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  • 1.
    Alsen, Pia
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Thörn, Susanna
    Primary Health Care, Sollentuna, Sweden.
    Nordqvist, Linnea
    Primary Health Care, Munkedal, Sweden.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Men’s Experience of Difficulties during First Year Following Myocardial Infarction: Not OnlyFatigue2016Inngår i: Health, ISSN 1949-4998, Vol. 8, s. 1654-1667Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Recovery from a myocardial infarction (MI) can be a very difficult process and some patients are also stricken by fatigue. The aim of the study was to describe the difficulties experienced by men with fatigue during the first year following their MI. The study was conducted using qualitative content analysis of semi-structured interviews with nine men in working age (mean age: 55 years) with verified fatigue (≥12 of 20 on the Multidimensional Fatigue Scale with a mean of 17) one year after their MI. During the first year after the MI the men suffering from fatigue experienced various difficulties in terms of both themselves and the care received. The analysis generated three themes with difficulties described by the interviewed men. 1) Going through involuntary change: not recognizing their body and the inability to recognize themselves. 2) Lacking individualized care: To be denied satisfactory health care treatment and to be denied respectful treatment. 3) Not being seen in the light of the social context: The MI affects the whole family and caregivers do not pay attention to the family. In order to make both the patient and relatives feel secure and cared for, it is essential that caregivers be aware of the importance of providing individualized care over time with particular attention for the patient’s social context.

  • 2.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Illness perception and fatigue after myocardial infarction2009Doktoravhandling, med artikler (Annet vitenskapelig)
  • 3.
    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 study2013Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 11-12, s. 1647-1652Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 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.
    Living with incomprehensible fatigue after recent myocardial infarction2008Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 64, nr 5, s. 459-468Artikkel i tidsskrift (Fagfellevurdert)
  • 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.
    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 variables2010Inngår i: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, nr 4, s. 326-334Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 6.
    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 life2010Inngår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 25, nr 2, s. E1-E10Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 7.
    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.2008Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 5A, s. 25-33Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 8.
    Alsén, Pia
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Eriksson, Monica
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa och kultur.
    Illness perceptions of fatigue and the association with sense of coherence and stress in patients one year after myocardial infarction.2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 3-4, s. 525-533Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives. To explore the associations between illness perceptions offatigue, sense of coherence and stress in patients one year after myocardial infarc-tion.Background. Post-myocardial infarction fatigue is a stressful symptom that is dif-ficult to cope with. Patients' illness perceptions of fatigue guide professionals inpredicting how individuals will respond emotionally and cognitively to symptoms.Individuals' sense of coherence can be seen as a coping resource in managingstressors.Design. A cross-sectional study design was used.Method. One year post-myocardial infarction, a total of 74 patients still experi-encing fatigue completed four questionnaires: the Multidimensional Fatigue ScaleInventory -20, the Brief Illness Perception Questionnaire, the Sense of Coherencescale (sense of coherence-13) and a single-item measure of stress symptoms.Descriptive statistics, correlations and stepwise regression analysis were carriedout.Results. Strong negative associations were found between illness perceptions offatigue, sense of coherence and stress. Sense of coherence has an impact on illnessperceptions of fatigue. Of the dimensions of sense of coherence, comprehensibilityseemed to play the greatest role in explaining illness perceptions of fatigueone year after myocardial infarction.Conclusion. To strengthen patients' coping resources, health-care professionalsshould create opportunities for patients to gain individual-level knowledge thatallows them to distinguish between common fatigue symptoms and warning signsfor myocardial infarction.Relevance to clinical practice. There is a need to improve strategies for copingwith fatigue. It is also essential to identify patients with fatigue after myocardialinfarction, as they need explanations for their symptoms and extra support

  • 9.
    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.2011Inngår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 52, nr 6, s. 573-579Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 10.
    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 infarction2012Inngår i: Psychology, Health & Medicine, ISSN 1354-8506, Vol. 17, nr 3, s. 346-355Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 11.
    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 Fatigue2018Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 08, nr 11, s. 811-822Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 12.
    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 infarction2009Inngår i: International journal of nursing practice, ISSN 1440-172X, Vol. 15, nr 3, s. 191-7Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 13.
    Eriksson, Monica
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Lycke, Liselott
    Högskolan Väst, Institutionen för ingenjörsvetenskap.
    Tano, Ingrid
    Högskolan Väst, Institutionen för ingenjörsvetenskap, Avdelningen för Matematik, Data- och Lantmäteriteknik.
    Aronsson, Gunnar
    Stockholms universitet, Stockholm, Sverige.
    ARK: modell för att systematiskt arbeta med hållbart arbetsliv inom universitet och högskola (UoH)2018Inngår i: FALF 2018 - program och abstraktbok / [ed] Per Lindberg, Gävle: University Press , 2018, s. 123-123Konferansepaper (Fagfellevurdert)
    Abstract [sv]

    Bakgrund

    Hållbart arbetsliv är idag ledord för arbetslivets förändrade villkor. Inom UoH i Sverige fanns i slutet av 2017 omkring 75 000 anställda varav ca 35 000 inom forskning och undervisning (UKÄ, 2017). Det är en sektor med stor betydelse för samhällsutvecklingen i Sverige. Arbetsmiljön inom sektorn ställer särskilda krav på personalen. Förvånansvärt få studier har gjorts i Sverige om arbetsmiljön för personal inom UoH. Med förebild från Norge implementeras nu för första gången i Sverige en forskningsbaserad (krav-resurs-modellen) och sektorsspecifik ny modell för att systematiskt arbeta med arbetsmiljön, den s.k. Ark-modellen (arbeidsmiljø- og klimaundersøkelser, se figur) vid Högskolan Väst. Arbetsmiljöverkets föreskrift 2015:4 betonar den organisatoriska och sociala arbetsmiljön, vilket väl tillgodoses i denna modell.

    Syfte

    Att systematiskt och långsiktigt arbeta med arbetsmiljön ur ett främjande, förebyggande och rehabiliterande perspektiv på såväl individ- som organisatorisk nivå för att utveckla förhållanden som bidrar till ett hållbart arbetsliv.

    Metod

    Genom KIWEST (Knowledge Intensive Work Environment Survey Target) kartläggs arbetsmiljön utifrån 28 olika dimensioner. Kategorier som belyses är t.ex. sociala, uppgiftsbaserade och organisatoriska resurser samt jobbkrav och tillhörighet till jobbet. Organisatoriska förhållanden mäts med FaktaARK 1 medan genomförda insatser mäts med FaktaARK 2.

    Resultat

    KIWEST sändes till all personal med 20 % anställning eller mer. Utav 539 tillfrågade personer svarade 376, vilket ger en svarsfrekvens på 69,8 %. Resultatet visar att specifikt för sektorn är upplevelsen av tidspress samtidigt som arbetet upplevs som meningsfullt och viktigt. Nu följer analyser, planering, genomförande och utvärdering av insatser på olika nivåer inom högskolan. KIWEST-formuläret sänds till personalen med 3-års intervall. I förbättringsarbetet ingår även att granska och utvärdera genomförandet, därvid ingår även metodutveckling. Förbättringsarbetet sätts in i ett större organisatoriskt perspektiv och är en naturlig del i kvalitetssäkringsprocessen och ledningssystemet. ARK-processen förväntas bidra till teoriutveckling av krav- och resursmodellen samt öka kunskapen om arbetsmiljön inom UoH.

  • 14.
    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 strategiesArtikkel i tidsskrift (Fagfellevurdert)
  • 15.
    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 infarction2013Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, s. 20836-Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 16.
    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.2015Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 15-16, s. 2192-2200Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 17.
    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 infarction2014Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 1 suppl, s. S15-S15Artikkel i tidsskrift (Fagfellevurdert)
  • 18.
    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 infarction2015Inngår i: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, Vol. 23, nr 1, s. 154-167Artikkel i tidsskrift (Fagfellevurdert)
  • 19.
    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.2015Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, s. 345-353Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 20.
    Fredriksson-Larsson, Ulla
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Lundgren-Nilsson, A.
    Univ Gothenburg, Inst Neurosci & Physiol, Ctr Person Centred Care.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa, kultur och pedagogik.
    Alsen, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Brink, E.
    Univ Gothenburg, Inst Hlth & Care Sci, Ctr Person Centred Care.
    Measuring fatigue with the multidimensional fatigue inventory (MFI-20) in persons treated for myocardial infarction2012Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, nr 1suppl, s. S50-S50Artikkel i tidsskrift (Fagfellevurdert)
  • 21. Hansson, Anders
    et al.
    Larsson, Lena G
    Närhälsan, FoU Primärvård, Västra Götalandsregionen och NU-akademin.
    Svensson, Ann
    Högskolan Väst, Institutionen för ekonomi och it, Avd för informatik.
    Alsén, Pia
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå.
    Ahlström, Britt Hedman
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Forsman, Berit
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Vem tar bollen?: går vården för de mest sjuka äldre att förbättra?2016Rapport (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund Flera svenska rapporter visar att de mest sjuka äldre ofta far illa på grund av bristande samordning och oklar ansvarsfördelning mellan olika behandlingsinstanser. Primärvården, hemtjänsten och den kommunala hemsjukvården anses i otillräcklig omfattning ta över ansvaret efter utskrivningen av de sjuka äldre från sjukhuset. Svenska erfarenheter stämmer väl med vad man funnit i flera internationella studier: sjukvården är illa rustad för att möta de mest sjuka äldres komplexa behov av vård och omsorg.

  • 22.
    Hansson, Anders
    et al.
    University Health Care Research Centre, Region Örebro County; Örebro University, School of Medical Sciences, Sweden; University of Gothenburg, Academy of Sahlgrenska, Institute of Medicine, Sweden.
    Svensson, Ann
    Högskolan Väst, Institutionen för ekonomi och it, Avd för informatik.
    Hedman Ahlström, Britt
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Larsson, Lena G.
    University of Gothenburg, Academy of Sahlgrenska, Institute of Medicine, Sweden.
    Forsman, Berit
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Flawed communications: Health professionals’ experience of collaboration in the care of frail elderly patients2018Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 7, s. 680-689Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals’ experience of obstacles and opportunities for collaboration. Methods: Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. Results: Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. Conclusions: Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees’ own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.

  • 23.
    Kristiansson, Susanne Olsson
    et al.
    Central Infant Welfare Unit, Fyrbodal, Sweden.
    Wijk, Sofia
    Central Infant Welfare Unit, Göteborg och Södra Bohuslän, Sweden.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Participation in parental group support offered by the Child Health Service in Sweden: A qualitative study2018Inngår i: Journal of Health Visiting, E-ISSN 2052-2908, Vol. 6, nr 3, s. 142-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    All new parents in Sweden are invited to participate in parent groups by the Child Health Service (CHS), but not all choose to attend. The aim of this study was to identify factors that promote and impede the participation of parents in parent groups managed by the CHS during their child's first year. Twelve parents with children aged 10–12 months were interviewed during 2013. The interview text was analysed using qualitative manifest content analysis. The analysis resulted in eight categories. Those describing promoting factors were: feeling personally invited; having social hopes; being influenced by those around you; experiencing social fellowship; and being satisfied with the group leader. Categories describing impeding factors were: the parent group is not perceived to be addressed to both parents; the parents do not prioritise the group sessions offered; and expectations are not met. The study found that it is important for parents to feel personally invited and that the group leader's actions may be significant both for promoting and impeding participation in parent groups. The CHS nurse needs to be aware of parents' and children's individual needs and work actively to make all group participants feel included.

  • 24.
    Nordqvist, L.
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Thorn, S.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    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.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Difficulties experienced by men during the first year after their myocardial infarction and fatigue2015Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, nr S1, s. S46-S46, artikkel-id 125Artikkel i tidsskrift (Fagfellevurdert)
  • 25.
    Nunstedt, Håkan
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Rudolfsson, Gudrun
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Pennbrant, Sandra
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Patients' Variations of Reflection About and Understanding of Long-term Illness: Impact of Illness Perception on Trust in Oneself or Others2017Inngår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 11, s. 43-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patients' understanding of their illness is of great importance for recovery. Lacking understanding of the illness is linked with the patients' level of reflection about and interest in understanding their illness. Objective: To describe patients’ variations of reflection about and understanding of their illness and how this understanding affects their trust in themselves or others. Method: The study is based on the “Illness perception” model. Latent content analysis was used for the data analysis. Individual, semi-structured, open-ended and face-to-face interviews were conducted with patients (n=11) suffering from a long-term illness diagnosed at least six months prior to the interview. Data collection took place in the three primary healthcare centres treating the participants. Results: The results show variations in the degree of reflection about illness. Patients search for deeper understanding of the illness for causal explanations, compare different perspectives for preventing complication of their illness, trust healthcare providers, and develop own strategies to manage life. Conclusion: Whereas some patients search for deeper understanding of their illness, other patients are less reflective and feel they can manage the illness without further understanding. Patients' understanding of their illness is related to their degree of trust in themselves or others. Patients whose illness poses an existential threat are more likely to reflect more about their illness and what treatment methods are available.

  • 26.
    Nunstedt, Håkan
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Rudolfsson, Gudrun
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Alsén, Pia
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Pennbrant, Sandra
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Strategies for healthcare professionals to facilitate patient illness understanding.2017Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 23-24, s. 4696-4706Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe how healthcare professionals facilitate patient illness understanding.

    BACKGROUND: Healthcare professionals and patients differ in their illness understanding. If the information provided by healthcare professionals is not adapted to the patient's daily life it may be unusable for the patient. Previous research has found that healthcare professionals should individualise the information to enable the patient to apply the knowledge to the personal situation and to develop illness understanding. However, little is known of how healthcare professionals can facilitate patient illness understanding.

    METHOD: A qualitative descriptive study based on individual, semi-structured, open-ended and face-to-face interviews was conducted with healthcare professionals (n=11) concerning how they facilitate patients illness understanding. Three health centres were involved during the period of March to November 2014. The interviews were analysed with qualitative content analysis.

    RESULTS: The result identified a continuous and collaborative process with three strategies used by healthcare professionals to facilitate the patient's illness understanding: 1) assess the patient's illness understanding, 2) interact with the patient to develop illness understanding, and 3) support the patient's personal development for illness understanding. The steps in the process depend on each other.

    CONCLUSIONS: The results of our analysis indicate that healthcare professionals can use the continuous and collaborative process to enhance the patient's self-care ability and turn his or her knowledge into action for improving illness understanding.

    RELEVANCE TO CLINICAL PRACTICE: The three continuous and collaborative process strategies involving pedagogical approaches can create conditions for healthcare professionals to obtain a holistic view of the patient's life and to be a key resource for person-centred care. This article is protected by copyright. All rights reserved.

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