Skip header and navigation

Refine By

17 records – page 1 of 2.

Advanced palliative home care: next-of-kin's perspective.

https://arctichealth.org/en/permalink/ahliterature18088
Source
J Palliat Med. 2003 Oct;6(5):749-56
Publication Type
Article
Date
Oct-2003
Author
Anna Milberg
Peter Strang
Maria Carlsson
Susanne Börjesson
Author Affiliation
Linköpings Universitet, Division of Geriatrics and Palliative Research Unit, Linköping, Sweden. anna.milberg@lio.se
Source
J Palliat Med. 2003 Oct;6(5):749-56
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Caregivers - psychology
Comparative Study
Family - psychology
Female
Home Care Services - organization & administration
Humans
Male
Palliative Care - organization & administration
Professional-Family Relations
Questionnaires
Reproducibility of Results
Research Support, Non-U.S. Gov't
Sweden
Abstract
GOALS: (1). To describe what aspects are important when next-of-kin evaluate advanced palliative home care (APHC) and (2). to compare the expressed aspects and describe eventual differences among the three settings, which differed in terms of length of services, geographic location, and population size. SUBJECTS AND METHODS: Four to 7 months after the patient's death (87% from cancer), 217 consecutive next-of-kin from three different settings in Sweden responded (response rate 86%) to three open-ended questions via a postal questionnaire. Qualitative content analysis was performed. MAIN RESULTS: Service aspects and comfort emerged as main categories. The staff's competence, attitude and communication, accessibility, and spectrum of services were valued service aspects. Comfort, such as feeling secure, was another important aspect and it concerned the next-of-kin themselves, the patients, and the families. Additionally, comfort was related to interactional issues such as being in the center and sharing caring with the staff. The actual place of care (i.e., being at home) added to the perceived comfort. Of the respondents, 87% described positive aspects of APHC and 28% negative aspects. No major differences were found among the different settings. CONCLUSIONS: Next-of-kin incorporate service aspects and aspects relating to the patient's and family's comfort when evaluating APHC. The importance of these aspects is discussed in relation to the content of palliative care and potential goals.
PubMed ID
14622454 View in PubMed
Less detail

Coeliac disease--women's experiences in everyday life.

https://arctichealth.org/en/permalink/ahliterature120102
Source
J Clin Nurs. 2012 Dec;21(23-24):3442-50
Publication Type
Article
Date
Dec-2012
Author
Lisa R Jacobsson
Claes Hallert
Anna Milberg
Maria Friedrichsen
Author Affiliation
Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden. lisa.ring.jacobsson@liu.se
Source
J Clin Nurs. 2012 Dec;21(23-24):3442-50
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Celiac Disease - diet therapy - physiopathology - psychology
Diet, Gluten-Free
Female
Humans
Middle Aged
Qualitative Research
Quality of Life
Sweden
Abstract
To describe what life is like as a woman living with coeliac disease.
The therapy for coeliac disease is a gluten-free diet, and if sufferers keep strictly to this, it is suggested that they will stay well. However, previous studies point out that people who are treated for coeliac disease, particularly women, experience various kinds of inconvenience in relation to having coeliac disease and to being treated with gluten-free diet.
A qualitative research design was chosen.
A phenomenological approach as devised by Giorgi was used. Tape-recorded qualitative interviews with a total of 15 women who were being treated for coeliac disease were conducted in 2008 in Sweden.
The results demonstrated that coeliac disease can influence women's lives in different ways. The general structure of being a woman with coeliac disease was described as a striving towards a normalised lifeworld. Three conditions necessary to achieve a normalised life were described, namely being secure, being in control and being seen and included.
Understanding factors affecting the ability to live with coeliac disease as normally as possible can help caregivers, and others, to support these women in their aims.
Nurses should help women to adopt facilitating thoughts in relation to the disease and, in so doing, help them to select appropriate coping strategies.
PubMed ID
23039244 View in PubMed
Less detail

Constipation in Specialized Palliative Care: Prevalence, Definition, and Patient-Perceived Symptom Distress.

https://arctichealth.org/en/permalink/ahliterature271796
Source
J Palliat Med. 2015 Jul;18(7):585-92
Publication Type
Article
Date
Jul-2015
Author
Eva Erichsén
Anna Milberg
Tiny Jaarsma
Maria J Friedrichsen
Source
J Palliat Med. 2015 Jul;18(7):585-92
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Constipation - epidemiology - physiopathology - psychology
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice
Humans
Logistic Models
Palliative Care
Prevalence
Sweden
Terminally ill
Abstract
The prevalence of constipation among patients in palliative care has varied in prior research, from 18% to 90%, depending on study factors.
The aim of this study was to describe and explore the prevalence and symptom distress of constipation, using different definitions of constipation, in patients admitted to specialized palliative care settings.
Data was collected in a cross-sectional survey from 485 patients in 38 palliative care units in Sweden. Variables were analyzed using logistic regression and summarized as odds ratio (OR).
The prevalence of constipation varied between 7% and 43%, depending on the definition used. Two constipation groups were found: (1) medical constipation group (MCG): =3 defecations/week, n=114 (23%) and (2) perceived constipation group (PCG): patients with a perception of being constipated in the last two weeks, n=171 (35%). Three subgroups emerged: patients with (1) only medical constipation (7%), (2) only perceived constipation (19%), and (3) both medical and perceived constipation (16%). There were no differences in symptom severity between groups; 71% of all constipated patients had severe constipation.
The prevalence of constipation may differ, depending on the definition used and how constipation is assessed. In this study we found two main groups and three subgroups, analyzed from the definitions of frequency of bowel movements and experience of being constipated. To be able to identify constipation, the patients' definition has to be further explored and assessed.
PubMed ID
25874474 View in PubMed
Less detail

Costs and Effects of an Ambulatory Geriatric Unit (the AGe-FIT Study): A Randomized Controlled Trial.

https://arctichealth.org/en/permalink/ahliterature270515
Source
J Am Med Dir Assoc. 2015 Jun 1;16(6):497-503
Publication Type
Article
Date
Jun-1-2015
Author
Anne W Ekdahl
Ann-Britt Wirehn
Jenny Alwin
Tiny Jaarsma
Mitra Unosson
Magnus Husberg
Jeanette Eckerblad
Anna Milberg
Barbro Krevers
Per Carlsson
Source
J Am Med Dir Assoc. 2015 Jun 1;16(6):497-503
Date
Jun-1-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Ambulatory Care - organization & administration
Cause of Death
Cost-Benefit Analysis
Female
Geriatric Assessment
Health Services Research
Hospitalization - statistics & numerical data
Humans
Interviews as Topic
Male
Patient Care Team - organization & administration
Quality of Life
Single-Blind Method
Sweden - epidemiology
Abstract
To examine costs and effects of care based on comprehensive geriatric assessment (CGA) provided by an ambulatory geriatric care unit (AGU) in addition to usual care.
Assessor-blinded, single-center randomized controlled trial.
AGU in an acute hospital in southeastern Sweden.
Community-dwelling individuals aged 75 years or older who had received inpatient hospital care 3 or more times in the past 12 months and had 3 or more concomitant medical diagnoses were eligible for study inclusion and randomized to the intervention group (IG; n = 208) or control group (CG; n = 174). Mean age (SD) was 82.5 (4.9) years.
Participants in the IG received CGA-based care at the AGU in addition to usual care.
The primary outcome was number of hospitalizations. Secondary outcomes were days in hospital and nursing home, mortality, cost of public health and social care, participant' sense of security in care, and health-related quality of life (HRQoL).
Baseline characteristics did not differ between groups. The number of hospitalizations did not differ between the IG (2.1) and CG (2.4), but the number of inpatient days was lower in the IG (11.1 vs 15.2; P = .035). The IG showed trends of reduced mortality (hazard ratio 1.51; 95% confidence interval [CI] 0.988-2.310; P = .057) and an increased sense of security in care interaction. No difference in HRQoL was observed. Costs for the IG and CG were 33,371 £ (39,947 £) and 30,490 £ (31,568 £; P = .432).
This study of CGA-based care was performed in an ambulatory care setting, in contrast to the greater part of studies of the effects of CGA, which have been conducted in hospital settings. This study confirms the superiority of this type of care to elderly people in terms of days in hospital and sense of security in care interaction and that a shift to more accessible care for older people with multimorbidity is possible without increasing costs. This study can aid the planning of future interventions for older people.
clinicaltrials.gov identifier: NCT01446757.
Notes
Comment In: J Am Med Dir Assoc. 2015 Jun 1;16(6):446-725843620
PubMed ID
25703450 View in PubMed
Less detail

Differences in predictors of 5-year survival over a 10-year period in two cohorts of elderly nursing home residents in Sweden.

https://arctichealth.org/en/permalink/ahliterature281585
Source
Scand J Caring Sci. 2016 Dec;30(4):714-720
Publication Type
Article
Date
Dec-2016
Author
Märta Sund Levander
Anna Milberg
Nils Rodhe
Pia Tingström
Ewa Grodzinsky
Source
Scand J Caring Sci. 2016 Dec;30(4):714-720
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Humans
Inpatients
Nursing Homes
Proportional Hazards Models
Survival Analysis
Sweden
Abstract
The aim was to compare 5-year survival in two included cohorts (from year 2000 and year 2007) of 249 nursing home residents (NHR) in this retrospective, comparative study.
The cohorts were compared regarding chronic diseases, medication, physical/cognitive/nutritional status, body mass index, body temperature and 5-year mortality. Factors correlated with 5-year survival were determined using Cox regression analysis.
In average, cohort 2007 survived 31 ± 16 months and cohort 2000, 38 ± 13 months, p
PubMed ID
26842844 View in PubMed
Less detail

Does a half-day course about palliative care matter? A quantitative and qualitative evaluation among health care practitioners.

https://arctichealth.org/en/permalink/ahliterature114602
Source
J Palliat Med. 2013 May;16(5):496-501
Publication Type
Article
Date
May-2013
Author
Maria Friedrichsen
Per-Anders Heedman
Eva Åstradsson
Maria Jakobsson
Anna Milberg
Author Affiliation
Palliative Education and Research Center in the County of Östergötland, Vrinnevi Hospital, Norrköping, Sweden. maria.friedrichsen@liu.se
Source
J Palliat Med. 2013 May;16(5):496-501
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Education, Medical, Continuing - organization & administration
Educational Measurement
Female
Focus Groups
Humans
Interviews as Topic
Male
Middle Aged
Palliative Care
Questionnaires
Sweden
Abstract
To date there has been a paucity of research examining whether a course in palliative care influences the clinical work. Therefore a half-day course was started for different professionals.
The aims of this study were to quantitatively and qualitatively explore professionals' experience of the usefulness and importance of such a course.
An evaluation study was used with two measurement points in the quantitative part; qualitative focus group interviews were conducted three times.
Data was collected in Sweden through structured and open-ended questions (n=355) and in focus group discussions (n=40).
The majority of participants were allied professionals (86%). Course evaluation immediately after the intervention showed high scores. At three months, 78% of the 86 participants who had cared for a dying patient since the course claimed that the course had been useful in their work. In addition, there were improvements regarding symptom management (37%), support to family members (36%), more frequent break point conversations (31%), and improved cooperation in the teams (26%). The qualitative analysis showed that the course made participants start to compare their own working experiences with the new knowledge. When returning to work, the participants feel strengthened by the the newly acquired knowledge, but the will to improve the care also led to frustration, as some of the participants described that they wanted to change routines in the care of the dying, but felt hindered.
The course was appreciated and useful in the professionals' work, but it also created problems.
PubMed ID
23600332 View in PubMed
Less detail

Dying cancer patients' own opinions on euthanasia: an expression of autonomy? A qualitative study.

https://arctichealth.org/en/permalink/ahliterature134773
Source
Palliat Med. 2012 Jan;26(1):34-42
Publication Type
Article
Date
Jan-2012
Author
Marit Karlsson
Anna Milberg
Peter Strang
Author Affiliation
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. marit.karlsson@ki.se
Source
Palliat Med. 2012 Jan;26(1):34-42
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Decision Making
Euthanasia - psychology
Female
Humans
Male
Middle Aged
Neoplasms - psychology
Palliative Care
Personal Autonomy
Qualitative Research
Questionnaires
Sweden
Trust
Abstract
Deliberations on euthanasia are mostly theoretical, and often lack first-hand perspectives of the affected persons.
Sixty-six patients suffering from cancer in a palliative phase were interviewed about their perspectives of euthanasia in relation to autonomy. The interviews were transcribed verbatim and analysed using qualitative content analysis with no predetermined categories.
The informants expressed different positions on euthanasia, ranging from support to opposition, but the majority were undecided due to the complexity of the problem. The informants' perspectives on euthanasia in relation to autonomy focused on decision making, being affected by (1) power and (2) trust. Legalization of euthanasia was perceived as either (a) increasing patient autonomy by patient empowerment, or (b) decreasing patient autonomy by increasing the medical power of the health care staff, which could be frightening. The informants experienced dependence on others, and expressed various levels of trust in others' intentions, ranging from full trust to complete mistrust.
Dying cancer patients perceive that they cannot feel completely independent, which affects true autonomous decision making. Further, when considering legalization of euthanasia, the perspectives of patients fearing the effects of legalization should also be taken into account, not only those of patients opting for it.
PubMed ID
21543526 View in PubMed
Less detail

Early nonspecific signs and symptoms of infection in institutionalized elderly persons: perceptions of nursing assistants.

https://arctichealth.org/en/permalink/ahliterature147015
Source
Scand J Caring Sci. 2010 Mar;24(1):24-31
Publication Type
Article
Date
Mar-2010
Author
Pia Tingström
Anna Milberg
Märtha Sund-Levander
Author Affiliation
Department of Medicine and Health Sciences, Center for Educational Development and Research, Faculty of Health Sciences, Linköping University, Berzelius Science Park, Linköping, Sweden.
Source
Scand J Caring Sci. 2010 Mar;24(1):24-31
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Aged
Attitude of Health Personnel
Bacterial Infections - diagnosis - epidemiology
Humans
Institutionalization - statistics & numerical data
Nursing Care
Nursing Homes - statistics & numerical data
Prevalence
Questionnaires
Sweden - epidemiology
Time Factors
Abstract
To explore early nonspecific signs and symptoms of infection in elderly institutionalized individuals as described by nursing assistants.
Nonspecific signs and symptoms and lack of specific ones are common in connection with infection in institutionalized elderly persons and contribute to a delayed diagnosis and treatment. In clinical care, the nurse makes notes on the individual status of the patient on a daily basis and decides whether to contact the physician or not. However, in Sweden nursing assistants provide most of the daily care and therefore have many opportunities to observe subtle changes that may be early signs of infection.
Data were collected in 2006 from focus interviews with 21 female nursing assistants. The interviews were verbatim transcripted and analysed with qualitative content analysis for manifest content with no preconceived categories.
Nursing assistants' descriptions of nonspecific signs and symptoms of infection comprised two exclusive categories. Is not as usual described general signs and symptoms of discomfort related to possible infection, such as discomfort, unrestrained behaviour, aggressiveness, restlessness, confusion, tiredness and feebleness, and decreased eating. Seems to be ill was more distinctly related to signs and symptoms of established infection in general terms of fever and pain or more specifically related to pneumonia, urinary tract infection, skin infection, cold and eye infection.
Nursing assistants have a keen observational ability to detect early signs that might help to confirm suspected infections in elderly nursing home residents early on. Whether or not the cited categories are actual early signs and symptoms of infectious disease needs to be further investigated.
PubMed ID
19954493 View in PubMed
Less detail

End of Life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer.

https://arctichealth.org/en/permalink/ahliterature274386
Source
PLoS One. 2016;11(2):e0147694
Publication Type
Article
Date
2016
Author
Heléne Eriksson
Anna Milberg
Katarina Hjelm
Maria Friedrichsen
Source
PLoS One. 2016;11(2):e0147694
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Communication
Disease Management
Family
Female
Humans
Male
Neoplasms - epidemiology
Odds Ratio
Palliative Care - standards
Prevalence
Quality of Health Care
Registries
Retrospective Studies
Stroke - diagnosis - epidemiology
Sweden - epidemiology
Terminal Care - standards
Abstract
Although stroke is a significant public health challenge and the need for palliative care has been emphasized for these patients, there is limited data on end-of-life care for patients dying from stroke.
To study the end-of-life care during the last week of life for patients who had died of stroke in terms of registered symptom, symptom management, and communication, in comparison with patients who had died of cancer.
This study is a retrospective, comparative registry study.
A retrospective comparative registry study was performed using data from a Swedish national quality register for end-of-life care based on WHO`s definition of Palliative care. Data from 1626 patients who had died of stroke were compared with data from 1626 patients who had died of cancer. Binary logistic analyses were used to calculate odds ratios, with 95% CI.
Compared to patients who was dying of cancer, the patients who was dying of stroke had a significantly higher prevalence of having death rattles registered, but a significantly lower prevalence of, nausea, confusion, dyspnea, anxiety, and pain. In addition, the stroke group had significantly lower odds ratios for health care staff not to know whether all these six symptoms were present or not. Patients who was dying of stroke had significantly lower odds ratio of having informative communication from a physician about the transition to end-of-life care and of their family members being offered bereavement follow-up.
The results indicate on differences in end-of-life care between patients dying of stroke and those dying from cancer. To improve the end-of-life care in clinical practice and ensure it has consistent quality, irrespective of diagnosis, education and implementation of palliative care principles are necessary.
Notes
Cites: Health Aff (Millwood). 2010 Aug;29(8):1489-9520679652
Cites: Eur J Neurol. 2010 Jan;17(1):73-719614968
Cites: J Nurs Manag. 2012 Mar;20(2):206-1422380415
Cites: Palliat Med. 2012 Jun;26(4):313-2121737480
Cites: Nurs Ethics. 2012 Sep;19(5):642-5322140179
Cites: Stroke. 2012 Dec;43(12):3405-823150658
Cites: Clin Ter. 2013;164(1):e23-523455747
Cites: Am J Hosp Palliat Care. 2013 Sep;30(6):601-1623236090
Cites: Palliat Med. 2013 Dec;27(10):939-5123442878
Cites: J Neurosci Nurs. 2014 Jun;46(3):162-7024796473
Cites: Stroke. 2014 Jun;45(6):1887-91624676781
Cites: Med J Aust. 2014 Oct 20;201(8):452-525332031
Cites: Circulation. 2015 Jan 27;131(4):e29-32225520374
Cites: Palliat Med. 2015 Apr;29(4):293-30125634627
Cites: Palliat Med. 2015 May;29(5):451-725634632
Cites: PLoS One. 2015;10(6):e013183626121338
Cites: Stroke. 2015 Sep;46(9):2714-926243219
Cites: Vasc Health Risk Manag. 2015;11:507-1026366088
Cites: J Pain Symptom Manage. 2015 Nov;50(5):659-75.e326212095
Cites: Scand J Caring Sci. 2016 Mar;30(1):5-2526190052
Cites: Acta Neurol Scand. 2016 Apr;133(4):261-726104048
Cites: Stroke. 1995 Dec;26(12):2242-87491644
Cites: BMC Med Ethics. 2007;8:717577420
Cites: Int J Stroke. 2007 May;2(2):139-4318705975
Cites: Palliat Med. 2010 Mar;24(2):146-5319926644
Cites: Acta Oncol. 2011 Jun;50(5):642-721391772
PubMed ID
26845149 View in PubMed
Less detail

Ethical dilemmas around the dying patient with stroke: a qualitative interview study with team members on stroke units in Sweden.

https://arctichealth.org/en/permalink/ahliterature258547
Source
J Neurosci Nurs. 2014 Jun;46(3):162-70
Publication Type
Article
Date
Jun-2014
Author
Helene Eriksson
Gisela Andersson
Louise Olsson
Anna Milberg
Maria Friedrichsen
Source
J Neurosci Nurs. 2014 Jun;46(3):162-70
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Death
Communication Barriers
Female
Hospice and Palliative Care Nursing - ethics
Humans
Male
Neuroscience Nursing - ethics
Nurses' Aides - ethics - psychology
Nursing Staff, Hospital - ethics - psychology
Nursing, Team - ethics
Palliative Care - ethics
Physical Therapists - ethics - psychology
Qualitative Research
Right to Die - ethics
Stroke - nursing - rehabilitation
Sweden
Terminal Care - ethics
Abstract
In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on "nondecisions" about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had "problems holding to the decision." The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was "communication barriers," a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.
PubMed ID
24796473 View in PubMed
Less detail

17 records – page 1 of 2.