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Agreement in documentation of symptoms, clinical signs, and treatment at the end of life: a comparison of data retrieved from nurse interviews and electronic patient records using the Resident Assessment Instrument for Palliative Care.

https://arctichealth.org/en/permalink/ahliterature130221
Source
J Clin Nurs. 2012 May;21(9-10):1416-24
Publication Type
Article
Date
May-2012
Author
Simen A Steindal
Liv Wergeland Sørbye
Inger Schou Bredal
Anners Lerdal
Author Affiliation
Diakonhjemmet University College, Institute of Nursing and Health, Oslo, Norway. Steindal@diakonhjemmet.no
Source
J Clin Nurs. 2012 May;21(9-10):1416-24
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Interviews as Topic
Male
Medical Records Systems, Computerized
Middle Aged
Norway
Nursing Records
Palliative Care
Terminal Care
Abstract
To assess agreement between data retrieved from interviews with nurses and data from electronic patient records (EPR) about hospitalised patients' symptoms, clinical signs and treatment during the last three days of life.
Patient records have been used to map symptom prevalence in dying hospitalised patients. However, deficiencies have been found regarding nursing documentation. To our knowledge, this is the first study to assess the agreement between nurse interviews and patient electronic records during the last three days of life in a hospital.
This retrospective study was undertaken in a Norwegian hospital.
We used the resident assessment instrument for palliative care to interview nurses on 112 dying patients, and we independently extracted data from EPR. The agreement between the two data sets was computed with the kappa coefficient. Sensitivity and specificity were calculated. Interview data were used as a reference.
The agreement between the two data sets ranged from poor to good and was highest among symptom variables, including pain, dyspnoea, nausea and the clinical sign falls. In contrast, several clinical variables ranged from poor to fair levels of agreement. The majority of the treatment variables ranged from moderate to good levels of agreement.
Data from the EPR on symptoms (e.g., pain, dyspnoea and nausea) and treatment variables appeared to be reliable and trustworthy, but the data related to fatigue, dry mouth, bloating and sleep interfering with normal functioning should be interpreted carefully.
This study contributed to knowledge of agreement between data from nurse interviews and electronic records on symptoms, clinical signs and treatment of dying patients in last three days of life.
PubMed ID
22023535 View in PubMed
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The characterisation of workloads and nursing staff allocation in intensive care units: a descriptive study using the Nursing Activities Score for the first time in Norway.

https://arctichealth.org/en/permalink/ahliterature131837
Source
Intensive Crit Care Nurs. 2011 Oct;27(5):290-4
Publication Type
Article
Date
Oct-2011
Author
Siv K Stafseth
Diana Solms
Inger Schou Bredal
Author Affiliation
Department of Emergency, Oslo University Hospital-Rikshospitalet, Norway. siv.stafseth@oslo-universitetssykehus.no
Source
Intensive Crit Care Nurs. 2011 Oct;27(5):290-4
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Humans
Infant
Intensive Care Units - manpower
Length of Stay
Middle Aged
Norway
Nursing Staff, Hospital - organization & administration - supply & distribution
Task Performance and Analysis
Workload
Abstract
This study compares the Nine Equivalents of Nursing Manpower Use Score (NEMS) to the Nursing Activities Score (NAS) in terms of characterising the nursing workload by examining and calculating the per-nurse NAS% over a 24-h period.
The sample consisted of 235 patients from four volunteered for the study multidisciplinary ICUs in Norway. The daily NEMS, NAS and number of nurses who were involved in patient care per ICU were measured over one month from 2008 to 2009.
The average length of stay for the included patients was 5 days, and the mean patient age was 52.8 years. The mean NEMS was 32.7 points (S.D., 8.98 points), and the mean NAS was 96.24% (S.D., 22.35%). Several nurses exhibited mean NEMS points that ranged from 16 to 39.7 per ICU per day. The correlation between the NEMS and NAS could only be separately determined for each ICU. The correlation was r=0.16-0.40 [significant at the 0.01 level (2-tailed)] per unit. Depending on which unit was investigated, each nurse was observed to perform of capacity with a NAS as high as 75-90%.
The study suggests that the actual numbers of nurses might explain the calculated NAS of 75-90% per nurse.
PubMed ID
21871805 View in PubMed
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Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain.

https://arctichealth.org/en/permalink/ahliterature265488
Source
J Pain Symptom Manage. 2014 Nov;48(5):852-62
Publication Type
Article
Date
Nov-2014
Author
Inger Schou Bredal
Nina A Smeby
Stig Ottesen
Torhild Warncke
Ellen Schlichting
Source
J Pain Symptom Manage. 2014 Nov;48(5):852-62
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety - epidemiology
Breast Neoplasms - epidemiology - therapy
Chemotherapy, Adjuvant
Chronic Pain - epidemiology
Comorbidity
Depression - epidemiology
Female
Humans
Middle Aged
Neuralgia - epidemiology
Norway - epidemiology
Pain Measurement
Pain, Postoperative - epidemiology
Questionnaires
Risk factors
Survivors
Abstract
According to the literature, 25%-60% of women treated for breast cancer, regardless of the stage, experience pain. Many risk factors have been suggested, with many possible confounding factors.
The aim was to investigate psychosocial, surgical, and medical factors associated with chronic pain by comparing breast cancer survivors with chronic pain with survivors without chronic pain. In addition, we investigated the prevalence, intensity, and body location of chronic pain after breast cancer treatment nationwide.
A nationwide postal survey of 1332 women who received surgery and adjuvant therapy for breast cancer in Norway two to six years before the onset of this study.
A total of 832 women (63%) returned the questionnaires, and 41% reported pain, of which 51% had mild, 41% moderate, and 8% severe pain. Among the women who experienced pain, 33.8% reported symptoms and signs of neuropathic pain. Young age (odds ratio [OR], 0.95; 95% CI, 0.93-0.98; P
PubMed ID
24703940 View in PubMed
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Concerns Related to the COVID-19 in Adult Norwegians during the First Outbreak in 2020: A Qualitative Approach.

https://arctichealth.org/en/permalink/ahliterature312154
Source
Int J Environ Res Public Health. 2021 04 19; 18(8):
Publication Type
Journal Article
Date
04-19-2021
Author
Laila Skogstad
Inger Schou-Bredal
Tore Bonsaksen
Trond Heir
Øivind Ekeberg
Tine Grimholt
Author Affiliation
Department of Research, Sunnaas Rehabilitation Hospital HF, 1453 Bjørnemyr, Norway.
Source
Int J Environ Res Public Health. 2021 04 19; 18(8):
Date
04-19-2021
Language
English
Publication Type
Journal Article
Keywords
Adult
COVID-19
Cross-Sectional Studies
Female
Humans
Male
Norway - epidemiology
Pandemics
SARS-CoV-2
Abstract
Concerns related to the first outbreak of the COVID-19 pandemic in the Norwegian population are studied in a cross-sectional web-survey conducted between 8 April and 20 May 2020. The qualitative thematic analysis of the open-ended question "Do you have other concerns related to the pandemic?", followed a six-step process. Concerns from 1491 informants were analyzed, 34% of women and 30% of men (p = 0.05) provided concerns. Respondents with higher educational level reported concerns more often (86% vs. 83%, p = 0.022). The qualitative analysis revealed five themes-society, health, social activities, personal economy and duration-and 13 sub-themes, mostly related to the themes "society" and "health" (724 and 704, respectively). Empathy for others was prominent, for society (nationally and globally), but also concerns related to infecting others and family members at risk for developing serious illness if infected. The responses to the open-ended question yielded additional information, beyond the information obtained from questions with pre-categorized response options, especially related to concerns about society and health. Themes arising from the qualitative analysis shed light on what are important concerns for people during the pandemic and this may serve as targeted measures for the authorities.
PubMed ID
33921705 View in PubMed
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Flight Anxiety Reported from 1986 to 2015.

https://arctichealth.org/en/permalink/ahliterature302013
Source
Aerosp Med Hum Perform. 2019 Apr 01; 90(4):384-388
Publication Type
Comparative Study
Journal Article
Date
Apr-01-2019
Author
Tine K Grimholt
Tore Bonsaksen
Inger Schou-Bredal
Trond Heir
Anners Lerdal
Laila Skogstad
Øivind Ekeberg
Source
Aerosp Med Hum Perform. 2019 Apr 01; 90(4):384-388
Date
Apr-01-2019
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Adult
Aerospace Medicine - statistics & numerical data - trends
Aged
Aged, 80 and over
Anxiety - epidemiology - psychology
Aviation - statistics & numerical data
Fear - psychology
Female
Humans
Male
Middle Aged
Norway - epidemiology
Phobic Disorders - epidemiology - psychology
Prevalence
Self Report - statistics & numerical data
Sex Factors
Young Adult
Abstract
BACKGROUND: Fear of flying is one of the most common phobias. It hinders people in performing their work and hampers family relations. Even though flight traffic has increased, there are new fears. Valid studies are needed to answer whether there have been changes in the prevalence of flight anxiety, are there sex differences in relation to fear of flying, use of alcohol, and tranquilizers, which situations cause the most flight anxiety, and whether the above factors have changed compared to a similar study from 1986.METHODS: A questionnaire was distributed to a representative random sample of the Norwegian population (N = 5500), where 36% answered. To assess flight anxiety across the time period, we used similar instruments to those we used in 1986.RESULTS: The prevalence of an assumed flight phobia decreased from 8% in 1986 to 3% in 2015. The percentage of those reported to never fly had decreased from 5% in 1986 to 0.5% in 2015. There were 11.0% who always used alcohol in 1986 and 7.5% in 2015 and 3% and 2%, respectively, always used tranquillizers. More women reported being afraid of both flying and other situations compared to men. Turbulence, unknown sounds, and fear of terror attacks caused the most anxiety.DISCUSSION: Flight anxiety still affects a considerable proportion of the Norwegian population and more women than men report that they are afraid of flying. However, in spite of methodology, people are significantly less afraid of flying than in 1986.Grimholt TK, Bonsaksen T, Schou-Bredal I, Heir T, Lerdal A, Skogstad L, Ekeberg Ø. Flight anxiety reported from 1986 to 2015. Aerosp Med Hum Perform. 2019; 90(4):384-388.
PubMed ID
30922426 View in PubMed
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General self-efficacy in the Norwegian population: Differences and similarities between sociodemographic groups.

https://arctichealth.org/en/permalink/ahliterature310752
Source
Scand J Public Health. 2019 Nov; 47(7):695-704
Publication Type
Journal Article
Date
Nov-2019
Author
Tore Bonsaksen
Anners Lerdal
Trond Heir
Øivind Ekeberg
Laila Skogstad
Tine K Grimholt
Inger Schou-Bredal
Author Affiliation
Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Source
Scand J Public Health. 2019 Nov; 47(7):695-704
Date
Nov-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Age Factors
Aged
Cross-Sectional Studies
Employment - statistics & numerical data
Female
Humans
Male
Middle Aged
Norway
Self Efficacy
Sex Factors
Socioeconomic Factors
Surveys and Questionnaires
Young Adult
Abstract
Aims: General self-efficacy (GSE) refers to optimistic self-beliefs of being able to perform and control behaviors, and is linked with various physical and mental health outcomes. Measures of self-efficacy are commonly used in health research with clinical populations, but are less explored in relationship to sociodemographic characteristics in general populations. This study investigated GSE in relation to sociodemographic characteristics in the general population in Norway. Methods: As part of a larger national survey, the GSE scale was administered to a general population sample, and 1787 out of 4961 eligible participants (response rate 36%) completed the scale. Group comparisons were conducted using independent t-tests and one-way analyses of variance. Linear regression analysis was used to examine factors independently associated with GSE. Results: GSE was lower for older compared to younger participants (p
PubMed ID
29417880 View in PubMed
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The last three days of life: a comparison of pain management in the young old and the oldest old hospitalised patients using the Resident Assessment Instrument for Palliative Care.

https://arctichealth.org/en/permalink/ahliterature277108
Source
Int J Older People Nurs. 2015 Dec;10(4):263-72
Publication Type
Article
Date
Dec-2015
Author
Simen Alexander Steindal
Inger Schou Bredal
Anette Hylen Ranhoff
Liv Wergeland Sørbye
Anners Lerdal
Source
Int J Older People Nurs. 2015 Dec;10(4):263-72
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analgesics - administration & dosage
Cross-Sectional Studies
Documentation
Female
Geriatric Assessment
Geriatric Nursing
Humans
Male
Norway
Nursing Assessment
Pain Management - methods
Pain Measurement
Palliative Care - methods
Retrospective Studies
Terminal Care - methods
Abstract
Pain is a common symptom in older patients at the end of life. Little research has evaluated pain management among the oldest hospitalised dying patients.
To compare the pain characteristics documented by healthcare workers for the young old and the oldest old hospitalised patients and the types of analgesics administered in the last three days of life.
A retrospective cross-sectional comparative study.
The study included 190 patients from a Norwegian general hospital: 101 young old patients (aged 65-84 years) and 89 oldest old patients (aged 85-100 years). Data were extracted from electronic patient records (EPRs) using the Resident Assessment Instrument for Palliative Care.
No significant differences were found between the young old and the oldest old patients with regard to pain characteristics. Pain intensity was poorly recorded in the EPRs. Most of the patients received adequate pain control. Morphine was the most frequently administered analgesic for dying patients. Compared to the oldest old patients, a greater proportion of the young old patients received paracetamol combined with codeine (OR = 3.25, 95% CI 1.02-10.40).
There appeared to be no differences in healthcare workers' documentation of pain characteristics in young old and oldest old patients, but young old patients were more likely to receive paracetamol in combination with codeine.
A limitation of the study is the retrospective design and that data were collected from a single hospital. Therefore, caution should be taken for interpretation of the results. The use of systematic patient-reported assessments in combination with feasible validated tools could contribute to more comprehensive documentation of pain intensity and improved pain control.
PubMed ID
25418556 View in PubMed
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Post-Traumatic Stress Disorder and Associated Factors during the Early Stage of the COVID-19 Pandemic in Norway.

https://arctichealth.org/en/permalink/ahliterature303914
Source
Int J Environ Res Public Health. 2020 12 09; 17(24):
Publication Type
Journal Article
Date
12-09-2020
Author
Tore Bonsaksen
Trond Heir
Inger Schou-Bredal
Øivind Ekeberg
Laila Skogstad
Tine K Grimholt
Author Affiliation
Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, 2418 Elverum, Norway.
Source
Int J Environ Res Public Health. 2020 12 09; 17(24):
Date
12-09-2020
Language
English
Publication Type
Journal Article
Keywords
Adult
COVID-19 - psychology
Female
Humans
Male
Norway - epidemiology
Pandemics
Stress Disorders, Post-Traumatic - epidemiology
Abstract
The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people's daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (=18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, post-traumatic stress reactions appear to be common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter.
PubMed ID
33317135 View in PubMed
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Prevalence and predictors of return to work in hospitalised trauma patients during the first year after discharge: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature135319
Source
Injury. 2012 Sep;43(9):1606-13
Publication Type
Article
Date
Sep-2012
Author
Kirsti Tøien
Laila Skogstad
Øivind Ekeberg
Hilde Myhren
Inger Schou Bredal
Author Affiliation
Division of Critical Care, Oslo University Hospital, Ulleval, Norway. kirsti.toien@uus.no
Source
Injury. 2012 Sep;43(9):1606-13
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anxiety - epidemiology - physiopathology - rehabilitation
Cohort Studies
Craniocerebral Trauma - epidemiology
Depression - epidemiology - physiopathology - rehabilitation
Employment - statistics & numerical data
Female
Humans
Injury Severity Score
Logistic Models
Male
Middle Aged
Norway - epidemiology
Prevalence
Prospective Studies
Questionnaires
Recovery of Function
Return to Work - psychology - statistics & numerical data
Wounds and Injuries - epidemiology - physiopathology - rehabilitation
Young Adult
Abstract
The aim of the study was to investigate the proportion of patients who return to work and predictors of return to pre-injury level of work participation the first year after trauma.
A prospective single-centre study of 188 patients aged 18-65 years with different degrees of injury severity was carried out in a trauma referral centre. All patients were working or studying full or part time before the injury. The first assessments were performed a median time of 27 days after discharge. Participation in work/education was measured 3 and 12 months after the first assessment with self-report questionnaires. The Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) were independent measures of anxiety, depression and post-traumatic stress symptoms (PTS) at baseline and 3 months. The Life Orientation Test Revised (LOT-R) measured optimism and pessimism at baseline. Predictors of return to work were identified by multiple logistic regression analysis.
After one year, 131 patients (70%) had returned to the same level of participation in work or education; 95 (50%) had returned at 3 months. Independent predictors of return to work after 3 months were low age, low Injury Severity Score (ISS) score, not needing ventilator treatment and low score for depression symptoms, adjusted for gender (Nagelkerke R square 0.38). Low ISS, absence of serious head injury, low HADS depression score and an optimistic life orientation remained significant predictors of return to work at the same level after 12 months (Nagelkerke R square 0.38). In addition, good physical function (SF-36 PF score>65) at 3 months was an independent predictor of return to work at 12 months in the 93 patients who had not returned to work at 3 months.
Independent predictors of return to work at 3 months were low age, low ISS and absence of depression symptoms. At 12 months, independent predictors of return to work were low ISS, low depression score and an optimistic life orientation. To promote early return to work, trauma patients might be screened for depression symptoms and pessimism, and intervention or treatment provided for those in need.
PubMed ID
21489524 View in PubMed
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Psychological Distress After Severe Trauma: A Prospective 1-Year Follow-Up Study of a Trauma Intensive Care Unit Population.

https://arctichealth.org/en/permalink/ahliterature96251
Source
J Trauma. 2010 Jul 20;
Publication Type
Article
Date
Jul-20-2010
Author
Kirsti Tøien
Hilde Myhren
Inger Schou Bredal
Laila Skogstad
Leiv Sandvik
Oivind Ekeberg
Author Affiliation
From the Intensive Care Unit (K.T., H.M.) and Department of Nursing Research (K.T.), Oslo University Hospital, Ulleval, Oslo, Norway; Institute of Nursing Science (K.T., I.S.B.), Faculty of Medicine, University of Oslo, Ulleval, Oslo, Norway; Unit of Breast and Endocrine surgery (I.S.B.), Oslo University Hospital, Ulleval, Oslo, Norway; Emergency Department and Department of Nursing Research (L.S.), Oslo University Hospital, Ulleval, Oslo, Norway; Section of Epidemiology and Biostatistics (L.S.), Oslo University Hospital, Ulleval, Oslo, Norway; Department of Acute Medicine (O.E.), Oslo University Hospital, Ulleval, Oslo, Norway; and Department of Behavioral Sciences in Medicine (O.E.), Faculty of Medicine, University of Oslo, Ulleval, Oslo, Norway.
Source
J Trauma. 2010 Jul 20;
Date
Jul-20-2010
Language
English
Publication Type
Article
Abstract
BACKGROUND:: The aim of the study was to investigate the level of psychologic distress after trauma and intensive care unit (ICU) stay, memory from the ICU, and predictors for psychologic distress at 12 months. METHODS:: Prospective single center study in a trauma referral center for Eastern and Southern Norway. Participants were 150 trauma patients treated in an ICU for >24 hours. Assessments were performed after discharge, at 3 months, and at 12 months using the Impact of Event Scale, Hospital Anxiety and Depression Scale, ICU memory tool, and Life Orientation Test-Revised. RESULTS:: At baseline, the mean Impact of Event scores were 22.7 decreasing to 18.4 at 12 months (p = 0.039). At 1-year follow-up, mean anxiety scores were 5.5 (95% confidence interval [CI]: 4.6-6.4) and depression scores 3.8 (95% CI: 3.1-4.5). Factual memories from ICU (odds ratio [OR] 6.58, [95% CI: 2.01-21.52], p = 0.002), low educational level (OR 0.29, [95% CI: 0.10-0.86] p = 0.025), not having care of children (OR 0.14, [95% CI: 0.04-0.47] p = 0.002), and female gender (OR 2.95, [95% CI: 1.04-8.34] p = 0.042) predicted posttraumatic stress symptoms at 12 months. Anxiety at 12 months was predicted only by pessimism (OR 0.83, [95% CI: 0.75-0.93] p = 0.001). Depression at 12 months was predicted by being out of work before the injury (OR 3.64, [95% CI: 1.11-11.94] p = 0.033) and pessimism (OR 0.83, [95% CI: 0.73-0.93] p = 0.002). CONCLUSIONS:: Many patients suffer from posttraumatic stress symptoms, anxiety, and depression after trauma and ICU stay. The strongest predictors of psychologic distress 12 months after discharge were having factual memories from the ICU stay, being pessimistic, and being out of work before the injury.
PubMed ID
20664371 View in PubMed
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14 records – page 1 of 2.