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Olinder, Anna Lindholm, PhD
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Publications (10 of 18) Show all publications
Brorsson, A. L., Leksell, J., Franko, M. A. & Olinder, A. L. (2019). A person-centered education for adolescents with type 1 diabetes: A randomized controlled trial. Pediatric Diabetes, 20(7), 986-996
Open this publication in new window or tab >>A person-centered education for adolescents with type 1 diabetes: A randomized controlled trial
2019 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, no 7, p. 986-996Article in journal (Refereed) Published
Abstract [en]

Introduction: Young people with type 1 diabetes and their parents need to receive person-centered education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centered communication and reflection education model that can be used in educational program for young people with type 1 diabetes.

Objective: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents.

Methods: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for 12 months. The intervention group (n = 37) attended seven group training sessions over a period of 5 months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring.

Results: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at 12 months, favoring the intervention group (62 vs 70 mmol/mol, P = .009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after 12 months (P = .019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy.

Conclusions: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centered care in adolescents with type 1 diabetes.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
adolescent, diabetes mellitus, health education, parents, type 1
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:uu:diva-396698 (URN)10.1111/pedi.12888 (DOI)000489353900020 ()31268224 (PubMedID)
Funder
Swedish Child Diabetes FoundationSwedish Diabetes AssociationSven Jerring Foundation
Available from: 2019-11-08 Created: 2019-11-08 Last updated: 2019-11-08Bibliographically approved
Haas, J., Persson, M., Brorsson, A. L., Toft, E. H. & Olinder, A. L. (2017). Guided self-determination-young versus standard care in the treatment of young females with type 1 diabetes: study protocol for a multicentre randomized controlled trial. Trials, 18, Article ID 562.
Open this publication in new window or tab >>Guided self-determination-young versus standard care in the treatment of young females with type 1 diabetes: study protocol for a multicentre randomized controlled trial
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2017 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 18, article id 562Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Female adolescents with type 1 diabetes mellitus (T1DM) have the most unsatisfactory glycaemic control of all age groups and report higher disease burden, poorer perceived health, and lower quality of life than their male counterparts. Females with T1DM face an excess risk of all-cause mortality compared with men with T1DM. New methods are needed to help and support young females with T1DM to manage their disease. A prerequisite for successful diabetes management is to offer individualized, person-centred care and support the patient's own motivation. Guided self-determination (GSD) is a person-centred reflection and problem-solving method intended to support the patient's own motivation in the daily care of her diabetes and help develop skills to manage difficulties in diabetes self-management. GSD has been shown to improve glycaemic control and decrease psychosocial stress in young women with T1DM. The method has been adapted for adolescents and their parents, termed GSD-young (GSD-Y). The aim of this study was to evaluate whether an intervention with GSD-Y in female adolescents with T1DM leads to improved glycaemic control, self-management, treatment satisfaction, perceived health and quality of life, fewer diabetes-related family conflicts, and improved psychosocial self-efficacy.

METHODS/DESIGN: This is a parallel-group randomized controlled superiority trial with an allocation ratio of 1:1. One hundred female adolescents with T1DM, 15-20 years of age, and their parents (if < 18 years of age), will be included. The intervention group will receive seven individual GSD-Y education visits over 3 to 6 months. The control group will receive standard care including regular visits to the diabetes clinic. The primary outcome is level of glycaemic control, measured as glycosylated haemoglobin (HbA1c). Secondary outcomes include diabetes self-management, treatment satisfaction, perceived health and quality of life, diabetes-related family conflicts, and psychosocial self-efficacy. Data will be collected before randomization and at 6 and 12 months.

DISCUSSION: Poor glycaemic control is common in female adolescents and young adults with T1DM. Long-standing hyperglycaemia increases the risks for severe complications and may also have an adverse impact on the outcome of future pregnancies. In this study, we want to evaluate if the GSD-Y method can be a useful tool in the treatment of female adolescents with T1DM.

TRIAL REGISTRATION: Current controlled trials, ISRCTN57528404 . Registered on 18 February 2015.

Keywords
Adolescents, Female, Guided self-determination-young (GSD-Y), Intervention, Person-centred care, Type 1 diabetes
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:uu:diva-337473 (URN)10.1186/s13063-017-2296-6 (DOI)000416113700001 ()29178923 (PubMedID)
Available from: 2017-12-29 Created: 2017-12-29 Last updated: 2018-02-23Bibliographically approved
Brorsson, A. L., Olinder, A. L., Wikblad, K. & Viklund, G. (2017). Parent's perception of their children's health, quality of life and burden of diabetes: testing reliability and validity of 'Check your Health' by proxy.. Scandinavian Journal of Caring Sciences, 31(3), 497-504
Open this publication in new window or tab >>Parent's perception of their children's health, quality of life and burden of diabetes: testing reliability and validity of 'Check your Health' by proxy.
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 497-504Article in journal (Refereed) Published
Abstract [en]

AIM: To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years.

METHODS: One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later.

RESULTS: Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes.

CONCLUSIONS: The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.

Keywords
burden of diabetes, parents, perceived health, quality of life, type 1 diabetes
National Category
Other Medical Sciences
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-318152 (URN)10.1111/scs.12362 (DOI)000412401200008 ()27440173 (PubMedID)
Funder
Swedish Child Diabetes FoundationSwedish Diabetes Association
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2017-12-20Bibliographically approved
Rooth, E. & Olinder, A. L. (2016). Nurses’ experiences of giving care to children with autism spectrum disorder within somatic emergency care. Scientific Times Journal of Paediatrics, 1(1), 1-11
Open this publication in new window or tab >>Nurses’ experiences of giving care to children with autism spectrum disorder within somatic emergency care
2016 (English)In: Scientific Times Journal of Paediatrics, Vol. 1, no 1, p. 1-11Article in journal (Refereed) Published
Abstract [en]

Aims: To describe nurses’ experiences of giving care to children with autism spectrum disorder in a paediatric emergency care unit and to explore how the nurses had obtained their knowledge of the subject.

Background: Within somatic paediatric care, nurses frequently encounter children with autism spectrum disorder. Many parents of these children report a lack of knowledge about the diagnosis and difficulties in encounters with somatic care. According to Patricia Benner’s theory of learning, a skill is developed through education, tutoring and experience.

Design: A qualitative interview study. 

Method: Semi-structured interviews were held with ten nurses during the spring of 2015. Data was analysed by content analysis to find categories and codes corresponding to the study’s aims.

Findings: The findings present information regarding: 1) knowledge and experience; 2) the context in which the child finds itself, as well as an unsafe working environment for the nurses; 3) how the treatment and care of the child, among other things, is affected by information given by the parents about the diagnosis, and how the nurses feel in difficult situations; 4) interaction with the children, the parents and colleagues. The findings in this study mainly show the complexity in encounters with children with autism spectrum disorder and their parents and that nurses require further education. The nurses also give a number of suggestions for improvements that well concur with the literature.

Conclusion: To be able to care well for children with autism spectrum disorder, a combination of knowledge and experience is necessary.

Keywords
Children, Autism Spectrum Diagnosis, Emergency Care, Nursing, Interviews
National Category
Other Medical Sciences
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-318159 (URN)
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2017-03-24Bibliographically approved
Granström, T., Forsman, H., Olinder, A. L., Gkretsis, D., Eriksson, J. W., Granstam, E. & Leksell, J. (2016). Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting. Diabetes Research and Clinical Practice, 121, 157-165
Open this publication in new window or tab >>Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting
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2016 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, p. 157-165Article in journal (Refereed) Published
Abstract [en]

Aims: To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

Methods: In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

Results: The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

Conclusions: Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

Keywords
Patient-reported measurements, Diabetic macular edema, Anti-VEGF treatment, Visual function
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-313411 (URN)10.1016/j.diabres.2016.09.015 (DOI)000390460100020 ()27718374 (PubMedID)
Funder
Magnus Bergvall Foundation
Available from: 2017-01-30 Created: 2017-01-19 Last updated: 2017-11-29Bibliographically approved
Lindholm Olinder, A., Fischier, J., Fries, J., Alfonsson, S., Elvingson, V., Eriksson, J. W. & Leksell, J. (2015). A randomised wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes: a study protocol. BMC Nursing, 14, Article ID 61.
Open this publication in new window or tab >>A randomised wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes: a study protocol
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2015 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, article id 61Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

In order to manage the acute and long-term effects of living with a chronic disease such as diabetes, both medical treatment and good psychosocial support are needed. In this study, we wish to examine whether a psychological group intervention targeting people with poorly controlled type 1 diabetes can be helpful in augmenting quality of life while also lowering participants' HbA1c level. The group intervention will consist of a brief treatment developed from a branch of cognitive behavioural therapy called acceptance and commitment therapy, which is part of the so-called third wave of cognitive behavioural therapy. Common for these third-wave therapies, the focus is less on the content and restructuring of thoughts and more on the function of behaviour. Here, we describe the protocol and plans for study enrolment.

METHODS/DESIGN

This on-going study is designed as a randomised wait-list controlled trial. Eighty patients aged 26-55 years and with an HbA1c level >70 mmol/mol at the time of enrolment will be included.

DISCUSSION

In this study, we will assess the effect of starting acceptance and commitment therapy group treatment for patients with type 1 diabetes and its effect on glycaemic control and well-being.

TRIAL REGISTRATION

Current controlled trials: ISRCTN17006837, registered 12(th) January 2015.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-278192 (URN)10.1186/s12912-015-0101-y (DOI)26594131 (PubMedID)
Available from: 2016-02-24 Created: 2016-02-24 Last updated: 2017-11-30Bibliographically approved
Brorsson, A. L., Viklund, G., Örtqvist, E. & Lindholm Olinder, A. (2014). Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes?: A retrospective case-control study. Pediatric Diabetes, 16(7), 546-553
Open this publication in new window or tab >>Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes?: A retrospective case-control study
2014 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 16, no 7, p. 546-553Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI).

METHODS: This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events.

RESULTS: In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group.

CONCLUSIONS: This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis.

Keywords
adolescent; case-control studies; child; diabetes mellitus type 1; insulin infusion systems
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-239774 (URN)10.1111/pedi.12209 (DOI)000362550400009 ()25327782 (PubMedID)
Funder
Swedish Child Diabetes FoundationSwedish Diabetes Association
Available from: 2014-12-30 Created: 2014-12-30 Last updated: 2017-12-05Bibliographically approved
Saarinen, T., Fernström, L., Brorsson, A.-L. & Lindholm Olinder, A. (2014). Insulin pump therapy is perceived as liberating, but to many it can imply a sense of the diabetes made visible. European Diabetes Nursing, 11(2), 38-42
Open this publication in new window or tab >>Insulin pump therapy is perceived as liberating, but to many it can imply a sense of the diabetes made visible
2014 (English)In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 11, no 2, p. 38-42Article in journal (Refereed) Published
Abstract [en]

This study describes how adults with type 1 diabetes experience the transition from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII or ‘insulin pump’). The study is based on interviews in focus groups, with 11 persons with type 1 diabetes who had had CSII for at least one year, which were analysed using qualitative content analysis. The analysis resulted in three categories: life and health; involvement of others; and technology dependence. Participants' experiences are summarised in the theme ‘CSII is perceived as liberating, but also implies a sense of the diabetes made visible’. The transition resulted in changed life and health with greater freedom and flexibility, particularly in meal situations. The participants felt that their blood glucose was easier to control. Those around them reacted with curiosity, but some participants felt compelled to tell others that they had diabetes since the pump could be seen or heard. The participants found that coping with CSII in daily life was easier and more comfortable than they had expected. However, having to constantly be prepared for technical failure was experienced as cumbersome. All participants indicated that they were satisfied with their treatment and recommended it to others. Transition to CSII may be experienced as liberating, but might also imply a sense of the diabetes made visible. The results can be used in clinical practice, when advising about CSII. Being aware of both positive and negative experiences with CSII can contribute to better care for those already being treated with CSII.

National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-239776 (URN)10.1002/edn.246 (DOI)
Available from: 2014-12-30 Created: 2014-12-30 Last updated: 2017-12-05Bibliographically approved
Forsner, M., Berggren,, J., Masaba, J., Ekbladh, A. & Lindholm Olinder, A. (2014). Parents' experiences of caring for a child younger than two years of age treated with continuous subcutaneous insulin infusion. European Diabetes Nursing, 11(1), 7-12
Open this publication in new window or tab >>Parents' experiences of caring for a child younger than two years of age treated with continuous subcutaneous insulin infusion
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2014 (English)In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 11, no 1, p. 7-12Article in journal (Refereed) Published
Abstract [en]

Diabetes during infancy is uncommon and continuous subcutaneous insulin infusion (CSII) is the recommended treatment with such young children. However, this form of treatment has not been investigated previously from the perspective of the parents.

The aim of this study was to determine parents' experiences of caring for a child less than two years old who had diabetes mellitus and was being treated with CSII therapy.

Three pairs of parents were interviewed twice to elucidate their views on the initial period and on daily living. Data were submitted to qualitative content analysis and resulted in seven categories and one theme, the latter being: ‘The diabetes disease was threatening our baby's life, but then the insulin pump came as a rescuing, though challenging, angel’. Parents initially felt life had been turned upside down, but later they felt in control nearly all the time.

It was concluded that parents of infants with diabetes are in great need of support in order to manage the disease and CSII technology. The fear of losing control and the lack of relief lead to social isolation. Educating someone close to the family could be a valuable intervention.

Keywords
diabetes mellitus, parents, infant, child, insulin infusion system, qualitative study
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-224270 (URN)10.1002/edn.239 (DOI)
Available from: 2014-05-08 Created: 2014-05-08 Last updated: 2017-12-05Bibliographically approved
Brorsson, A. L., Leksell, J., Viklund, G. & Olinder, A. L. (2013). A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion: a study protocol. BMC Pediatrics, 13, 212
Open this publication in new window or tab >>A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion: a study protocol
2013 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, p. 212-Article in journal (Refereed) Published
Abstract [en]

Background:

Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment.

Methods/design:

This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment.

Discussion:

In this study, we will assess the effect of starting an CSII together with the model of GSD to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family.

Keywords
Type 1 diabetes, Continuous subcutaneous insulin infusion (CSII), Adolescence, Parental involvement, Person-centred care, Guided self-determination-Young (GSD-Y)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-218599 (URN)10.1186/1471-2431-13-212 (DOI)000329609400001 ()
Available from: 2014-02-13 Created: 2014-02-13 Last updated: 2017-12-06Bibliographically approved
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