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  • 1.
    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.

  • 2.
    Fredriksson-Larsson, Ulla
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Fatigue och återhämtning efter hjärtinfarkt2015Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Fast and efficient acute medical treatment of myocardial infarction (MI) has developed during recent years and has resulted in a reduced number of days spent in hospital and increased survival. To optimize persons’ recovery, secondary preventive strategies are important. Fatigue has been reported to be the most bothersome symptom in 50% of persons treated for MI and was described as incomprehensible due to its unpredictable occurrence and unknown cause. Today, in cardiac rehabilitation programs there are typically few or no recommendations at all concerning strategies for dealing with fatigue after MI. The main focus was to explore how self-reported fatigue after MI could be measured in a psychometrically valid manner and to describe the symptom of fatigue in relation to other concurrent symptoms, how the heart attack was handled and its consequences in everyday life two months after MI. With a view to creating opportunities to identify and measure fatigue post-MI, the first specific aim was to validate the usefulness of the questionnaire Multidimensional Fatigue Inventory-20 (MFI-20). A psychometric method called Rasch analysis was used. The results showed that the MFI-20 can be used to obtain a global score reflecting an underlying unidimensional trait of fatigue; and transformation of the summarized raw scale scores into interval scale scores was possible. Also, four of the five original dimensions separately fitted the Rasch model and could be used to identify general fatigue, physical fatigue, mental fatigue and reduced activity. One of the specific aims was to examine persons’ experiences of fatigue consequences and strategies used to manage fatigue two months after the heart attack. Interviews were conducted (n= 18) and analyzed 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. Another specific aim was to explore fatigue levels two months after myocardial infarction (MI) and examine associations with other concurrent symptoms, sleep quality and the coping strategies used to handle the MI. The results showed that a global fatigue score two months post-MI was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies, such as change of values, intrusion, and isolation. In comparisons of present fatigue dimension levels (general fatigue, physical fatigue, reduced activity and mental fatigue) two months post-MI and baseline measurements (first week in hospital), the results showed that levels of fatigue dimensions had decreased. In comparisons with levels of fatigue four months post-MI in a reference group, we found lower levels of fatigue two months post-MI. In the final study, the aim was to validate a single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. The results confirmed the convergent validity of the single-item measure of stress symptoms. 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). In conclusion, fatigue two months post-MI had significant consequences because it restricted informants’ potential to function in daily life as they had done previously. The present thesis showed that post-MI fatigue could be identified both globally and multidimensionality. The results could serve as the basis for a future recovery intervention aimed at preventing and relieving post-MI fatigue and based on managing daily life in relation to personal experiences. By facilitating identification of fatigued persons using quantitative measurements and personal narratives about the consequences of fatigue, such an intervention would enable health-care professionals to tailor fatigue relief support during the recovery period. Elaboration of this intervention is a question for further research.

  • 3.
    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)
  • 4.
    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.

  • 5.
    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.

  • 6.
    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)
  • 7.
    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

  • 8.
    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)
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