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  • 1.
    Andersson, Henrik
    et al.
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Axelsson, Christer
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Larsson, Anna
    Ambulance Department, South Älvsborg's Hospital, Borås, Sweden.
    Bremer, Anders
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; Linnaeus University, Faculty of Health and Life Sciences, Växjö, Sweden.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Bång, Angela
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Herlitz, Johan
    University of Borås, PreHospen - Centre for Prehospital Researc Borås, Sweden; University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.
    Ljungström, Lars
    Skaraborg Hospital, Infection Disease Department, Skövde, Sweden.
    The early chain of care in bacteraemia patients: Early suspicion, treatment and survival in prehospital emergency care.2018In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 36, no 12, p. 2211-2218, article id S0735-6757(18)30279-1Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28days after admission to hospital. Furthermore, the long-term outcome was assessed.

    METHODS: This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records.

    RESULTS: In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code "fever, infection" more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p<0.0001).

    CONCLUSION: This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years.

  • 2.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Livskvalitet och sexualitet efter stomioperation2010Conference paper (Refereed)
    Abstract [sv]

    Fysiska och psykiska besvär kan påverka hälsan och i förlängningen sexualiteten. Ett exempel är patienten som har diarréer, ont i magen och förlorar vikt och energi orsakat av en inflammatorisk tarmsjukdom.  Medan att ha en cancer i colon eller rektum ger oftast inga besvärliga symtom, inte i början. Men för patienten med cancer påverkar behandlingen i form av strålning, kirurgi och cytostatika bla. sexualiteten.

    Det är viktigt att sjuksköterskan är medveten om patienten påverkas även sexuellt. Sjuksköterskan kan vanligtvis prata med patienten om privata saker som tex. avföringsvanor och om döden. Sjuksköterskan skall även ges information om sexualiteten, och frågor skall kunna ställas av patienten och eventuell partner. Sexualiteten betyder olika mycket för olika personer och vid olika tidpunkter i livet. Att negligera patientens behov om att prata om detta eller resonera som att de får någon annan ta upp om (läkaren) är inte rätt. Människan är en sexuell varelse.

  • 3.
    Khorram-Manesh, Amir
    et al.
    Göteborgs universitet .
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology. University West, Department of Social and Behavioural Studies, Division of Social Work and Social Pedagogy.
    Carlström, Eric
    Göteborgs universitet .
    Two Validated Ways of Improving the Ability of Decision-Making in Emergencies: Results from a Literature Review2016In: Bulletin of Emergency and Trauma, ISSN 2322-2522, Vol. 4, no 4, p. 186-196Article in journal (Refereed)
    Abstract [en]

    The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.

  • 4.
    Onerup, Aron
    et al.
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Angerås, Ulf
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Bock, David
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Börjesson, Mats
    Karolinska University Hospital, Swedish School of Sport and Health Sciences and Karolinska University Hospital,.
    Fagevik Olsén, Monika
    Sahlgrenska Academy at Gothenburg University, Department of Gastrosurgical Research and Education.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Law, Economics, Statistics and Politics. University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Haglind, Eva
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Nilsson, Hanna
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Angenete, Eva
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    The preoperative level of physical activity is associated to the postoperative recovery after elective cholecystectomy: A cohort study2015In: International Journal of Surgery, ISSN 1743-9191, E-ISSN 1743-9159, Vol. 19, no July, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Introduction There is an increasing interest in the role of preoperative physical activity for postoperative recovery. The effect of preoperative physical activity and recovery after cholecystectomy is unknown. The aim of this study was to evaluate the association of self-reported leisure-time preoperative physical activity with postoperative recovery and complications after elective cholecystectomy due to gallstone disease. Methods Prospective observational cohort study with 200 patients scheduled to undergo elective cholecystectomy. Level of self-assessed leisure-time physical activity was compared with recovery. Results Regular physical activity was associated with a higher degree of return to work within three weeks post-operatively (relative chance (RC) 1.26, p = 0.040); with a higher chance of leaving hospital within one day post-op (RC 1.23, p = 0.001), as well as with better mental recovery (RC 1.18, p = 0.049), compared to physically inactive. No statistically significant association was seen with return to work within one week or with self-assessed physical recovery. Discussion In clinical practice, evaluating the patients’ level of physical activity is feasible, and may potentially be used to identify patients being more suitable for same-day surgery. Given the study design, the results from this study cannot prove causality. Conclusion The present study shows that the preoperative leisure-time physical activity-level, is positively associated with less sick leave, a shorter hospital stay and with better mental recovery, three weeks post-elective cholecystectomy. We recommend assessing the physical activity-level preoperatively for prognostic reasons. If preoperative/postoperative physical training will increase recovery remains to be shown in a randomized controlled study.

  • 5.
    Persson, E.
    et al.
    University of Borås, School of Health sciences.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Carlsson, E.
    Göteborg University, The Sahlgrenska Academy, Institute of Health and Care Sciences.
    Hallén, A. M.
    Sahlgrenska University Hospital.
    Lindholm, E.
    Sahlgrenska University Hospital.
    Stoma-related complications and stoma size – a 2-year follow up2010In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 12, no 10, p. 971-976Article in journal (Refereed)
    Abstract [en]

    Abstract Aim The purpose of the study was to prospectively describe stoma configuration and evaluate stoma-related complications and their association with possible risk factors. Method All elective patients (n = 180) operated on with a formation of colostomy, ileostomy or loop-ileostomy between 2003 and 2005 were included in the study. Follow up took place on the ward postoperatively and five times during 2 years after discharge. On these occasions the diameter and height of the stoma were recorded. Complications such as peristomal skin problems, necrosis, leakage caused by a low stoma, stenosis, granuloma formation, prolapse and peristomal hernia formation were evaluated. Results Most complications occurred 2 weeks after discharge; 53% of patients with colostomies, 79% with loop-ileostomies and 70% of patients with end-ileostomy had one or more complications. The most common complication was skin problems and it was most common in patients with end-ileostomies (60%) and loop-ileostomies (73%). Postoperatively at ward review, the most common complication was necrosis, which occurred in 20% of patients with a colostomy. Granuloma formation was most frequent in colostomies. Almost all patients with an end-ileostomy and loop-ileostomy with a height lower than 20 mm had leakage and skin problems as had half of the patients with a colostomy height lower than 5 mm. Conclusion To prevent stoma-related complications, it is important to produce an adequate height of the stoma, with early and regular follow ups and adjustment of the appliance. To work closely in collaboration with the colorectal surgeons is of utmost important to provide feedback and in turn, to improve stoma outcome.

  • 6.
    Rönnberg, Katarina
    et al.
    Göteborg University, Department of Orthopaedics, Sahlgrenska University Hospital.
    Lind, B.
    Göteborg University, Department of Orthopaedics, Sahlgrenska University Hospital.
    Zoega, B.
    Department of Orthopaedics, Landspitali University Hospital, Reykjavik, Iceland.
    Gadeholt-Göthlin, G.
    Göteborg University, Sahlgrenska University Hospital, Department of Radiology .
    Halldin, K.
    Göteborg University, Department of Orthopaedics, Sahlgrenska University Hospital.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Brisby, H.
    Göteborg University, Department of Orthopaedics, Sahlgrenska University Hospital.
    Peridural scar and its relation to clinical outcome: A randomised study on surgically treated lumbar disc herniation patients2008In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 17, no 12, p. 1714-1720Article in journal (Refereed)
    Abstract [en]

    A prospective randomised 2-year follow-up study on patients undergoing lumbar disc herniation surgery. The objective was to investigate the relationship between peridural scarring and clinical outcome, the scar development 6 and 24 months postoperatively by using MRI, and if ADCON-L (a bioresorbable carbohydrate polymer gel) has an effect on scar size and/or improve patients' outcome after lumbar disc herniation surgery. The association between peridural scarring and recurrent pain after lumbar disc herniation surgery is debated. Numerous materials have been used in attempts to prevent or reduce postoperative peridural scarring; however, there are conflicting data regarding the clinical effects. The study included 119 patients whose mean age was 39 years (18-66); 51 (47%) were women. Sixty patients (56%) were perioperatively randomised to receive ADCON-L, and 48 (44%) served as controls. All patients underwent MRI at 6 and 24 months postoperatively, and an independent radiologist graded the size, location and development of the scar, by using a previously described scoring system. Pre- and 2-year postoperatively patients graded their leg pain on a visual analogue scale (VAS). At the 2-year follow-up patients rated their satisfaction with treatment (subjective outcome) and were evaluated by an independent neurologist (objective outcome), using MacNab score. There was no relationship between size or localisation of the scar and any of the clinical outcomes (VAS, subjective and objective outcome). The scar size decreased between 6 and 24 months in 49%, was unchanged in 42% and increased in 9% of the patients. Patients treated with ADCON-L did not demonstrate any adverse effects, nor did they demonstrate less scarring or better clinical outcome than control patients. No significant association between the presence of extensive peridural scar or localisation of scar formation and clinical outcome could be detected in the present study. Further, no positive or negative effects of ADCON-L used in disc herniation surgery could be seen. 

  • 7.
    Rönnberg, Katarina
    et al.
    Sahlgrenska University Hospital, Department of Orthopaedics.
    Lind, Bengt
    Sahlgrenska University Hospital, Department of Orthopaedics.
    Zoëga, Björn
    Landspitali University Hospital, Reykjavik, Department of Orthopaedics.
    Halldin, Klas
    Sahlgrenska University Hospital, Department of Orthopaedics.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Brisby, Helena
    Sahlgrenska University Hospital, Department of Orthopaedics.
    Patients' satisfaction with provided care/information and expectations on clinical outcome after lumbar disc herniation surgery2007In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 32, no 2, p. 256-261Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN. A prospective study of patients undergoing lumbar disc herniation surgery. OBJECTIVES. To assess patients' satisfaction with care/preoperative information, if expectations on surgical results and ability to return to work are related to baseline characteristics, and/or can predict self-reported outcome. Self-reported outcome was compared with objective outcome. SUMMARY OF BACKGROUND DATA. Patients' expectations on treatment results have been discussed as a predictive factor for postoperative outcome and satisfaction demonstrated to be directly related to patient expectations. METHODS. The study includes 148 patients, 46% women, mean age 40 (range 18-66). Before and 2 years after surgery, questionnaires about given information/care, expected/present work ability, and expectations on/obtained improvement of physical functions/symptoms (leg and back pain, sensibility, and muscle function) were filled in. The visual analog scale leg pain, Zung Depression Scale, and Oswestry Disability Index were used as baseline characteristics. At 2-year follow-up, self-reported and objective outcome was assessed. RESULTS. Satisfaction with given information/care were reported by 46% and 82%, respectively. Zung Depression Scale related to expectations on leg pain recovery (P = 0.022), work ability (P = 0.046), and satisfaction with given information (P = 0.031). Patients who expected to return (76%) and not return (24%) to work, returned in 78% and 26%, respectively (P = 0.021). A high agreement between self-reported outcome and objective outcome were found (P < 0.001). CONCLUSIONS. Patients undergoing lumbar disc herniation surgery are mostly satisfied with provided care before and after surgery, however, less satisfied with information provided. Further, patients with preoperative positive expectations on work return and realistic expectations on pain and physical recovery have a greater chance to be satisfied with the surgical results. © 2007 Lippincott Williams & Wilkins, Inc.

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