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Milberg, A., Liljeroos, M. & Krevers, B. (2019). Can a single question about family members' sense of security during palliative care predict their well-being during bereavement?: A longitudinal study during ongoing care and one year after the patient's death. BMC Palliative Care, 18, Article ID 63.
Open this publication in new window or tab >>Can a single question about family members' sense of security during palliative care predict their well-being during bereavement?: A longitudinal study during ongoing care and one year after the patient's death
2019 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, article id 63Article in journal (Refereed) Published
Abstract [en]

BackgroundIt has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family members' sense of security during palliative care, and iii) to evaluate if family members' sense of security during ongoing palliative care predicts well-being during bereavement.MethodsBetween September 2009 and October 2010, 227 family members (of patients admitted to six Swedish palliative home care units) participated in the study (participation rate 75%) during ongoing care and 158 participated also 1 year after the patient's death (70%). They answered a single question regarding the family members' sense of security during the palliative care period. The question was constructed and validated by the researchers. Data were also collected using other questions and validated instruments and analysed stepwise with Generalized Linear Models (ordinal multinomial distribution and logit link).ResultsSixteen variables were positively related to family members' sense of security during ongoing palliative care. The five variables with the highest importance were selected into the model (listed in decreasing importance): Family members' mastery; nervousness and stress; self-efficacy; patient having gynaecological cancer; family members' perceived quality of life. Moreover, the family members' sense of security during ongoing palliative care predicted ten variables indicating their well-being 1 year after the patient's death, e.g. psychological well-being, complicated grief symptoms, health related quality of life.ConclusionsThe findings reveal possibilities to identify family members at risk of negative adjustment to bereavement in clinical practice and may help to develop interventions to support family members during ongoing palliative care.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Family members, Palliative care, Security, Bereavement
National Category
Nursing Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-391366 (URN)10.1186/s12904-019-0446-1 (DOI)000477619500002 ()31345200 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1621
Available from: 2019-09-04 Created: 2019-09-04 Last updated: 2019-09-04Bibliographically approved
Liljeroos, M. & Strömberg, A. (2019). Introducing nurse-led heart failure clinics in Swedish primary care settings. European Journal of Heart Failure, 21(1), 103-109
Open this publication in new window or tab >>Introducing nurse-led heart failure clinics in Swedish primary care settings
2019 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 21, no 1, p. 103-109Article in journal (Refereed) Published
Abstract [en]

AIM: According to clinical guidelines, it is recommended that patients with heart failure (HF) receive structured multidisciplinary care at nurse-led HF clinics in order to optimise treatment and avoid preventable readmissions. Today, there are HF clinics with specialist-trained nurses at almost all Swedish hospitals, but HF clinics remain scarce in primary care (PC). The aim of this study was two-fold: firstly, to evaluate the effects of systematically implementing nurse-led HF clinics in PC settings with regard to hospital healthcare utilisation and evidence-based HF treatment, and secondly to explore patients' experiences of HF clinics in PC.

METHODS AND RESULTS: The study had a pre-post design. Annual measurement were done between 2010-2017 regarding in-hospital healthcare consumption and medical treatment. Data from 2011-2017 after the implementation of HF clinics in PC in one county council Sweden were compared with baseline data collected before the implementation in 2010. The implementation of HF clinics in PC significantly reduced the number of HF-related hospital admissions by 27% (P < 0.001), HF hospital days by 27.3% (P < 0.001) and HF emergency room visits by 24% (P < 0.001). Further, patients were to a higher extent medically treated according to guidelines and satisfied with the care they received at the PC HF clinic.

CONCLUSION: Nurse-led HF clinics in PC seem to be effective in reducing the need for in-hospital care and provide high quality person-centred care.

Keywords
Healthcare utilisation, Heart failure management, Nurse-led heart failure clinics, Primary care
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-364863 (URN)10.1002/ejhf.1329 (DOI)000459741600016 ()30338881 (PubMedID)
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-03-18Bibliographically approved
Allemann, H., Thylén, I., Ågren, S., Liljeroos, M. & Strömberg, A. (2019). Perceptions of Information and Communication Technology as Support for Family Members of Persons With Heart Failure: Qualitative Study. Journal of Medical Internet Research, 21(7), Article ID e13521.
Open this publication in new window or tab >>Perceptions of Information and Communication Technology as Support for Family Members of Persons With Heart Failure: Qualitative Study
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2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 7, article id e13521Article in journal (Refereed) Published
Abstract [en]

Background: Heart failure (HF) affects not only the person diagnosed with the syndrome but also family members, who often have the role of informal carers. The needs of these carers are not always met, and information and communications technology (ICT) could have the potential to support them in their everyday life. However, knowledge is lacking about how family members perceive ICT and see opportunities for this technology to support them.

Objective: The aim of this study was to explore the perceptions of ICT solutions as supportive aids among family members of persons with HF.

Methods: A qualitative design was applied. A total of 8 focus groups, comprising 23 family members of persons affected by HF, were conducted between March 2015 and January 2017. Participants were recruited from 1 hospital in Sweden. A purposeful sampling strategy was used to find family members of persons with symptomatic HF from diverse backgrounds. Data were analyzed using qualitative content analysis.

Results: The analysis revealed 4 categories and 9 subcategories. The first category, about how ICT could provide relevant support, included descriptions of how ICT could be used for communication with health care personnel, for information and communication retrieval, plus opportunities to interact with persons in similar life situations and to share support with peers and extended family. The second category, about how ICT could provide access, entailed how ICT could offer solutions not bound by time or place and how it could be both timely and adaptable to different life situations. ICT could also provide an arena for family members to which they might not otherwise have had access. The third category concerned how ICT could be too impersonal and how it could entail limited personal interaction and individualization, which could lead to concerns about usability. It was emphasized that ICT could not replace physical meetings. The fourth category considered how ICT could be out of scope, reflecting the fact that some family members were generally uninterested in ICT and had difficulties envisioning how it could be used for support. It was also discussed as more of a solution for the future.

Conclusions: Family members described multiple uses for ICT and agreed that ICT could provide access to relevant sources of information from which family members could potentially exchange support. ICT was also considered to have its limitations and was out of scope for some but with expected use in the future. Even though some family members seemed hesitant about ICT solutions in general, this might not mean they are unreceptive to suggestions about their usage in, for example, health care. Thus, a variety of factors should be considered to facilitate future implementations of ICT tools in clinical practice.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC, 2019
Keywords
family, caregivers, telemedicine, perception, heart failure, social support, focus groups, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-391943 (URN)10.2196/13521 (DOI)000476841200001 ()31313662 (PubMedID)
Funder
Swedish Research Council, K2015-99X -22124-04-4Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4100Medical Research Council of Southeast Sweden (FORSS), FORSS-665001
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-08-29Bibliographically approved
Allemann, H., Liljeroos, M., Thylen, I. & Stromberg, A. (2018). Information and Communication Technology (ICT) as a supportive aid; perceptions amongst family caregivers to persons with heart failure. European Journal of Cardiovascular Nursing, 17(suppl 1), 100-100
Open this publication in new window or tab >>Information and Communication Technology (ICT) as a supportive aid; perceptions amongst family caregivers to persons with heart failure
2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no suppl 1, p. 100-100Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sage Publications, 2018
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
urn:nbn:se:uu:diva-366311 (URN)10.1177/1474515118787764 (DOI)000440339600168 ()
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2018-11-20 Created: 2018-11-20 Last updated: 2018-11-20Bibliographically approved
Liljeroos, M., Ågren, S., Jaarsma, T. & Stromberg, A. (2017). Dialogues between nurses, patients with heart failure and their partners during a dyadic psychoeducational intervention: a qualitative study. BMJ Open, 7(12), Article ID e018236.
Open this publication in new window or tab >>Dialogues between nurses, patients with heart failure and their partners during a dyadic psychoeducational intervention: a qualitative study
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 12, article id e018236Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe nurses’ documentation of the content in a psychoeducational intervention inspired by Stuifbergen’s model addressing cognitive, supportive and behavioural needs of patient–partner dyads affected by heart failure.

Design: A descriptive qualitative design was used analysing nurses’ documentation in a dialogue guide based on a health promotion model.

Settings: The dialogue guide was used during three nurse-led sessions at two heart failure clinics in Sweden with patients affected with heart failure and their partners during the years 2005–2008.

Participants: The dialogue guides from 71 patient–partner dyads were analysed using direct deductive content analyses. Patients’ mean age was 69 years and 31% were female, partners’ mean age was 67 years and 69% were female.

Results: The findings supported the conceptual health promotion model and identified barriers, recourses and self-efficacy described by the dyads within each category.

Conclusion: The dyads described that during the sessions, they had gained enhanced knowledge and greater confidence to handle their life situation and expressed that they needed psychoeducational support during the whole illness trajectory. The results may guide and help to improve content and quality when caring for patients affected with heart failure and their partners and also when designing new interventions.

Trial registration number: NCT02398799; Post-results.

Keywords
communication, content analysis, dyad, family, heart failure, nurses, nursing, patient education, self-care, support
National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-342500 (URN)10.1136/bmjopen-2017-018236 (DOI)000423826700115 ()29247098 (PubMedID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-03-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7957-8600

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