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  • 1.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Fatigue after myocardial infarction - a two-year follow-up study2013Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 11-12, s. 1647-1652Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: To investigate changes in self-reported fatigue and depression from four months to two years following a myocardial infarction, as well as to explore gender differences, identify the incidence of fatigue without coexisting depression and finally predict health-related quality of life at a two-year follow-up. Background: Depression and fatigue are associated with decreased health-related quality of life after myocardial infarction. Although there is a close relationship between fatigue and depression, it has been shown that symptoms of fatigue can occur without coexisting depression. Design: Quantitative and longitudinal design. Methods: Participants (n = 155) were asked to complete the following questionnaires: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory-20 (MFI-20) and the Short Form Survey (SF-36) following myocardial infarction (after four months and two years). Descriptive statistics, paired t-tests and multiple regressions were carried out. Results: In the entire group, self-reported fatigue had decreased from four months to two years after myocardial infarction. After two years, 18% of respondents reported depression together with fatigue and 30% reported fatigued without depression. Women scored higher than men on the fatigue dimensions reduced activity, reduced motivation and mental fatigue. Moreover, the physical dimension of health-related quality of life two years after myocardial infarction was predicted by experienced general fatigue at four months. Conclusion: Fatigue with or without coexisting possible/probable depression remains as a significant symptom two years after myocardial infarction in nearly half of the entire group. Relevance to clinical practice: Fatigue is a problem following myocardial infarction. Therefore, systematic screening and early identification of patients experiencing symptoms of depression and fatigue after myocardial infarction are important for suitable care planning. In contemporary coronary care, strategies aimed at relieving fatigue should be developed. ᅵ 2013 Blackwell Publishing Ltd.

  • 2.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Living with incomprehensible fatigue after recent myocardial infarction2008Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 64, nr 5, s. 459-468Artikel i tidskrift (Refereegranskat)
  • 3.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brändström, Yvonne
    Uddevalla Hospital, NU Hospital Group, Department of Medicine.
    Karlsson, Björn
    AstraZeneca R&D, Mölndal.
    Persson, Lars-Olof
    University of Gothenburg, Sahlgrenska Academy, Institute of Health and Care Sciences.
    Fatigue after myocardial infarction: Relationships with indices of emotional distress, and sociodemographic and clinical variables2010Ingår i: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, nr 4, s. 326-334Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fatigue and depressive symptoms are relatively common among patients recovering from myocardial infarction (MI). The symptoms of depression and fatigue overlap. The present study aimed at identifying patient fatigue and at examining the incidence of fatigue, particularly without coexisting depression, after MI. The sample comprised 204 consecutive patients who had completed the questionnaires Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory–20 after MI (1 week and 4 months). The results showed that fatigue had decreased after 4 months compared with the time of MI onset. Compared with the general population, patients reported significantly higher levels of fatigue. Furthermore, fatigue was associated with depression, but 33% of the sample reported fatigue without coexisting depression after 4 months. In order to prevent or treat patients' symptoms of fatigue after MI, the concepts of fatigue and depression should be assessed separately so as to exclude overlapping effects.

  • 4.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brändström, Yvonne
    Uddevalla Hospital, NU Hospital Group, Department of Medicine.
    Karlsson, Björn W.
    AstraZeneca R and D, Mölndal.
    Persson, Lar-Olof
    Göteborg University, Sahlgrenska Academy, Institute of Health Care Sciences.
    Illness perceptions after myocardial infarction: relations to fatigue, emotional distress, and health-related quality of life2010Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 25, nr 2, s. E1-E10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and RESEARCH Objective: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. Subjects and Methods: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). Results: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. Conclusions: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  • 5.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Persson, Lars-Olof
    Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences.
    Patients' illness perception four months after a myocardial infarction.2008Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 5A, s. 25-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of this study was to explore patients' illness perception of myocardial infarction four months after a myocardial infarction. BACKGROUND: An important task for research on recovery from myocardial infarction is to understand the factors that influence an individual's adherence to secondary preventive strategies. Perceptual, cognitive and motivational factors have been found to influence adherence to a secondary preventive regimen. METHOD: Twenty-five patients were interviewed four months after a myocardial infarction. In accordance with grounded theory methodology, data collection and analysis were carried out simultaneously. RESULTS: The findings can be understood in light of two core categories: 'trust in oneself ' vs. 'trust in others'; belief in one's own efforts to control the illness; and 'illness reasoning', lines of thought about illness identity. In searching for relationships, six categories describing variation in illness perceptions of a myocardial infarction emerged: (i) 'sign of a chronic condition - feasible to influence'; (ii) 'sign of a chronic condition - uncontrollable'; (iii) 'acute event that can recur - feasible to influence'; (iv) 'acute event that can recur - uncontrollable'; (v) 'unthinkable acute event'; and (vi) 'non-recurring acute event'. CONCLUSION: The more reflective patients perceived the heart attack as a sign of a chronic condition; they also devoted time for reasoning about the possible causes of their illness. This is in contrast to patients who were less reflective and viewed their myocardial infarction as an acute event, which they avoided thinking about. The findings contribute to our understanding of variation in illness perceptions. RELEVANCE TO CLINICAL PRACTICE: The examination of how individuals perceive myocardial infarction may help health-care professionals individualize secondary preventive strategies, thereby improving adherence to health-care regimens. Nurse-patient discussions could begin with identification of the patient's variations of reflectiveness concerning his/her illness.

  • 6.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning. Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lundgren, Jesper
    Avdelningen för psykologi, Göteborgs Universitet.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    Personality traits in relation to health-related quality of life in persons with asthma and/or allergic rhinitis2011Ingår i: 30th Congress of the European Academyof Allergy and Clinical Immunology in Istanbul, 2011Konferensbidrag (Refereegranskat)
  • 7.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lundgren, Jesper
    University of Gothenburg, Department of Psychology.
    Lötvall, Jan
    University of Gothenburg, Krefting Research Centre, Internal Medicine, Institute of Medicine, Sahlgrenska Academy.
    The influence of personality traits on reported adherence to medication in individuals with chronic disease: An Epidemiological study in West Sweden2011Ingår i: PLoS ONE, Vol. 6, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease. Methodology/Principal Findings: Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30-70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences. Conclusions: This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence. © 2011 Axelsson et al.

  • 8.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lötvall, Jan
    University of Gothenburg, Krefting Research Centre, Institute of Medicine and Clinical Nutrition, Internal Medicine, Sahlgrenska Academy.
    A personality and gender perspective on adherence and health-related quality of life in people with asthma and/or allergic rhinitis.2014Ingår i: Journal of the American Association of Nurse Practitioners, ISSN 2327-6886, E-ISSN 2327-6924, Vol. 26, nr 1, s. 32-39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Poor adherence to medication treatment for asthma and allergic rhinitis could challenge a positive health outcome. Health-related quality of life (HRQL) is an important measure of health outcome. Both personality and gender could influence adherence and perceptions of HRQL. The purpose was to clarify the role of personality and gender in relation to adherence and HRQL in people with asthma and/or rhinitis.

    DATA SOURCES: Participants (n = 180) with asthma and allergic rhinitis, selected from a population-based study, filled out questionnaires on the five-factor model personality traits-neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness-HRQL, and adherence to medication treatment. Data were statistically analyzed using t-tests, Mann-Whitney tests, bivariate correlations, and multiple regressions.

    CONCLUSIONS: Personality traits were associated with adherence to medication treatment in men. The influence of personality traits on HRQL also differed between men and women. These differences suggest that both a personality and gender perspective should be considered when planning care support aimed at improving adherence and HRQL in people living with asthma and/or allergic rhinitis.

    IMPLICATIONS FOR PRACTICE: It is suggested that both a personality and gender perspective be taken into account in care support aimed at improving adherence and HRQL in people with asthma and allergic rhinitis.

  • 9.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning. Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    Lundgren, Jesper
    Avdelningen för psykologi, Göteborgs Universitet.
    Patients´ adherence reasoning in relation to asthma medication2011Ingår i: 30th Congress of the European Academy of Allergy and Clinical Immunology in Istanbul, 11-15 june 2011, 2011Konferensbidrag (Refereegranskat)
  • 10.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Emilsson, Maria
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lundgren, J.
    University of Gothenburg, Department of Psychology.
    Torén, K.
    University of Gothenburg, Sahlgrenska Academy, Department of Community Medicine.
    Lötvall, J.
    University of Gothenburg, Sahlgrenska Academy, Department of Internal Medicine.
    Personality, adherence, asthma control and health-related quality of life in young adult asthmatics2009Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 103, nr 7, s. 1033-1040Artikel i tidskrift (Refereegranskat)
  • 11.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Lötvall, Jan
    Krefting Research Centre, Institute of Medicine, Internal Medicine, Sahlgrenska Academy, University of Gothenburg.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Lundgren, Jesper
    Department of Psychology, University of Gothenburg.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life2013Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 22, nr 3, s. 567-575Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose Personality traits are rather stable dispositions inadulthood, while self-efficacy and adherence may bemodified through targeted interventions. Health-relatedquality of life (HRQL) serves as a vital outcome measure.The present aim was to explore the function of self-efficacyand adherence as mediators for the influencing effect ofpersonality traits on HRQL in people with chronic disease.Methods An epidemiological sample of 786 personscompleted questionnaires on personality, general self-efficacy,adherence behaviour and HRQL. Data were statisticallyanalysed using descriptive statistics, correlationanalyses and path models.Results Self-efficacy mediated the effect of Extraversionand Conscientiousness on mental HRQL. Neuroticism hada direct effect on both physical and mental HRQL.Adherence partially mediated the effect of both Agreeablenessand Conscientiousness on mental HRQL.Conclusions The mental HRQL in people scoring low onExtraversion or low on Conscientiousness could beimproved by strengthening general self-efficacy. Increasingadherence in people scoring low on Agreeableness orConscientiousness could improve their mental HRQL, butthe improvement was small and may be of lesser clinicalrelevance. These results argue for personalized interventionsintended to positively affect health outcomes inpeople with chronic disease.

  • 12.
    Axelsson, Malin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Lötvall, Jan
    Krefting Research Centre, Institute of Medicine, Internal Medicine, Sahlgrenska Academy, University of Gothenburg.
    Lundgren, Jesper
    Department of Psychology, University of Gothenburg.
    Brink, Eva
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Motivational foci and asthma medication tactics directed towards a functional day2011Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, s. 809-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    There appears to be an obvious gap between a medical and patient adherence perspective.

    Deviating from a medication prescription could be regarded as fairly irrational, but with respect to patients' goals and/or concerns it could be seen as understandable. Thus, the aim was to elucidate adherence reasoning in relation to asthma medication.

    Methods:

    This was a qualitative study; data collection and analysis procedures were conducted according to Grounded Theory methodology. Eighteen persons, aged 22 with asthma and regular asthma medication treatment, were interviewed.

    Results:

    The emerged theoretical model illustrated that adherence to asthma medication was motivated by three foci, all directed towards a desired outcome in terms of a functional day as desired by the patient. Apromotive focus was associated with the ambition to achieve a positive asthma outcome by being adherent either to the received prescription or to a self-adjusted dosage. A preventive focuswas intended to ensure avoidance of a negative asthma outcome either by sticking to the prescription or by preventively overusing the medication. A permissive focus was associated with unstructured adherence behaviour in which medication intake was primarily triggered by asthma symptoms.

    Conclusions:

    As all participants had consciously adopted functioning medication tactics that directed them

    towards the desired goal of a functional day. In an effort to bridge the gap between a patient- and a medical adherence perspective, patients need support in defining their desired functionality and guidance in developing a person-based medication tactic.

  • 13.
    Berghammer, Malin
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Sahlgrenska Academy, Institute of Medicine.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Rydberg, Annika M.
    University of Umeå, Department of Clinical Sciences, Pediatrics.
    Dellborg, Mikael
    Sahlgrenska Academy, Institute of Medicine.
    Ekman, Inger
    University of Gothenburg, Centre for Person-Centred Care.
    Committed to Life: Adolescents’ and Young Adults’ Experiences of Living with Fontan Circulation2015Ingår i: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 10, nr 5, s. 403-412Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect has on their life in general. Objective The aim was to illuminate and gain a deeper understanding of adolescents’ and young adults’ experiences of living with a surgically palliated univentricular heart. Design Seven open-ended in-depth interviews were conducted, transcribed, and analyzed according to the henomenological hermeneutical method. All adolescents and young adults operated before 1995 according to the Fontan procedure or the total cavo-pulmonary connection procedure at one pediatric cardiology unit were included in the study. They were 17–32 years of age (median age 22 years). Results The interpretation of the interview transcripts showed that the participants experienced living with a surgically palliated univentricular heart in terms of feeling exceptional, strong, and healthy. This was supported by two structural analyses, where three themes emerged: happiness over being me, focusing on possibilities, and being committed to life. Conclusion Living with a Fontan circulation included negative experiences but the analyses clearly demonstrated a feeling of being strong and healthy. An appreciation of having survived and being committed to life was found to be an integral part of the development of the interviewees’ existential growth. This probably strengthens them further in their ability to balance expectations and hurdles in life. This study provides valuable insights into the experience of patients after the Fontan procedure and the importance of a positive health care environment throughout their lives.

  • 14.
    Boman, Åse
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för vårdvetenskap på avancerad nivå.
    Brink, Eva
    Högskolan Väst, Institutionen för hälsovetenskap.
    Salutogen omvårdnad2015Ingår i: Salutogenes: om hälsans ursprung : [från forskning till praktisk tillämpning] / [ed] Eriksson, Monica, Stockholm: Liber, 2015, 1. uppl., s. 191-208Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 15.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Adaptation Positions and Behavior Among Post–Myocardial Infarction Patients2009Ingår i: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 18, nr 2, s. 119-135Artikel i tidskrift (Refereegranskat)
  • 16.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Considering both health-promoting and illness-related factors in assessment of health-related quality of life after myocardial infarction2012Ingår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 6, nr 1, s. 90-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study addresses factors that contributed to explaining the variance in health-related quality of life (HRQOL) one year after myocardial infarction, considering both illness-related and health-promoting factors. The aim was to elucidate the influence of depression, fatigue, optimism and sense of coherence on HRQOL. The sample consisted of 95 persons who had been treated for myocardial infarction. Correlation and multiple regression analyses were performed. The results showed that depression, fatigue, optimism and sense of coherence variables were all correlated with both the physical and the mental dimensions of HRQOL. In two multiple regression analyses where the physical component score (PCS) and the mental component score (MCS) were the criterion variables, fatigue contributed to the explained variance in the PCS (p< 0.001), and both depression (p< 0.01) and fatigue (p< 0.01) contributed to explained the variance in the MCS, after controlling for age and gender. To conclude, fatigue was the most significant variable associated with HRQOL, which was interpreted as having the following clinical implication: When a person suffers from post-myocardial infarction fatigue, this must be addressed first. Clearly, it is time to take the problems of patients who suffer from post-myocardial infarction fatigue seriously. It is of vital importance to develop and evaluate fatigue relief strategies in cardiovascular nursing and to test them in interventional studies. This does not exclude investing in health-promoting factors, e.g. sense of coherence, in coronary care interventions. Intervention strategies focusing on both illness-related and salutogentic factors may be optimal. This is a question for further research.

  • 17.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Psykosociala konsekvenser av hjärtinfarkt.2006Ingår i: Inre och yttre världar.: Funktionshinder i psykologisk belysning / [ed] Hjelmquist, Erland., Lund: Studentlitteratur , 2006, s. 129-145Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 18.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa, kultur och pedagogik.
    Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction – the Swedish version.2011Ingår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 52, nr 6, s. 573-579Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When people’s health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach’s alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R’s seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.

  • 19.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning. Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Herlitz, Johan
    University of Borås, School of Health Sciences, .
    Kjellgren, Karin
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    General self-efficacy and health-related quality of life after myocardial infarction2012Ingår i: Psychology, Health & Medicine, ISSN 1354-8506, Vol. 17, nr 3, s. 346-355Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fatigue after myocardial infarction (MI) has been found to be distressing. A person's self-efficacy will influence his/her health behavior and plays an active role in tackling illness consequences. This study investigated associations between fatigue, disturbed sleep, general self-efficacy, and health-related quality of life (HRQoL) in a sample of 145 respondents admitted to hospital for MI two years earlier. The aim was to identify the predictive value of general self-efficacy and to elucidate mediating factors between self-efficacy and HRQoL. General self-efficacy measured four months after MI was positively related to HRQoL after two years. In tests of indirect effects, fatigue meditated the effects between self-efficacy and the physical and the mental dimension of HRQoL, respectively. The indirect effect of disturbed sleep went through that of fatigue. To conclude, patients who suffer from post-MI fatigue may need support aimed at helping them increase their self-efficacy as well as helping them adapt to sleep hygiene principles and cope with fatigue, both of which will have positive influences on HRQoL.

  • 20.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Brändström, Yvonne
    Department of Medicine, Uddevalla Hospital, Sweden.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Herlitz, Johan
    Sahlgrenska University Hospital, Department of Molecular and Clinical Medicine.
    Karlson, Björn W.
    AstraZeneca R&D, Mölndal, Sweden.
    Illness consequences after myocardial infarction: Problems with physical functioning and return to work2008Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 64, nr 6, s. 587-594Artikel i tidskrift (Refereegranskat)
  • 21.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Herlitz, Johan
    Department of Cardiology, Sahlgrenska University Hospital.
    Karlson, Björn W.
    Medicine and Science, AstraZeneca R and D, Mölndal.
    Dimensions of the Somatic Health Complaints Questionnaire (SHCQ) in a sample of myocardial infarction patients2007Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, nr 1, s. 27-31Artikel i tidskrift (Refereegranskat)
  • 22.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Dellve, Lotta
    Klingberg, Gunilla
    Henning Abrahamsson, Kajsa
    Wentz, Kerstin
    Hallberg, Ulrika
    Charmaz, Kathy (2006). Constructing grounded theory: a practical guide through qualitative analysis. London: SAGE2006Ingår i: International Journal of Qualitative Studies on Health and Well-Being, ISSN 1748-2623, Vol. 1, nr 3, s. 188-192Artikel, recension (Övrig (populärvetenskap, debatt, mm))
  • 23.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Fredriksson-Larsson, Ulla
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Lång, Marianne
    Department of Cardiology, NU Hospital Group, Trollhättan, Sweden.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Development of a Tool for Assessment of Post-Myocardial Infarction Fatigue2018Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 08, nr 11, s. 811-822Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: After treatment for myocardial infarction (MI) quite a few persons will experience different symptoms, including fatigue, during the recovery phase. The aim of the present study was to construct the multidimensional Post-Myocardial Infarction Fatigue (PMIF) scale, based on empirical data gathered in coronary heart disease contexts. Methods: The construction of the post-MI fatigue scale was conducted in seven steps, ending in a psychometric evaluation of the internal structure of the scale, using confirmatory factor analysis, as well as testing of convergent and discriminant validity, using correlational analysis, in a sample of 141 persons treated for MI. Results: The results showed that the PMIF scale represents three dimensions: physical, cognitive and emotional fatigue. It was also found that the scale is suitable for summing the items to obtain a total score representing a post-MI global fatigue dimension. Conclusion: The PMIF is a brief and easily completed scale for identifying persons experiencing post-MI fatigue. Early identification of fatigue, together with health behavior support, might prevent progression toward a more severe state of fatigue.

  • 24.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa och kultur.
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Associations between depression, fatigue, and life orientation in myocardial infarction patients2006Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, Vol. 21, nr 5, s. 407-411Artikel i tidskrift (Övrigt vetenskapligt)
  • 25.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Karlson, Björn W
    Sahlgrenska University, Division of Cardiology.
    Hallberg, Lillemor R M
    Halmstad University, School of Social and Health Sciences.
    Health-related quality of life in women and men one year after acute myocardial infarction2005Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, nr 3, s. 749-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the present study was, first, to detect possible changes in health-related quality of life (HRQL) over time and, second, to predict HRQL at 1 year based on measures made 1 week and 5 months after a first-time acute myocardial infarction. There was an improvement in HRQL at 1 year, as measured by the questionnaire 36-item Medical Outcomes Study Short-Form (SF-36), for both men and women as compared with the assessment 5 months after the acute myocardial infarction. However, the pattern was somewhat different for women and men. Women mainly reported increased scores on scales reflecting better mental health, whereas men, on the whole, demonstrated higher scores in the physical health domain. Depression (HAD) and fatigue were identified as early predictors of lower HRQL at the 1-year follow-up. Our conclusion is that early assessment of fatigue and depression is worthwhile, as they may indicate decreased HRQL in men and women 1 year after first-time myocardial infarction.

  • 26.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Karlson, Björn W
    Medicine and Science, AstraZeneca R&D, Mölndal.
    Hallberg, Lillemor R-M
    Halmstad University, School of Social and Health Sciences.
    Readjustment 5 months after a first-time myocardial infarction: reorienting the active self.2006Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 53, nr 4, s. 403-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This paper reports on an interview study exploring the self-regulation process in women and men, 5 months after a first-time myocardial infarction. BACKGROUND: Somatic, psychological and social factors affect readjustment after a first-time myocardial infarction, and studies have demonstrated substantial rates of depression in patients after myocardial infarction Women report poorer mental health and physical condition than do men. Reconstruction of the self begins when disease poses novel problems and is more likely to occur in cases of long-lasting and disruptive illnesses. Experiencing myocardial infarction is likely to alter a person's mental representation of self. However, the self-regulation process following first-time myocardial infarction is not yet fully understood. METHOD: Twenty-one people (11 women, 10 men) were interviewed 5 months after first-time myocardial infarction. The grounded theory method provided the strategies for data collection and analysis. FINDINGS: Interviewees' definition of themselves as active was threatened by fatigue and other health problems that kept them from taking part in activities as they had done before the heart attack. Although reorienting the active self was central to the process of recovery from myocardial infarction, reorienting was restricted by illness perception and coping. CONCLUSION: Participants had not established a stable health condition 5 months after first-time myocardial infarction. They mainly preferred to moderate rather than radically change their daily life activities. They needed more knowledge and support. Nurses can help with information and advice on managing daily life activities, including dialogue about lifestyle changes at this phase of readjustment.

  • 27.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Persson, Lars-Olof
    University of Gothenburg, Sahlgrenska Academy, Institute of Health and Care Sciences.
    Karlson, Bjön W.
    Astra Zeneca RandD, Mölndal.
    Coping with myocardial infarction: Evaluation of a coping questionnaire2009Ingår i: Scandinavian Journal of Caring Sciences, Vol. 23, nr 4, s. 792-800Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Coping with myocardial infarction: evaluation of a coping questionnaire The negative effects of emotional distress on the recovery following myocardial infarction make it important to study coping strategies in this situation. The present study aimed to evaluate the psychometric properties and the validity of a 10 dimensions questionnaire labelled The General Coping Questionnaire (GCQ). The structure of the questionnaire was based on a previous interview study with 26 persons with different diseases. The 10 dimensions are called self-trust, problem-reducing actions, change of values, social trust, minimization, fatalism, resignation, protest, isolation and intrusion. The present study comprised 114 first-time myocardial infarction patients (37 women, 77 men). Five months after myocardial infarction, they answered questions about health-related quality of life, health complaints, sense of coherence and the GCQ. A multi-trait/multi-item analysis showed good item-scale convergent and discriminatory validity when the GCQ was reduced from 47 to 40 items. In conclusion, the results showed that the 40-item GCQ is a well-structured and reliable questionnaire for measuring coping strategies in myocardial infarction patients.

  • 28.
    Brink, Eva
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Skott, Carola
    University of Gothenburg, Institute of Health and Care Sciences.
    Caring about symptoms in person-centred care2013Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, nr 8, s. 563-567Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In the present article, we emphasize the symptom experience perspective in person-centred care and discuss barriers to implementation of this approach. There are obstacles to overcome: the diversity of understandings of symptoms in clinical settings, the current biomedical discourse and the incompleteness of symptom research. Since the 19th century, the bio-medical perspective has been powerful in conceptualizing symptoms in terms of pathology and diagnosis. Many diagnoses conjure up preconceived notions about the persons receiving them. This perspective may influence person-centred care negatively. Yet symptoms often mean something beyond the diagnosis. Recognizing this discrepancy, it is crucial that we consider a perspective that starts from each person’s symptom experience, thus complementing the biomedical perspective. Using the notion caring about symptoms, we advocate a person-centred approach that includes a symptom experience perspective. This requires that health-care professionals be skilled in listening to patient narratives and acquire knowledge about how symptom experiences can be individually expressed and interpreted. Listening to symptom experiences may give insights into the personal meaning of illness as well as information about bodily and social restrictions caused by symptom distress. In this way, caring about symptoms will improve the prerequisites for establishing person-centred care planning.

  • 29.
    Brändström, Yvonne
    et al.
    NU Hospital Group, Trollhättan, Department of Internal Medicine, Heart Center.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Herlitz, Johan
    Sahlgrenska University Hospital, Department of Molecular and Clinical Medicine.
    Karlson, Björn W
    AstraZeneca R&D, Mölndal.
    Physical activity six months after a myocardial infarction2009Ingår i: International journal of nursing practice, ISSN 1440-172X, Vol. 15, nr 3, s. 191-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In the present study, we wished to explore physical activity in middle-aged patients 6 months after a myocardial infarction and to compare the patients' self-reported activity level with pedometric measures of footsteps/day. The sample comprised 89 patients with myocardial infarction, aged

  • 30.
    Dahlborg Lyckhage, Elisabeth
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Faculty of Medicine and Health Sciences, Department of Health Science Aalesund, NTNU, Norway .
    Brink, Eva
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Sweden.
    A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons' Own and Shared Lifeworld2018Ingår i: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 41, nr 4, s. 340-350Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    By giving a brief overview of the metaconcepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the antioppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.

  • 31.
    Emilsson, Maria
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Lötvall, Jan
    Krefting Research center.
    Millqvist, Eva
    Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska University Hospital.
    Lundgren, Jesper
    Instutionen för Psykologi, Göteborgs universitet.
    Johansson, Åke
    Avdelning för lung medicin Central sjukhuset Skövde.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning. Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    The Influence of personality traits and beliefs about medicines on adherence to asthma treatment2011Ingår i: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, nr 2, s. 141-147Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Aim:To explore the influence of personality traits and beliefs about medicines on adherence to treatment with asthma medication.

    Methods:Respondents were 35 asthmatic adults prescribed controller medication. They answered questionnaires about medication adherence, personality traits, and beliefs about medicines.

    Results:In gender comparisons, the personality traits “Neuroticism” in men and “adherence to medication” were associated with lower adherent behaviour. Associations between personality traits and beliefs in the necessity of medication for controlling the illness were identified. Beliefs about the necessity of medication were positively associated with adherent behaviour in women. In the total sample, a positive “necessity-concern” differential predicted adherent behaviour.

    Conclusion:The results imply that personality and beliefs about medicines may influence how well adults with asthma adhere to treatment with asthma medication.

  • 32.
    Fors, Andreas
    et al.
    University of Gothenburg, Institute of Health and Care Sciences,.
    Ulin, Kerstin
    University of Gothenburg, Institute of Health and Care Sciences,.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa, kultur och pedagogik.
    Ekman, Inger
    University of Gothenburg, Institute of Health and Care Sciences,.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    The Cardiac Self-Efficacy scale, a useful tool to evaluate person-centred care.2015Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, nr 6, s. 536-543Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:Cardiac self-efficacy is a person's belief in his/her ability to manage the challenges posed by a coronary disease, and its role has been evaluated in several coronary populations using the Cardiac Self-Efficacy Scale (CSE Scale). Self-efficacy has an important role in person-centred care, however there is a lack of appropriate instruments that evaluate person-centred interventions.AIM:The purpose of this study was to validate the CSE Scale by examining its psychometric properties as a first step in evaluating a person-centred care intervention in persons with acute coronary syndrome (ACS).METHODS:The study sample consisted of 288 persons (72 women, 216 men) who completed the Swedish version of the CSE Scale two months after hospitalisation for an ACS event. Construct validity was psychometrically evaluated using confirmatory factor analysis. Additionally, convergent and discriminant validity were tested using correlation analyses.RESULTS:The results revealed that the CSE Scale was represented by three dimensions (control symptoms, control illness and maintain functioning). The analyses also showed that the CSE Scale is suitable for providing a total summary score that represents a global cardiac self-efficacy dimension. Evaluation of convergent and discriminant validity showed the expected correlations.CONCLUSION:The CSE Scale is a valid and reliable measure when evaluating self-efficacy in patients with ACS. It also seems to be a useful tool to promote person-centred care in clinical practice since it may offer useful guidance in the dialogue with the patient in the common creation of a personal health plan.

  • 33.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Fatigue two months after MI and its relationships with other concurrent symptoms, sleep quality and coping strategiesArtikel i tidskrift (Refereegranskat)
  • 34.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    I've lost the person I used to be-Experiences of the consequences of fatigue following myocardial infarction2013Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, s. 20836-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction (MI), influencing health-related quality of life negatively. Moreover, fatigue after MI has been described as incomprehensible due to its unpredictable occurrence and lack of relationship to physical effort. The aim of this study is therefore to explore persons' experiences of consequences of fatigue and their strategies for dealing with it 2 months after MI. In total, 18 informants, aged 42-75 years, participated in the study. Interviews were conducted and analysed using constructivist grounded theory methodology. Grounded in the data, the main consequence of fatigue, as illustrated in the core category, was: I've lost the person I used to be. It indicates a sense of reduced ability to manage daily life due to experiences of fatigue. The core category was developed from the four categories: involuntary thoughts, certainties replaced with question marks, driving with the handbrake on and just being is enough. Furthermore, attempts to relieve fatigue were limited. These findings indicate that patients with symptoms of fatigue should be supported in developing relief strategies, for example, rest and sleep hygiene as well as physical activity. In conclusion, the results show that fatigue can be understood in light of the concepts "comprehensibility" and "manageability." They also indicate that, working from a person-centered perspective, health-care professionals can support patients experiencing post-MI fatigue by giving them opportunities to straighten out the question marks and by inviting them to discuss involuntary thoughts and feelings of being restricted in their daily life functioning.

  • 35.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. 3Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden..
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Karlson, Björn W
    AstraZeneca, Mölndal, Sweden.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning. University of Gothenburg, Institute of Health and Care Sciences.
    Fatigue two months after myocardial infarction and its relationships with other concurrent symptoms, sleep quality and coping strategies.2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 15-16, s. 2192-2200Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore fatigue levels two months after myocardial infarction and examine the associations with other concurrent symptoms, sleep quality and coping strategies.

    BACKGROUND: Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction, influencing health-related quality of life negatively.

    DESIGN: The present study was explorative and cross-sectional. The focus was on fatigue two months postmyocardial infarction, complemented with a comparative analysis of fatigue dimension levels.

    METHODS: The sample included 142 persons (mean age 63 years), treated for myocardial infarction, who responded to a questionnaire package measuring fatigue, depression, health complaints (symptoms), sleep quality and coping strategies.

    RESULTS: The main results showed that a global fatigue score two months postmyocardial infarction was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies such as change in values, intrusion and isolation. In comparisons of present fatigue dimension levels (general fatigue, physical fatigue, reduced activity and mental fatigue) two months postmyocardial infarction with baseline measurements (first week in hospital), the results showed that levels of fatigue dimensions had decreased. In comparisons with levels of fatigue four months postmyocardial infarction in a reference group, we found lower levels of fatigue two months postmyocardial infarction.

    CONCLUSION: The present findings indicated that postmyocardial infarction fatigue is lowest two months postmyocardial infarction. This may thus be the right time to identify persons experiencing postmyocardial infarction fatigue, as timely fatigue relief support may prevent progression into a state of higher levels of fatigue.

    RELEVANCE TO CLINIC PRACTICE: Measuring fatigue two months postmyocardial infarction would enable healthcare professionals to identify persons experiencing fatigue and to introduce fatigue relief support. Tailored rehabilitation support should include stress management and breathlessness relief support. If maladaptive use of the coping strategies isolation and intrusion is observed, these strategies could be discussed together with the patient.

  • 36.
    Fredriksson-Larsson, Ulla
    et al.
    Univ Gothenburg, Ctr Person Cent Care, Inst Hlth & Care Sci,.
    Brink, Eva
    Univ Gothenburg, Ctr Person Cent Care, Inst Hlth & Care Sci,.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Associations between fatigue, symptom experiences and sleep quality after myocardial infarction2014Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 1 suppl, s. S15-S15Artikel i tidskrift (Refereegranskat)
  • 37.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Falk, Kristin
    Lundgren-Nilsson, Åsa
    Univ Gothenburg, Inst Neurosci & Physiol, Ctr Person Centred Care.
    Psychometric analysis of the Multidimensional Fatigue Inventory in a sample of persons treated for myocardial infarction2015Ingår i: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, Vol. 23, nr 1, s. 154-167Artikel i tidskrift (Refereegranskat)
  • 38.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden..
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden..
    Jonsdottir, Ingibjörg H.
    University of Gothenburg, Institute of Stress Medicine, Sahlgrenska Academy, , Gothenburg, Sweden..
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    The single-item measure of stress symptoms after myocardial infarction and its association with fatigue.2015Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, s. 345-353Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Surviving a myocardial infarction (MI) can be a stressful event entailing challenges in daily life during the recovery period. Experiencing fatigue symptoms post-MI has been described as bothersome and occurs in nearly half of patients four months and two years after MI. The aetiology of fatigue disorder is unclear, but research has shown that fatigue plays an important role in the relationship between stress and perceived poor health. Previous findings indicate that having access to an easily administered stress measurement is worthwhile both in the clinic and in research. The single-item measure of stress symptoms has not been validated in persons treated for MI. The aim was to validate the single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. Methods: 142 respondents completed the questionnaires of the Multidimensional Fatigue Inventory-20, the single-item measure of stress symptoms and the Perceived Stress Scale-10 (PPS-10) two months post-MI. Correlation analysis and t-tests were used to validate the single-item stress measure and its association with post-MI fatigue. Results: The convergent validity of the single-item measure of stress symptoms was confirmed. In analyses of relations between stress and fatigue, it was found that the single-item stress measure was strongly associated with both the global fatigue score and all four fatigue dimension scores (general, physical and mental fatigue as well as reduced activity). Conclusion: The single-item measure of stress symptoms was found to be a valid measure of post-MI stress. Also, the measure was useful in assessing associations between stress and fatigue and could therefore indicate that post-MI fatigue experiences should be further explored in full using multidimensional fatigue assessmen

  • 39.
    Grankvist, Gunne
    et al.
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Illness perception of nursing students regarding MYOCARDIAL INFARCTION2009Ingår i: Nursing Education Perspectives, ISSN 1536-5026, Vol. 30, nr 4, s. 234-238Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Health Interventions aimed at secondary prevention of myocardial infarction (MI) are important. Patients' illness perceptions influence adherence behaviors and actions. Providing adequate information about the disease and lifestyle interventions is an important task for health care professionals. Therefore, a question of interest is how health care professionals perceive myocardial infarction themselves. The aim with the present study was to investigate how nursing students at a Swedish university perceived Ml and to determine whether their illness perceptions changed during their six-term program of education. Illness perception was measured using the Revised Illness Perception Questionnaire (IPQ-R) in a sample of 196 students enrolled in terms 2, 4, and 6 of the nursing program. A quasi-experimental design was used. Illness perceptions among nursing students were also compared to illness perceptions in a group of patients with coronary heart disease. The belief that it is possible to control Ml through medical treatment became stronger during the course of nursing education. Nursing students were found to view the consequences of Ml as serious, but also as medically treatable and responsive to lifestyle changes.

  • 40.
    Johansson, Ann-Caroline
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Axelsson, Malin
    Malmo University, Department of Care Science, Faculty of Health and Society..
    Berndtsson, Ina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning. Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Illness perceptions in relation to experiences of contemporary cancer care settings among colorectal cancer survivors and their partners2014Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, artikel-id 23581Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people’s lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on leaving the cancer diagnosis behind and moving forward. The importance of illness perceptions among survivors, and the differences in illness perceptions between survivors and partners, should be recognized by healthcare professionals to achieve the goals of person-centered contemporary cancer care.

  • 41.
    Johansson, Ann-Caroline
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö, Sweden.
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avdelningen för psykologi, pedagogik och sociologi.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Brink, Eva
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment2018Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, nr 9, s. 591-604Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

  • 42.
    Johansson, Ann-Caroline B
    et al.
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö, Sweden.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Self-Reorientation Following Colorectal Cancer Treatment: A Grounded Theory Study2015Ingår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 9, s. 25-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    After colorectal cancer (CRC) treatment, people reorganize life in ways that are consistent with their understanding of the illness and their expectations for recovery. Incapacities and abilities that have been lost can initiate a need to reorient the self. To the best of our knowledge, no studies have explicitly focused on the concept of self-reorientation after CRC treatment. The aim of the present study was therefore to explore self-reorientation in the early recovery phase after CRC surgery. Grounded theory analysis was undertaken, using the method presented by Charmaz. The present results explained self-reorientation as the individual attempting to achieve congruence in self-perception. A congruent self-perception meant bringing together the perceived self and the self that was mirrored in the near environs. The results showed that societal beliefs and personal explanations are essential elements of self-reorientation, and that it is therefore important to make them visible.

  • 43.
    Johansson, Ann-Caroline
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Brink, Eva
    Högskolan Väst, Institutionen för hälsovetenskap. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö.
    The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer.2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 7-8, s. E1537-E1548Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the present study was twofold: 1) to measure changes in health-related quality of life (HRQoL), two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for CRC during the first year after surgical treatment, and 2) to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect HRQoL at 12 months post-surgery.

    BACKGROUND: There are fluctuations in HRQoL during the first year after treatment for colorectal cancer (CRC), and fatigue may negatively influence HRQoL. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with HRQoL in other cancer diagnoses. Concerning CRC, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to HRQoL at 12 months.

    DESIGN: A prospective longitudinal design.

    METHODS: Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostoma, participated. HRQoL, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

    RESULTS: No changes were reported in levels of HRQoL, fatigue, or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on HRQoL at 12 months.

    CONCLUSION: Persons treated for CRC who have lower self-efficacy 3 months post-surgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

    RELEVANCE TO CLINICAL PRACTICE: Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, i.e., carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy. This article is protected by copyright. All rights reserved.

  • 44.
    Johansson, Ingvor
    et al.
    NU Hospital group, Department of Internal Medicine.
    Karlson, Björn W.
    Astra Zeneca R&D, Mölndal.
    Grankvist, Gunne
    Högskolan Väst, Institutionen för individ och samhälle, Avd för psykologi och organisationsstudier.
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.
    Disturbed sleep, fatigue, anxiety and depression in myocardial infarction patients2010Ingår i: European Journal of Cardiovascular Nursing, ISSN 1873-1953, Vol. 9, nr 3, s. 175-180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Disturbed sleep has been linked to increased morbidity, mortality and depression and worsened health-related quality of life in patients with chronic illness. Few studies of readjustment after coronary artery disease have explicitly focused on sleep disturbance. Aim: To explore associations between disturbed sleep, fatigue, anxiety and depression, and to assess to what extent fatigue four months post-MI could be explained. Method: The sample included 204 consecutive patients, ≤ 80 years of age who answered questionnaires about disturbed sleep, fatigue, anxiety and depression four months after MI. Results: The variables anxiety, depression and disturbed sleep were all associated with fatigue. The regression model accounted for 46% of the variance in fatigue with depression and disturbed sleep as predictors. Infarct size measured by conventional biochemical markers, left ventricle ejection fraction and history of previous MI were not correlated with disturbed sleep, fatigue, anxiety or depression. Conclusions: From knowledge about associations between disturbed sleep, fatigue, anxiety and depression after MI, cardiac nurses could be trained to observe such symptoms. Optimal care for sleep disturbance may include actions to reduce anxiety and depression as well as self-care advices about sleep hygiene in order to improve sleep quality and reduce fatigue. © 2009 European Society of Cardiology.

  • 45.
    Olofsson, Brita
    et al.
    Northern Elvsborg County Hospital .
    Bengtsson, Claire
    Northern Elvsborg County Hospital .
    Brink, Eva
    Högskolan Väst, Institutionen för omvårdnad (HTU).
    Absence of response: a study of nurses' experience of stress in the workplace2003Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, nr 5, s. 351-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.

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