses were performed to examine the factor structure. Convergent validity was tested with Pearson's correlations. Changes over time were evaluated with paired t-test. Results: The confirmatory factor analyses showed that the CPAQ 2-factor model had a better fit compared with the 1-factor model, both for the 8- and 20-item versions. All CPAQ-8 scales demonstrated good internal consistency (alpha ≥ 0.80). They also correlated significantly with related constructs, supporting convergent validity. The CPAQ-8 explained a large share of the total variance in CPAQ-20 and was also able to track rehabilitation changes (large effect size, d = 0.89). Conclusion: CPAQ-8 demonstrated good psychometric properties and sensitivity to rehabilitation changes. Further research that considers other cultural contexts may lead enhance the applications of this instrument.

  • 115. Rönning, Helén
    et al.
    Årestedt, Kristofer
    Linköpings universitet.
    Erik Nielsen, Niels
    Swahn, Eva
    Strömberg, Anna
    Development and psychometric evaluation of the knowledge scale for adults with congenitally malformed hearts.2013In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 28, no 3, p. 228-237Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND RESEARCH OBJECTIVE: Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts.

    PARTICIPANTS AND METHODS: The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability.

    RESULTS: The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy.

    CONCLUSIONS: The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.

  • 116.
    Saveman, Britt-Inger
    et al.
    Umeå University.
    Benzein, Eva
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Engström, Åsa
    Luleå University of Technology.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Linköping University.
    Refinement and psychometric revalidation of the instrument: Families' Importance in Nursing Care - Nurses' Attitudes (FINC-NA)2011In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 17, no 3, p. 312-329Article in journal (Refereed)
    Abstract [en]

    The instrument Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) was developed to measure nurses’ attitudes toward the importance of families in nursing care. The low variations in item responses, which affect the discrimination ability and unstable internal consistency, have been considered as limitations. The aim of this study was to refine and revalidate FINC-NA regarding score distribution, homogeneity, dimensionality, differential item functioning for gender, stability, and internal consistency. There were 246 registered nurses studying at advanced levels who answered the revised FINC-NA. The FINC-NA had five response alternatives. The findings showed that although some subscales still deviated from a normal distribution, the variability of the scores and the homogeneity was improved. In addition, the dimensionality was reproduced and minor problems with differential item functioning for gender were detected. All FINC-NA scales showed good reliability. The results allow the use of the revised FINC-NA in studies where an assessment of nurses’ attitudes toward families’ importance in nursing care is desired.

  • 117.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    von Wangenheim, Burkard
    Kalmar County Hospital, Sweden.
    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.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sensitivitet och specificitet hos två olika hjärtstartare2016In: Presented at HLR2016: "Ett hjärtsäkert Sverige”, Gothenburg, Sweden, October 11-12, 2016, 2016Conference paper (Other academic)
  • 118.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, L
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Perk, Joep
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    The assessment of adverse events in medical care: lack of consistency between experienced teams using the Global Trigger Tool2012Conference paper (Refereed)
  • 119.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nilsson, Lena
    Linköpings Universitetssjukhus.
    Perk, Joep
    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. Linköpings Universitet.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, p. e003131-Article in journal (Refereed)
    Abstract [en]

    Objectives The aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm.

    Design A qualitative, descriptive approach with focus group interviews using content analysis.

    Setting 5 Swedish hospitals in 2011.

    Participants 5 GTT teams, with 5 physicians and 11 registered nurses.

    Intervention 5 focus group interviews were carried out with the five teams. Interviews were taped and transcribed verbatim.

    Results 8 categories emerged relating to the strengths and weaknesses of the GTT method. The categories found were: Usefulness of the GTT, Application of the GTT, Triggers, Preventability of harm, Team composition, Team tasks, Team members’ knowledge development and Documentation. Gradually, changes in the methodology were made by the teams, for example, the teams reported how the registered nurses divided up the charts into two sets, each being read respectively. The teams described the method as important and well functioning. Not only the most important, but also the most difficult, was the task of bringing the results back to the clinic. The teams found it easier to discuss findings at their own clinics.

    Conclusions The GTT method functions well for identifying adverse events and is strengthened by its adaptability to different specialties. However, small, gradual methodological changes together with continuingly developed expertise and adaption to looking at harm from a patient's perspective may contribute to large differences in assessment over time.

  • 120.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, Lena
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Perk, Joep
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Assessment of adverse events in medical care: lack of consistency between experienced teams using the global trigger tool.2012In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 21, no 4, p. 307-314Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many patients are harmed as the result of healthcare. A retrospective structured record review is one way to identify adverse events (AEs). One such review approach is the global trigger tool (GTT), a consistent and well-developed method used to detect AEs. The GTT was originally intended to be used for measuring data over time within a single organisation. However, as the method spreads, it is likely that comparisons of GTT safety outcomes between hospitals will occur.

    OBJECTIVE: To evaluate agreement in judgement of AEs between well-trained GTT teams from different hospitals.

    METHODS: Five teams from five hospitals of different sizes in the southeast of Sweden conducted a retrospective review of patient records from a random sample of 50 admissions between October 2009 and May 2010. Inter-rater reliability between teams was assessed using descriptive and κ statistics.

    RESULTS: The five teams identified 42 different AEs altogether. The number of identified AEs differed between the teams, corresponding to a level of AEs ranging from 27.2 to 99.7 per 1000 hospital days. Pair-wise agreement for detection of AEs ranged from 88% to 96%, with weighted κ values between 0.26 and 0.77. Of the AEs, 29 (69%) were identified by only one team and not by the other four groups. Most AEs resulted in minor and transient harm, the most common being healthcare-associated infections. The level of agreement regarding the potential for prevention showed a large variation between the teams.

    CONCLUSIONS: The results do not encourage the use of the GTT for making comparisons between hospitals. The use of the GTT to this end would require substantial training to achieve better agreement across reviewer teams.

  • 121.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nilsson, Lena
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Reply to Deilkas letter: Imprecision concerning the Global Trigger Tool Reply2013In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 22, no 3, p. 271-272Article in journal (Refereed)
  • 122.
    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)
  • 123.
    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)
  • 124.
    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, Sweden.
    Carlsson, Jörg
    Kalmar County Hospital, Sweden.
    von Wangenheim, Burkard
    Kalmar County Hospital, Sweden.
    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 review2015Conference paper (Other academic)
  • 125.
    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)
  • 126.
    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.

  • 127. Skagerström, Janna
    et al.
    Alehagen, Siw
    Häggström-Nordin, Elisabet
    Årestedt, Kristofer
    Linköpings universitet.
    Nilsen, Per
    Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden.2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 1, p. 780-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a paucity of research on predictors for drinking during pregnancy among women in Sweden and reported prevalence rates differ considerably between studies conducted at different antenatal care centres. Since this knowledge is relevant for preventive work the aim of this study was to investigate these issues using a multicenter approach.

    METHODS: The study was conducted at 30 antenatal care centers across Sweden from November 2009 to December 2010. All women in pregnancy week 18 or more with a scheduled visit were asked to participate in the study. The questionnaire included questions on sociodemographic data, alcohol consumption prior to and during the pregnancy, tobacco use before and during pregnancy, and social support.

    RESULTS: Questionnaires from 1594 women were included in the study. A majority, 84%, of the women reported alcohol consumption the year prior to pregnancy; about 14% were categorized as having hazardous consumption, here defined as a weekly consumption of > 9 standard drinks containing 12 grams of pure alcohol or drinking more than 4 standard drinks at the same occasion. Approximately 6% of the women consumed alcohol at least once after pregnancy recognition, of which 92% never drank more than 1 standard drink at a time. Of the women who were hazardous drinkers before pregnancy, 19% reduced their alcohol consumption when planning their pregnancy compared with 33% of the women with moderate alcohol consumption prior to pregnancy. Factors predicting alcohol consumption during pregnancy were older age, living in a large city, using tobacco during pregnancy, lower score for social support, stronger alcohol habit before pregnancy and higher score for social drinking motives.

    CONCLUSIONS: The prevalence of drinking during pregnancy is relatively low in Sweden. However, 84% of the women report drinking in the year preceding pregnancy and most of these women continue to drink until pregnancy recognition, which means that they might have consumed alcohol in early pregnancy. Six factors were found to predict alcohol consumption during pregnancy. These factors should be addressed in the work to prevent alcohol-exposed pregnancies.

  • 128.
    Smedback, Jonas
    et al.
    Ersta Sköndal Bräcke University College, Sweden.
    Ohlen, Joakim
    University of Gothenburg, Sweden;Ersta Sköndal Bräcke University College, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Bräcke University College, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Sweden;Dalen Hospital, Sweden; Karolinska Institutet, Sweden.
    Furst, Carl-Johan
    Lund University, Sweden.
    Hakanson, Cecilia
    Ersta Sköndal Bräcke University College, Sweden;Karolinska Institutet, Sweden.
    Palliative care during the final week of life of older people in nursing homes: A register-based study2017In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 15, no 4, p. 417-424Article in journal (Refereed)
    Abstract [en]

    Objective: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. Method: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics. Results: The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place. Significance of results: There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.

  • 129.
    Steel, Karin
    et al.
    Linköping University.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Gunnarsson, Lise-Lotte
    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. Kalmar County Council.
    Strömberg, Anna
    Linköping University.
    Hjelm, Carina
    Linköping University.
    Nurses’ perceptions of cognitive function in survivors after cardiac arrest: a qualitative study2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e128-e128Article in journal (Refereed)
  • 130.
    Thylen, Ingela
    et al.
    Linköping Univ Hosp / Cty Council Östergötland.
    Wenemark, Marika
    Linköping Univ.
    Fluur, Christina
    Cty Council Östergötland.
    Strömberg, Anna
    Linköping Univ Hosp / Cty Council Östergötland.
    Bolse, Karstin
    Halmstad Univ.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping Univ Hosp.
    Development and evaluation of the EOL-ICDQ as a measure of experiences, attitudes and knowledge in end-of-life in patients living with an implantable cardioverter defibrillator2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 2, p. 142-151Article in journal (Refereed)
    Abstract [en]

    Background: Due to extended indications and resynchronization therapy, many implantable cardioverter defibrillator (ICD) recipients will experience progressive co-morbid conditions and will be more likely to die of causes other than cardiac death. It is therefore important to elucidate the ICD patients' preferences when nearing end-of-life. Instead of avoiding the subject of end-of-life, a validated questionnaire may be helpful to explore patients' experiences and attitudes about end-of-life concerns and to assess knowledge of the function of the ICD in end-of-life. Validated instruments assessing patients' perspective concerning end-of-life issues are scarce. Aim: The purpose of this study was to develop and evaluate respondent satisfaction and measurement properties of the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients' Questionnaire' (EOL-ICDQ). Methods: The instrument was tested for validity, respondent satisfaction, and for homogeneity and stability in the Swedish language. An English version of the EOL-ICDQ was validated, but has not yet been pilot tested. Results: The final instrument contained three domains, which were clustered into 39 items measuring: experiences (10 items), attitudes (18 items), and knowledge (11 items) of end-of-life concerns in ICD patients. In addition, the questionnaire also contained items on socio-demographic background (six items) and ICD-specific background (eight items). The validity and reliability properties were considered sufficient. Conclusions: The EOL-ICDQ has the potential to be used in clinical practice and future research. Further studies are needed using this instrument in an Anglo-Saxon context with a sample of English-speaking ICD recipients.

  • 131. Ulander, M.
    et al.
    Brostrom, A.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Svanborg, E.
    Differences in the level of sleepiness measured by the different items of the Epworth sleepiness scale: a comparison to the Multiple sleep latency test2012In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 21, p. 308-308Article in journal (Other academic)
  • 132. Ulander, Martin
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Svanborg, Eva
    Johansson, Peter
    Brostrom, Anders
    The fairness of the Epworth Sleepiness Scale: two approaches to differential item functioning2013In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 17, no 1, p. 157-165Article in journal (Refereed)
    Abstract [en]

    Differential item functioning (DIF) is said to exist in an item if a subject's response to the item is affected by other aspects than that which the test is intended to assess. DIF might affect the validity of a test. The aim of this study was thus to examine whether any of the items in the Epworth Sleepiness Scale (ESS) exhibits DIF regarding age or gender, and if so, to which degree. Using previously collected cross-sectional ESS data from 1,168 subjects with different clinical characteristics (61% males, mean age 67.8 year (SD 12.2 year)), ordinal regression as well as Rasch-based DIF analyses were performed. Concerning age, both DIF analyses showed DIF for age in items 3 (inactive in a public place), 4 (passenger in a car), and 8 (in a car that has stopped in traffic). The Rasch model also showed DIF for gender in item 3. The DIF magnitudes as judged by McFadden pseudo-R (2) changes were, however, only minor. ESS has small but reproducible DIF for age in items 3, 4, and 8. The detected DIF might be worth to consider in large-sample studies, although it probably has no effect on an individual basis.

  • 133.
    Ulla, Walfridsson
    et al.
    Linköping Univ.
    Anna, Strömberg
    Linköping Univ.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings Universitet, Ersta Sköndal Univ Coll.
    Development and Validation of an Arrhythmia-Specific Scale in Tachycardia and Arrhythmia With Focus on Health-Related Quality of Life2015In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 30, no 2, p. 98-108Article in journal (Refereed)
    Abstract [en]

    Arrhythmias can cause a profoundly negative impact on a person's daily life, leading to impaired health-related quality of life (HRQOL). Assessment of HRQOL can provide valuable information before, during, and after healthcare interventions for arrhythmias. Objective: The aim was to develop and validate a disease-specific scale evaluating HRQOL in patients with different forms of arrhythmia. Methods: The Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA HRQOL) was developed from a literature review, patient interviews, and expert panel evaluations. This version was then psychometrically evaluated in patients treated with radiofrequency catheter ablation because of different forms of arrhythmias and patients who sought emergency care because of atrial fibrillation. Construct validity was evaluated with item-total correlations, confirmatory factor analyses, and convergent and discriminant validity. Internal consistency was evaluated using Cronbach's alpha. Results: All items reached the expected level of item-total correlations of greater than 0.3 for the total scale. The content validity index was sufficient for all items, as was the total scale (0.86-1.0). The 2-factor confirmatory factor analysis model that included the physical and mental factors showed a better fit between model and data than the 1-factor model did (P < .001). Convergent and discriminant validities were evaluated in the correlation analyses between the ASTA HRQOL subscales and SF-36 physical and mental dimensions. A strong correlation was found between the hypothesized physical and mental scales. Internal consistency was satisfactory with a lower bound confidence interval (95%) for Cronbach's alpha .70 or greater for all the ASTA HRQOL scales. Conclusions: The ASTA HRQOL questionnaire can be a valuable contribution to HRQOL assessments in patients with different forms of arrhythmia. Until there is more evidence regarding validity and reliability, using both the total and subscale scores is recommended.

  • 134.
    Vellone, Ercole
    et al.
    Tor Vergata University, Rome, Italy.
    Jaarsma, Tiny
    University of Linköping.
    Strömberg, Anna
    University of Linköping.
    Fida, Roberta
    Sapienza University, Italy.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Linköping.
    Rocco, Gennaro
    Center of Excellence for Nursing Scholarship, Italy.
    Cocchieri, Antonello
    Tor Vergata University, Italy.
    Alvaro, Rosaria
    Tor Vergata University, Italy.
    The European Heart Failure Self-care Behaviour Scale: new insights into factorial structure, reliability, precision and scoring procedure.2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, no 1, p. 97-102, article id S0738-3991(13)00367-4Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate a new factorial structure of the European Heart Failure Self-care Behaviour Scale 9-item version (EHFScBS-9), and to test its reliability, floor and ceiling effect, and precision. To propose a new 0-100 score with a higher score meaning better self-care.

    METHODS: A sample of 1192 Heart Failure (HF) patients (mean age 72 years, 58% male) was enrolled. Psychometric properties of the EHFScBS-9 were tested with confirmative factor analysis, factor score determinacy, determining the floor and ceiling effect, and evaluating the precision with the standard error of measurement (SEM) and the smallest real difference (SRD).

    RESULTS: We identified three well-fitting factors: consulting behaviour, autonomy-based adherence, and provider-based adherence (comparative fit index=0.96). Reliability ranged from 0.77 to 0.95. The EHFScBS-9 showed no floor and ceiling effect except for the provider-based adherence which had an expected ceiling effect. The SEM and the SRD indicated good precision of the EHFScBS-9.

    CONCLUSION: The new factorial structure of the EHFScBS-9 showed supportive psychometric properties.

    PRACTICE IMPLICATIONS: The EHFScBS-9 can be used to compute a total and specific scores for each identified factor. This may allow more detailed assessment and tailored interventions to improve self-care. The new score makes interpretation of the EHFScBS-9 easier.

  • 135.
    Waldréus, Nana
    et al.
    Karolinska Institutet, Sweden.
    Jaarsma, Tiny
    Linköping University, Sweden;Australian Catholic University, Sweden.
    Ivarsson, Bodil
    Lund University, Sweden;Skåne University Hospital, Sweden;Region Skåne, Sweden.
    Strömberg, Anna
    Linköping University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Kjellström, Barbro
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Development and validation of a questionnaire to measure patient's experiences of health care in pulmonary arterial hypertension outpatient clinics2019In: Heart, Lung and Circulation, ISSN 1443-9506, E-ISSN 1444-2892, Vol. 28, no 7, p. 1074-1081Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Measuring the patients' experience of care at an outpatient clinic can provide feedback about the quality of health care and if needed, can be support for quality improvements. To date, there is no patient reported experience measurement (PREM) developed targeting patients at the pulmonary arterial hypertension (PAH) outpatient clinics. Therefore, the aim was to develop and evaluate the psychometric properties of a PREM scale to be used for patients at PAH-outpatient clinics.

    METHODS: The development and psychometric evaluation of the PREM for patients at PAH outpatient clinics followed two stages: (I) development of the PAH Clinic PREM (PAHC-PREM) scale based on interviews with patients; and (II) psychometric evaluation of the PAHC-PREM scale including data quality, factor structure (construct validity), criterion validity and internal consistency.

    RESULTS: A sample of 156 patients at PAH outpatient clinics completed the PAHC-PREM scale (median age 69 years, 57% women). Unidimensionality of the PAHC-PREM scale was supported by parallel analysis. A single factor explained 67% of the variance. Inter-item and item-total correlations were satisfactory (0.46-0.88 and 0.64-0.91, respectively). Internal consistency reliability with ordinal coefficient alpha was good (0.93).

    CONCLUSIONS: The PAHC-PREM scale was demonstrated to have good psychometric properties and is now ready to be used to measure quality of health care experience from patients at PAH-outpatient clinics.

  • 136.
    Walfridsson, Ulla
    et al.
    Linköpings universitet.
    Walfridsson, Håkan
    Linköpings universitet.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Strömberg, Anna
    Linköpings universitet.
    Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment.2011In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 40, no 5, p. 405-411Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study evaluated the impact of radiofrequency ablation (RFA) on health-related quality of life (HRQOL) in patients with paroxysmal supraventricular tachycardia (PSVT).

    METHODS: HRQOL was assessed with the Short Form-36 Health Survey (SF-36) and EuroQol (EQ)-5D at baseline and 3 and 12 months after RFA. At 12 months, the patients were compared with an age- and gender-matched reference group.

    RESULTS: Patients showed a marked improvement in all the SF-36's scales at 3 months after treatment compared with baseline. Patients scored higher in all scales in the SF-36 but not in the EQ-5D's index at 12 months compared with baseline. No further improvements were detected from 3 to 12 months follow-up. Twelve months after treatment, patients scored equal to the reference group in the SF-36 and EQ-5D index, indicating a complete restoration of the HRQOL after RFA.

    CONCLUSION: PSVT is a condition with a pronounced impact on HRQOL. At 12 months follow-up after RFA, patients' HRQOL scores were similar to those of the age- and gender-matched reference group.

  • 137. Walfridsson, Ulla
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Linköpings universitet.
    Strömberg, Anna
    Development and validation of a new Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) with focus on symptom burden.2012In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 10, p. Article ID: 44-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Arrhythmias can appear with a variety of symptoms, all from vague to pronounced and handicapping symptoms. Therefore, patient-reported outcomes (PROs) concerning symptom burden are important to assess and take into consideration in the care and treatment of patients with arrhythmias. The main purpose was to develop and validate a disease-specific questionnaire evaluating symptom burden in patients with different forms of arrhythmias.

    METHODS: A literature review was conducted and arrhythmia patients were interviewed. Identified symptoms were evaluated by an expert panel consisting of cardiologists and nurses working daily with arrhythmia patients. SF-36 and Symptoms Checklist (SCL) were used in the validation of the new questionnaire Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA). Homogeneity was evaluated with Spearman's correlations and Cronbach's alpha coefficient (α) was used to evaluate internal consistency. Construct validity was evaluated using item-total correlations and convergent and discriminant validity. For this, Spearman's correlations were calculated between the ASTA symptom scale, SCL and SF-36. Concurrent validity was validated by Spearman's correlations between the ASTA symptom scale and SCL.

    RESULTS: The correlations between the different items in the ASTA symptom scale showed generally sufficient homogeneity. Cronbach's coefficient was found to be satisfactory (α = 0.80; lower bound 95% CI for α = 0.76). Construct validity was supported by item-total correlations where all items in the symptom scale were sufficiently correlated (≥0.3). Convergent and discriminant validity was supported by the higher correlations to the arrhythmia-specific SCL compared to the generic SF-36. Concurrent validity was evaluated and there were sufficiently, but not extremely strong correlations found between the ASTA symptom scale and SCL.

    CONCLUSIONS: The nine items of the ASTA symptom scale were found to have good psychometric properties in patients with different forms of arrhythmias. Arrhythmia patients suffer from both frequent and disabling symptoms. The validated ASTA questionnaire can be an important contribution to PROs regarding symptom burden in arrhythmia patients.

  • 138.
    Wikstrom, Lotta
    et al.
    Jönköping Univ.
    Eriksson, Kerstin
    Jönköping Univ.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings Universitet, Ersta Sköndal Univ Coll.
    Fridlund, Bengt
    Jönköping Univ.
    Broström, Anders
    Jönköping Univ.
    Healthcare Professionals' Perceptions of the Use of Pain Scales in Postoperative Pain Assessments2014In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 27, no 1, p. 53-58Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how healthcare professionals perceive the use of pain scales in postoperative care. Background: Pain scales are important but not an obvious choice to use in postoperative care. No study has explored how healthcare professionals experience the use of pain scales. Methods: An explorative design with a phenomenographic approach was used. The sample consisted of 25 healthcare professionals. Semistructured interviews were performed. Results: Four descriptive categories emerged - the use of pain scales facilitated the understanding of postoperative pain, facilitated treatment, demanded a multidimensional approach and was affected by work situations. Conclusions: Healthcare professionals described that pain scales contribute to the understanding of patient's postoperative pain. It is important to ensure patient understanding and be aware about variations in pain ratings. Dialogue and observations are necessary to be certain what the ratings mean to the patient. The use of pain scales depends on patient's needs and organization. (C) 2014 Elsevier Inc. All rights reserved.

  • 139.
    Wikström, Lotta
    et al.
    Jönköping University;Ryhov County Hospital.
    Eriksson, Kerstin
    Jönköping University;Ryhov County Hospital.
    Fridlund, Bengt
    Jönköping University.
    Nilsson, Mats
    Futurum Acad Hlth & Care, Jönköping.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Broström, Anders
    Jönköping University;University Hospital Linköping.
    The clinical applicability of a daily summary of patients' self-reported postoperative pain: A repeated measure analysis2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4675-4684Article in journal (Refereed)
    Abstract [en]

    Aim and objectives(i) To determine whether a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (ii) and to determine the number of self-ratings required for the calculation of this measure. BackgroundPerioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored. DesignA repeated measure design was carried out at three Swedish country hospitals. MethodsAssociations between the measures were analysed with nonparametric statistical methods; systematic and individual group changes were analysed separately. Measure I: pain scores at rest and activity postoperative day 1; measure II: retrospective average pain from postoperative day 1. ResultsThe sample consisted of 190 general surgery patients and 289 orthopaedic surgery patients with a mean age of 65; 56% were men. Forty-four percent had a pre-operative daily intake of analgesia, and 77% used postoperative opioids. A range of 49 pain scores seem to be eligible for the calculation of the daily measures of pain. Rank correlations for individual median scores, based on four ratings, vs. retrospective self-rated average pain, were moderate and strengthened with increased numbers of ratings. A systematic group change towards a higher level of reported retrospective pain was significant. ConclusionsThe median values were clinically applicable daily measures. The risk of obtaining a higher value than was recalled by patients seemed to be low. Applicability increased with increased frequency of self-rated pain scores and with high-quality pain assessments. Relevance to clinical practiceThe documenting of daily median pain scores at rest and during activity could constitute the basis for obtaining patients' experiences by showing their pain severity trajectories. The measures could also be an important key to predicting postoperative health-related consequences.

  • 140.
    Wikström, Lotta
    et al.
    Jönköping University ; Ryhov County Hospital.
    Eriksson, Kerstin
    Jönköping University ; Ryhov County Hospital.
    Fridlund, Bengt
    Jönköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University ; Linköping University Hospital.
    Broström, Anders
    Jönköping University ; Linköping University Hospital.
    Healthcare professionals' descriptions of care experiences and actions when assessing postoperative pain: a critical incident technique analysis2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, p. 802-812Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pain is a common postoperative symptom, and length of hospital stay after surgery is short which highlights the importance of pain assessments. Experiences of assessing pain are mainly described from the perspective of nurses. In postoperative care, enrolled nurses and physicians also assess pain. It is therefore important to take note of their experiences to improve postoperative pain assessments.

    OBJECTIVES: The aim of this study was, through considering critical incidents, to describe care experiences and actions taken by healthcare professionals when assessing postoperative pain.

    METHODS: An explorative design employing critical incidents technique analysis was used. A total of 24 strategically selected enrolled nurses, nurses and physicians employed at orthopaedic or general surgery wards in four Swedish hospitals were interviewed. The intention was to reach variation in age, sex, profession and professional experience.

    FINDINGS: In pain assessments, patient-related facilitators were patients' verbal and emotional expressions including pain ratings, while lack of consistency with observed behaviours was a barrier. Clinical competence, continuity in care and time were healthcare-related facilitators. The actions healthcare professionals took were gathering facts about patients' pain manifestations and adapting to patients' communication abilities. Patient observations, either passive or active were used to confirm or detect pain. Collaboration between healthcare professionals, including consultations with pain experts, social workers and relatives, strengthened understanding of pain.

    CONCLUSIONS: Communication skills and working conditions have an impact on performance of pain assessment. Patient comfort without compromising safety is reached by including healthcare professionals' dissimilar responsibilities when collecting patients' and relatives' perspectives on current pain.

  • 141.
    Wu, Tzu-Yi
    et al.
    Acad Sinica, Taiwan.
    Lin, Chung-Ying
    Hong Kong Polytech Univ, Peoples Republic of China.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Griffiths, Mark D.
    Nottingham Trent Univ, UK.
    Brostrom, Anders
    Jönköping University, Sweden.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran;Jönköping University.
    Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale - Short Form: Does gender and hours spent online gaming affect the interpretations of item descriptions?2017In: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, no 2, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background and aims: The nine-item Internet Gaming Disorder Scale -Short Form (IGDS-SF9) is brief and effective to evaluate Internet Gaming Disorder (IGD) severity. Although its scores show promising psychometric properties, less is known about whether different groups of gamers interpret the items similarly. This study aimed to verify the construct validity of the Persian IGDS-SF9 and examine the scores in relation to gender and hours spent online gaming among 2,363 Iranian adolescents. Methods: Confirmatory factor analysis (CFA) and Rasch analysis were used to examine the construct validity of the IGDS-SF9. The effects of gender and time spent online gaming per week were investigated by multigroup CFA and Rasch differential item functioning (DIF). Results: The unidimensionality of the IGDS-SF9 was supported in both CFA and Rasch. However, Item 4 (fail to control or cease gaming activities) displayed DIF (DIF contrast = 0.55) slightly over the recommended cutoff in Rasch but was invariant in multigroup CFA across gender. Items 4 (DIF contrast = -0.67) and 9 (jeopardize or lose an important thing because of gaming activity; DIF contrast = 0.61) displayed DIF in Rasch and were non-invariant in multigroup CFA across time spent online gaming. Conclusions: Given the Persian IGDS-SF9 was unidimensional, it is concluded that the instrument can be used to assess IGD severity. However, users of the instrument are cautioned concerning the comparisons of the sum scores of the IGDS-SF9 across gender and across adolescents spending different amounts of time online gaming.

  • 142.
    Årestedt, Kristofer
    Lund University, Department of Health Sciences, Faculty of Medicine.
    Health related quality of life among persons 65 years or older with chronic heart failure: An empirical and methodological study2007Doctoral thesis, monograph (Other academic)
  • 143.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Allert, Camilla
    Blekinge Institute of Technology, Sweden.
    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, Sweden.
    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, Sweden.
    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, Sweden.
    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)
  • 144.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Alvariza, A.
    Ersta Sköndal Bräcke University College, Sweden.
    Håkansson, C.
    Ersta Sköndal Bräcke University College, Sweden.
    Öhlén, J.
    University of Gothenburg, Sweden.
    Boman, K.
    Umeå University, Sweden.
    Goliath, I.
    Karolinska Institutet, Sweden.
    Fürst, C-J
    Lund University, Sweden.
    Brännstrom, M.
    Umeå University, Sweden.
    Symptom relief and palliative care during the last week of life among patients with heart failure2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S58-S59, article id 155Article in journal (Other academic)
    Abstract [en]

    Background: Heart failure is a disease with high morbidity, mortality and physical and psychological burden. Patients with heart failure have symptoms as severe and distressing as those of cancer patients. Likewise, the knowledge about care oriented towards palliation provided close to death is sparse.

    Purpose: To describe symptom prevalence and key aspects of palliative care the last week of life for patients with heart failure, from the perspective of health care professionals.Methods: Data was taken from the Swedish Register of Palliative Care, 2011 and 2012 (n=3981). Inclusion criteria were; heart failure as underlying cause of death (ICD-10; I50.0, I50.1 & I50.9), expected death and 18 years or older. During this period, the register covered 58% of all deaths in Sweden. Variables were described using univariate statistics.

    Results: The sample consisted of 3981 patients (63% women) with a mean age of 88.1 (SD=7.1) years. The most common reported symptom was pain (62%), followed by rattles (51%), anxiety (39%), shortness of breath (29%), confusion (25%), and nausea (11%). Symptom relief was most prominent for pain and anxiety. Still, 25% and 38% respectively were partly or not relieved. Poorer relief was found for patients suffering shortness of breath, nausea and rattles. More than half of patients were partly or not reviled, 61%, 58% and 55% respectively. Poorest symptom relief was showed for patients with confusion, 85 % were partly or not reviled. Validated self-rating scales were seldom used to assess symptoms. Pain was more often assessed (12%) than other symptoms (8%). Two third of the patients (72%) and almost half of family members (39%) did not have an end of life discussions with a physician. One fifth (17%) died alone without family members or health care professionals present.

    Conclusions: Our findings indicate that the palliative care is inadequate for patients with heart failure during their last week of life. Symptom management needs to be improved, for example by structured use of validated symptom rating scales. End of life discussions needs to be improved, both for patients and family members.

  • 145.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Sweden;Dalens Hospital, Sweden.
    Boman, Kurt
    Umeå University, Sweden.
    Öhlén, Joakim
    University of Gothenburg, Sweden.
    Goliath, Ida
    Karolinska Institutet, Sweden.
    Håkanson, Cecilia
    Ersta Sköndal Bräcke University College, Sweden;Sophiahemmet University, Sweden.
    Fürst, Carl Johan
    Lund University, Sweden;Region Skåne, Sweden.
    Brännström, Margareta
    Umeå University, Sweden.
    Symptom relief and palliative care during the last week of life among patients with heart failure: a national register study2018In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 21, no 3, p. 361-367Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Heart failure is a disease with high morbidity, mortality, and physical and psychological burden. More knowledge about the care provided for patients with heart failure close to death is needed.

    OBJECTIVE: The aim was to describe key aspects of palliative care during the last week of life in patients with heart failure, as reported by healthcare professionals.

    DESIGN: This is a national register study.

    SETTING/SUBJECTS: The study included 3981 patients with diagnosed heart failure as the underlying cause of death.

    MEASUREMENTS: Data were obtained from the Swedish Register of Palliative Care, a national quality register that focuses on patients' last week of life, independent of diagnosis or care setting. The register includes information about care interventions connected with key aspects of palliative care. Data are reported retrospectively by a nurse or physician at the healthcare unit where the patient dies.

    RESULTS: Only 4.2% of patients with heart failure received specialized palliative care. In their last week of life, symptom prevalence was high, validated scales were seldom used, and symptoms were unsatisfactorily relieved. Around one-fifth (17%) of the patients in the study died alone. Less than half of family members had been offered bereavement support (45%). Moreover, one-third (28%) of the patients and more than half (61%) of the family members were reported to have had end-of-life discussions with a physician during the illness trajectory.

    CONCLUSION: The results indicate inadequate palliative care for patients with heart failure during their last week of life.

  • 146.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Andreae, C.
    Stromberg, A.
    Initial psychometric evaluation of the council of nutrition appetite questionnaire (CNAQ) in patients with chronic heart failure2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, p. S12-S13Article in journal (Other academic)
  • 147.
    Årestedt, Kristofer
    et al.
    University of Kalmar, School of Human Sciences.
    Blomqvist, Kerstin
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    The impact of chronic heart failure on daily life in an elderly population: Validation of the Minnesota Living with Heart Failure Questionnaire2005Conference paper (Refereed)
  • 148.
    Årestedt, Kristofer
    et al.
    University of Kalmar, School of Human Sciences.
    Blomqvist, Kerstin
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Validation of a Swedish Version of Minnesota Living with Heart Failure Questionnaire in an Elderly Population2004Conference paper (Refereed)
  • 149.
    Årestedt, Kristofer
    et al.
    University of Kalmar, School of Human Sciences.
    Blomqvist, Kerstin
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Validation of the Minnesota Living with Heart Failure Questionnaire in a group of elderly persons with chronic heart failure2006Conference paper (Refereed)
  • 150.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    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.

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