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Anaemia, but not iron deficiency, is associated with clinical symptoms and quality of life in patients with severe heart failure and palliative home care: A substudy of the PREFER trial.

https://arctichealth.org/en/permalink/ahliterature294209
Source
Eur J Intern Med. 2017 Dec; 46:35-40
Publication Type
Journal Article
Date
Dec-2017
Author
Kurt Boman
Mona Olofsson
Ann-Charlotte R Bergman
Margareta Brännström
Author Affiliation
Research Unit, Department of Medicine, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Electronic address: kurt.boman@vll.se.
Source
Eur J Intern Med. 2017 Dec; 46:35-40
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Anemia - complications
Anxiety - epidemiology
Depression - epidemiology
Female
Heart Failure - mortality
Home Care Services
Hospitalization - statistics & numerical data
Humans
Iron - deficiency
Linear Models
Logistic Models
Male
Middle Aged
Palliative Care
Prospective Studies
Quality of Life
ROC Curve
Randomized Controlled Trials as Topic
Severity of Illness Index
Sweden
Abstract
To explore the relationships between anaemia or iron deficiency (ID) and symptoms, quality of life (QoL), morbidity, and mortality.
A post-hoc, non-prespecified, explorative substudy of the prospective randomized PREFER trial. One centre study of outpatients with severe HF and palliative need managed with advanced home care. Associations between anaemia, ID, and the Edmonton Symptom Assessment Scale (ESAS), Euro QoL (EQ-5D), Kansas City Cardiomyopathy Questions (KCCQ) were examined only at baseline but at 6months for morbidity and mortality.
Seventy-two patients (51 males, 21 females), aged 79.2±9.1years. Thirty-nine patients (54%) had anaemia and 34 had ID (47%). Anaemia was correlated to depression (r=0.37; p=0.001), anxiety (r=0.25; p=0.04), and reduced well-being (r=0.26; p=0.03) in the ESAS; mobility (r=0.33; p=0.005), pain/discomfort (r=0.27; p=0.02), and visual analogue scale of health state (r=-0.28; p=0.02) in the EQ-5D; and physical limitation (r=-0.27; p=0.02), symptom stability; (r=-0.43; p
PubMed ID
28899603 View in PubMed
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Care professional's experiences about using Liverpool Care Pathway in end-of-life care in residential care homes.

https://arctichealth.org/en/permalink/ahliterature295067
Source
Scand J Caring Sci. 2018 Mar; 32(1):299-308
Publication Type
Journal Article
Date
Mar-2018
Author
Sofia Andersson
Olav Lindqvist
Carl-Johan Fürst
Margareta Brännström
Author Affiliation
Department of Nursing, Umeå University, Umeå, Sweden.
Source
Scand J Caring Sci. 2018 Mar; 32(1):299-308
Date
Mar-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Decision Making
Female
Health Personnel - psychology
Homes for the Aged - statistics & numerical data
Humans
Male
Middle Aged
Nursing Homes - statistics & numerical data
Patient-Centered Care - organization & administration
Qualitative Research
Quality of Health Care - organization & administration
Quality of Life - psychology
Sweden
Terminal Care - psychology
Abstract
Residential care homes (RCHs) play an important role in end-of-life care, being the most common place of death for elderly people in several European countries. Care pathways such as the Liverpool Care Pathway for the Dying Patient (LCP) are used to improve and ensure quality care at the end of life. There is a lack of scientific evidence supporting the use of care pathways.
A descriptive qualitative study.
The aim was to describe care professionals' experiences of using the Liverpool Care Pathway for the Dying Patient in the care of dying residents in residential care homes.
Five focus group interviews and two individual interviews with enrolled nurses (n = 10), Registered Nurses (n = 9) and general practitioners (n = 5) were carried out and analysed using qualitative content analysis.
Care professionals expressed that they became confident through a shared approach to care, were supported to tailor the care according to the residents' individual needs, were supported to involve family members in decision-making and care and became more aware of the care environment.
The results of this study indicate that the LCP might be a useful tool for care professionals in improving end-of-life care in RCHs through increased attention to the goals of care, the individual needs of residents and family involvement.
PubMed ID
28664584 View in PubMed
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Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.

https://arctichealth.org/en/permalink/ahliterature278756
Source
Int Emerg Nurs. 2015 Jul;23(3):254-9
Publication Type
Article
Date
Jul-2015
Author
Helena Nord-Ljungquist
Margareta Brännström
Katarina Bohm
Source
Int Emerg Nurs. 2015 Jul;23(3):254-9
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Cardiopulmonary Resuscitation - standards
Communication
Emergency Medical Service Communication Systems
Guideline Adherence
Heart Arrest - therapy
Humans
Pilot Projects
Retrospective Studies
Sweden
Telephone
Abstract
In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions.
We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design.
If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR.
Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered.
PubMed ID
25680743 View in PubMed
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A cost-effectiveness study of person-centered integrated heart failure and palliative home care: Based on a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature278465
Source
Palliat Med. 2016 Mar;30(3):296-302
Publication Type
Article
Date
Mar-2016
Author
Klas-Göran Sahlen
Kurt Boman
Margareta Brännström
Source
Palliat Med. 2016 Mar;30(3):296-302
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cost-Benefit Analysis
Delivery of Health Care, Integrated - economics - standards
Female
Health Care Costs
Heart Failure - therapy
Home Care Services - economics - organization & administration - standards
Humans
Male
Middle Aged
Palliative Care - economics - organization & administration - standards
Person-Centered Therapy - economics - organization & administration - standards
Quality of Life
Quality-Adjusted Life Years
Sweden
Abstract
Previous economic studies of person-centered palliative home care have been conducted mainly among patients with cancer. Studies on cost-effectiveness of advanced home care for patients with severe heart failure are lacking when a diagnosis of heart failure is the only main disease as the inclusion criterion.
To assess the cost-effectiveness of a new concept of care called person-centered integrated heart failure and palliative home care.
A randomized controlled trial was conducted from January 2011 to 2013 at a center in Sweden. Data collection included cost estimates for health care and the patients' responses to the EQ-5D quality of life instrument.
Patients with chronic and severe heart failure were randomly assigned to an intervention (n?=?36) or control (n?=?36) group. The intervention group received the Palliative Advanced Home Care and Heart Failure Care intervention over 6?months. The control group received the same care that is usually provided by a primary health care center or heart failure clinic at the hospital.
EQ-5D data indicated that the intervention resulted in a gain of 0.25 quality-adjusted life years, and cost analysis showed a significant cost reduction with the Palliative Advanced Home Care and Heart Failure Care intervention. Even if costs for staffing are higher than usual care, this is more than made up for by the reduced need for hospital-based care. This intervention made it possible for the county council to use €50,000 for other needs.
The Palliative Advanced Home Care and Heart Failure Care working mode saves financial resources and should be regarded as very cost-effective.
PubMed ID
26603186 View in PubMed
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Effectiveness of the Liverpool care pathway for the dying in residential care homes: An exploratory, controlled before-and-after study.

https://arctichealth.org/en/permalink/ahliterature276408
Source
Palliat Med. 2016 Jan;30(1):54-63
Publication Type
Article
Date
Jan-2016
Author
Margareta Brännström
Carl Johan Fürst
Carol Tishelman
Max Petzold
Olav Lindqvist
Source
Palliat Med. 2016 Jan;30(1):54-63
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Critical Pathways
Female
Homes for the Aged - organization & administration
Humans
Male
Middle Aged
Surveys and Questionnaires
Sweden
Terminal Care - organization & administration - standards
Abstract
Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, are lacking.
To compare the effects of the Liverpool Care Pathway for the Dying Patient and usual care on patients' symptom distress and well-being during the last days of life, in residential care homes.
Exploratory, controlled before-and-after study. During a 15-month baseline, usual care was carried out in two areas. During the following 15-months, usual care continued in the control area, while residential care home staff implemented Liverpool Care Pathway for the Dying Patient use in the intervention area. The intervention was evaluated by family members completing retrospective symptom assessments after the patient's death, using the Edmonton Symptom Assessment System and Views of Informal Carers - Evaluation of Services.
Patients who died at all 19 residential care homes in one municipality in Sweden.
Shortness of breath (estimate?=?-2.46; 95% confidence interval?=?-4.43 to -0.49) and nausea (estimate?=?-1.83; 95% confidence interval?=?-3.12 to -0.54) were significantly reduced in Edmonton Symptom Assessment System in patients in the intervention compared to the control area. A statistically significant improvement in shortness of breath was also found on the Views of Informal Carers - Evaluation of Services item (estimate?=?-0.47; 95% confidence interval?=?-0.85 to -0.08).
When implemented with adequate staff training and support, the Liverpool Care Pathway for the Dying Patient may be a useful tool for providing end-of-life care of elderly people at the end of life in non-cancer settings.
PubMed ID
25986540 View in PubMed
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Effects of person-centred and integrated chronic heart failure and palliative home care. PREFER: a randomized controlled study.

https://arctichealth.org/en/permalink/ahliterature264278
Source
Eur J Heart Fail. 2014 Oct;16(10):1142-51
Publication Type
Article
Date
Oct-2014
Author
Margareta Brännström
Kurt Boman
Source
Eur J Heart Fail. 2014 Oct;16(10):1142-51
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Disease
Delivery of Health Care, Integrated - methods - organization & administration
Female
Heart Failure - physiopathology - psychology - therapy
Home Care Services
Hospitalization - statistics & numerical data
Humans
Male
Outcome Assessment (Health Care)
Palliative Care - methods
Patient-Centered Care - methods
Quality of Life
Sweden
Abstract
We evaluated the outcome of person-centred and integrated Palliative advanced home caRE and heart FailurE caRe (PREFER) with regard to patient symptoms, health-related quality of life (HQRL), and hospitalizations compared with usual care.
From January 2011 to October 2012, 36 (26 males, 10 females, mean age 81.9?years) patients with chronic heart failure (NYHA class III-IV) were randomized to PREFER and 36 (25 males, 11 females, mean age 76.6?years) to the control group at a single centre. Prospective assessments were made at 1, 3, and 6 months using the Edmonton Symptom Assessment Scale, Euro Qol, Kansas City Cardiomyopathy Questionnaire, and rehospitalizations. Between-group analysis revealed that patients receiving PREFER had improved HRQL compared with controls (57.6?±?19.2 vs. 48.5?±?24.4, age-adjusted P-value?=?0.05). Within-group analysis revealed a 26% improvement in the PREFER group for HRQL (P?=?0.046) compared with 3% (P?=?0.82) in the control group. Nausea was improved in the PREFER group (2.4?±?2.7 vs. 1.7?±?1.7, P?=?0.02), and total symptom burden, self-efficacy, and quality of life improved by 18% (P?=?0.035), 17% (P?=?0.041), and 24% (P?=?0.047), respectively. NYHA class improved in 11 of the 28 (39%) PREFER patients compared with 3 of the 29 (10%) control patients (P?=?0.015). Fifteen rehospitalizations (103?days) occurred in the PREFER group, compared with 53 (305?days) in the control group.
Person-centred care combined with active heart failure and palliative care at home has the potential to improve quality of life and morbidity substantially in patients with severe chronic heart failure.
NCT01304381.
PubMed ID
25159126 View in PubMed
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End-of-life care in residential care homes: a retrospective study of the perspectives of family members using the VOICES questionnaire.

https://arctichealth.org/en/permalink/ahliterature287416
Source
Scand J Caring Sci. 2017 Mar;31(1):72-84
Publication Type
Article
Date
Mar-2017
Author
Sofia Andersson
Olav Lindqvist
Carl-Johan Fürst
Margareta Brännström
Source
Scand J Caring Sci. 2017 Mar;31(1):72-84
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Family - psychology
Female
Health Care Surveys
Homes for the Aged - statistics & numerical data
Humans
Male
Middle Aged
Nursing Homes - statistics & numerical data
Palliative Care - organization & administration
Quality of Health Care - statistics & numerical data
Retrospective Studies
Surveys and Questionnaires
Sweden
Terminal Care - organization & administration
Abstract
In Europe, residential care homes (RCHs) are replacing hospitals as the place where death occurs, and they play an important role in end-of-life (EOL) care.
The aim was to describe the quality of care during the last 3 months and last 3 days of life of those who died in RCHs as reported by family members. We also investigated whether there were differences in the EOL care of younger patients (
PubMed ID
26987286 View in PubMed
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Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: a pilot study.

https://arctichealth.org/en/permalink/ahliterature146091
Source
Eur J Cardiovasc Nurs. 2010 Sep;9(3):168-74
Publication Type
Article
Date
Sep-2010
Author
Marja-Leena Kristofferzon
Ingela Johansson
Margareta Brännström
Eva Arenhall
Amir Baigi
David Brunt
Bengt Fridlund
Ulrica Nilsson
Sylvi Persson
Mikael Rask
Inger Wieslander
Bodil Ivarsson
Author Affiliation
Department of Caring Science and Sociology, University of Gävle, SE-801 76 Gävle, Sweden. mko@hig.se
Source
Eur J Cardiovasc Nurs. 2010 Sep;9(3):168-74
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Arousal - physiology
Factor Analysis, Statistical
Female
Heart Diseases - physiopathology - psychology
Humans
Male
Penile Erection - physiology
Pilot Projects
Psychometrics
Quality of Life
Questionnaires
Sexual Behavior
Sweden
Abstract
As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required.
The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.
A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.
Two separate factor analyses each revealed a two-factor structure on both occasions: "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test-retest values for all but one question exceeded 0.70.
The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.
PubMed ID
20071238 View in PubMed
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Experiences of surviving a cardiac arrest after therapeutic hypothermia treatment. An interview study.

https://arctichealth.org/en/permalink/ahliterature292602
Source
Int Emerg Nurs. 2018 01; 36:34-38
Publication Type
Journal Article
Date
01-2018
Author
Margareta Brännström
Camilla Niederbach
Ann-Charlotte Rödin
Author Affiliation
Department of Nursing, Campus Skellefteå, Umeå University, Sweden. Electronic address: margareta.brannstrom@umu.se.
Source
Int Emerg Nurs. 2018 01; 36:34-38
Date
01-2018
Language
English
Publication Type
Journal Article
Keywords
Adaptation, Psychological
Adult
Aged
Attitude to Death
Female
Heart Arrest - complications - therapy
Humans
Hypothermia, Induced - methods - psychology
Interviews as Topic
Life Change Events
Male
Middle Aged
Qualitative Research
Survivors - psychology
Sweden
Abstract
Cardiac arrest (CA) is often associated with high mortality. In Sweden, it is reported that 13-52 per 100,000 people suffer out-of-hospital CA, and survival to one month is 2-14%.
This study aimed to describe people's experiences of surviving a CA after therapeutic hypothermia treatment.
A descriptive qualitative design was used. Data were collected through individual interviews with seven CA survivors. The collected data were analyzed using qualitative content analysis.
The analysis resulted in six subthemes and three emerging themes. The themes were "Dealing with issues of mortality", "Living a changed life", and "Being confident with health care and family members".
Surviving a CA after therapeutic hypothermia treatment means having to deal with issues of mortality, and these patients face a turning point in life. The near-death event can create regression or progression in ethos among these patients.
This study implies that persons who have survived a CA need support to cope. One way to provide support might be to initially establish an individualized health care plan, including bringing up existential issues and involving family members in such conversations.
PubMed ID
28988657 View in PubMed
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Interaction between tele-nurses and callers with an evolving myocardial infarction: Consequences for level of directed care.

https://arctichealth.org/en/permalink/ahliterature310571
Source
Eur J Cardiovasc Nurs. 2019 10; 18(7):545-553
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-2019
Author
Maria Ericsson
Karin H Ängerud
Margareta Brännström
Sofia S Lawesson
Anna Strömberg
Ingela Thylén
Author Affiliation
Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Source
Eur J Cardiovasc Nurs. 2019 10; 18(7):545-553
Date
10-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Communication
Emergency Medical Services - standards
Female
Humans
Male
Middle Aged
Myocardial Infarction - diagnosis - nursing
Nurse-Patient Relations
Nursing Care - standards
Practice Guidelines as Topic
Sweden
Telemedicine - standards
Abstract
Rapid contact with emergency medical services is imperative to save the lives of acute myocardial infarction patients. However, many patients turn to a telehealth advisory nurse instead, where the delivery of urgent and safe care largely depends on how the interaction in the call is established.
The purpose of this study was to explore the interaction between tele-nurses and callers with an evolving myocardial infarction after contacting a national telehealth advisory service number as their first medical contact.
Twenty men and 10 women (aged 46-89 years) were included. Authentic calls were analysed using inductive content analysis.
One overall category, Movement towards directed level of care, labelled the whole interaction between the tele-nurse and the caller. Four categories conceptualised the different interactions: a distinct, reasoning, indecisive or irrational interaction. The interactions described how tele-nurses and callers assessed and elaborated on symptoms, context and actions. The interaction was pivotal for progress in the dialogue and affected the achievement of mutual understanding in the communicative process. An indecisive or irrational interaction could increase the risk of failing to recommend or call for acute care.
The interaction in the communication could either lead or mislead the level of care directed in the call. This study adds new perspectives to the communicative process in the acute setting in order to identify a myocardial infarction and the level of urgency from both individuals experiencing myocardial infarction and professionals in the health system.
Notes
CommentIn: Eur J Cardiovasc Nurs. 2020 Aug;19(6):462-464 PMID 32323572
PubMed ID
31067981 View in PubMed
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15 records – page 1 of 2.