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  • 1.
    Fossum, Mariann
    et al.
    Department of Health and Nursing Sciences, University of Adger.
    Söderhamn, Olle
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för hälsa, kultur och pedagogik.
    Söderhamn, Ulrika
    Translation and testing of the Risk Assessment Pressure Ulcer Sore scale used among residents in Norwegian nursing homes2012Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, nr 5, s. e001575-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose of this study was to translate and test the psychometric properties of the Norwegian language version of the Risk Assessment Pressure Sore (RAPS) scale.

    Background: Risk assessment scales for pressure ulcer (PU) prevention have become an aspect of quality improvement in healthcare, but their effectiveness depends on the reliability and validity of the scale.

    Methods: A convenience sample of 481 residents in 15 nursing homes in rural Norway was included between January and June 2007. The English-language version of the RAPS scale was translated into Norwegian, and this scale was used to collect the data, including a skin  examination. The number of PUs and grades were documented. Reliability was assessed in a small group of 26 residents and construct validity in the total study group.

    Results: Equivalence between two assessments regarding total scores of the RAPS scale was reflected in an intraclass correlation coefficient (ICC) of 0.95. Construct validity was supported, and the RAPS scale could define groups with expected low and high scores. Further evidence of construct validity was shown in a confirmatory factor analysis.

    Conclusion: The Norwegian version of the RAPS scale has shown sufficient psychometric properties to be considered a reliable and valid scale for identifying risk of PUs among nursing home residents. However, further testing is needed.

  • 2.
    Holst, Anna
    et al.
    University of Gothenburg, Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Björkelund, Cecilia
    University of Gothenburg, Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Metsini, Alexandra
    County Council of Värmland, Karlstad, Sweden.
    Madsen, Jens-Henrik
    Högskolan Väst, Institutionen för ekonomi och it, Avd för juridik, ekonomi, statistik och politik.
    Hange, Dominique
    University of Gothenburg, Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Petersson, Eva-Lisa L.
    University of Gothenburg, Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden Region Västra Götaland, Närhälsan Research and Development Primary Health Care, Gothenburg, Sweden.
    Eriksson, Maria C. M.
    University of Gothenburg, Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Kivi, Marie
    University of Gothenburg, Department of Psychology, Gothenburg, Sweden.
    Andersson, Per-Åke A.
    University of Gothenburg, Department of Economics, School of Business, Economics and Law, Gothenburg, Sweden.
    Svensson, Mikael
    University of Gothenburg, Department of Health Metrics, Sahlgrenska Academy, Gothenburg, Sweden.
    Cost-effectiveness analysis of internet-mediated cognitive behavioural therapy for depression in the primary care setting: results based on a controlled trial2018Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 6, artikel-id e019716Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To perform a cost-effectiveness analysis of a randomised controlled trial of internet-mediated cognitive behavioural therapy (ICBT) compared with treatment as usual (Tall) for patients with mild to moderate depression in the Swedish primary care setting. In particular, the objective was to assess from a healthcare and societal perspective the incremental cost-effectiveness ratio (ICER) of ICBT versus TaU at 12 months follow-up. Design A cost-effectiveness analysis alongside a pragmatic effectiveness trial. Setting Sixteen primary care centres (PCCs) in south-west Sweden. Participants Ninety patients diagnosed with mild to moderate depression at the PCCs. Main outcome measure ICERs calculated as (Cost(ICBT)-Cost(TaU))/(Health outcome(ICBT)-Health outcome(TaU))=Delta Cost/Delta Health outcomes, the health outcomes being changes in the Beck Depression Inventory-II (BDI-II) score and quality-adjusted life-years (QALYs). Results The total cost per patient for ICBT was 4044 Swedish kronor (SEK) ((sic)426) (healthcare perspective) and SEK47679 ((sic)5028) (societal perspective). The total cost per patient for TaU was SEK4434 ((sic)468) and SEK50 343 ((sic)5308). In both groups, the largest cost was associated with productivity loss. The differences in cost per patient were not statistically significant. The mean reduction in BDI-ll score was 13.4 and 13.8 units in the ICBT and Tall groups, respectively. The mean QALYs per patient was 0.74 and 0.79 in the ICBT and TaU groups, respectively. The differences in BDI-11 score reduction and mean QALYs were not statistically significant. The uncertainty of the study estimates when assessed by bootstrapping indicated that no firm conclusion could be drawn as to whether ICBT treatment compared with Tall was the most cost-effective use of resources. Conclusions ICBT was regarded to be as cost-effective as TaU as costs, health outcomes and cost-effectiveness were similar for ICBT and TaU, both from a healthcare and societal perspective.

  • 3.
    Nilsson, Hanna
    et al.
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Angerås, Ulf
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Bock, David
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences and Karolinska University Hospital, Stockholm, Sweden.
    Onerup, Aron
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Fagevik Olsen, Monika
    Department of Gastrosurgical Research and Education, Gothenburg, Sweden.
    Gellerstedt, Martin
    Högskolan Väst, Institutionen för ekonomi och it, Avd för juridik, ekonomi, statistik och politik. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Haglind, Eva
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Angenete, Eva
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Is preoperative physical activity related to post-surgery recovery?: A cohort study of patients with breast cancer2016Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, nr 1, artikel-id e007997Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of our study is to assess the association between preoperative level of activity and recovery after breast cancer surgery measured as hospital stay, length of sick leave and self-assessed physical and mental recovery. Design: A prospective cohort study. Setting: Patients included were those scheduled to undergo breast cancer surgery, between February and November 2013, at two participating hospitals in the Western Region of Sweden. Participants: Patients planned for breast cancer surgery filled out a questionnaire before, as well as at 3 and 6 weeks after the operation. The preoperative level of activity was self-assessed and categorised into four categories by the participants using the 4-level SaltinGrimby Physical Activity Level Scale (SGPALS). Main outcome measure: Our main outcome was postoperative recovery measured as length of sick leave, in-hospital stay and self-assessed physical and mental recovery. Results: 220 patients were included. Preoperatively, 14% (31/220) of participants assessed themselves to be physically inactive, 61% (135/220) to exert some light physical activity (PA) and 20% (43/220) to be more active (level 3+4). Patients operated with mastectomy versus partial mastectomy and axillary lymph node dissection versus sentinel node biopsy were less likely to have a short hospital stay, relative risk (RR) 0.88 (0.78 to 1.00) and 0.82 (0.70 to 0.96). More active participants (level 3 or 4) had an 85% increased chance of feeling physically recovered at 3 weeks after the operation, RR 1.85 (1.20 to 2.85). No difference was seen after 6 weeks. Conclusions: The above study shows that a higher preoperative level of PA is associated with a faster physical recovery as reported by the patients 3 weeks post breast cancer surgery. After 6 weeks, most patients felt physically recovered, diminishing the association above. No difference was seen in length of sick leave or self-assessed mental recovery between inactive or more active patients.

  • 4.
    Walladbegi, Java
    et al.
    University of Gothenburg, Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, Gothenburg, Sweden..
    Svanberg, Anncarin
    Uppsala University Hospital, Department of Hematology, Faculty of Medicine, Institute for Medical Sciences, Uppsala, Sweden.
    Gellerstedt, Martin
    Högskolan Väst, Institutionen för ekonomi och it, Avd för informatik.
    Protocol for a randomised controlled trial to study cryoprevention of chemotherapy-induced oral mucositis after autologous stem cell transplantation.2018Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 10, artikel-id e021993Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: A majority of patients who receive myeloablative therapy prior to hematopoetic stem cell transplantation develop oral mucositis (OM). This adverse cytotoxic effect manifests as oral mucosal erythema and ulcerations and frequently necessitates high doses of morphine for pain alleviation. OM may also interfere with food intake and result in parenteral nutrition, weight loss and impaired quality of life. To date, there have been a few studies of evidence-based interventions for prevention of OM. Cooling the oral mucosa using ice chips in conjunction with chemotherapy is known to reduce the severity of OM although clinical application is still limited due to several disadvantages. The primary endpoint of this study is therefore to evaluate the efficacy of an innovative intraoral cooling device (Cooral) compared with ice cooling in reducing the degree of OM, in patients with myeloma or lymphoma.

    METHOD AND ANALYSIS: A total of 180 patients from four different university hospitals in Sweden will be randomised to ice or Cooral in a proportion of 1:1. The degree of OM will be assessed at eight intraoral locations, in accordance with the Oral Mucositis Assessment Scale and WHO scale. Patients will be registered beginning at admission and will continue until discharge or until day +28. The primary variable is analysed in a multiple linear regression model. The significance level used is 5%.

    ETHICS AND DISSEMINATION: The study protocol, questionnaire, diaries and letter of invitation to participants have been reviewed by the local ethical board in Göteborg. The trial results will be published in a peer-reviewed journal and disseminated to participants.

    TRIAL REGISTRATION NUMBER: NCT03203733; Pre-results.

    PROTOCOL VERSION: Version 4, 2017-06-05.

1 - 4 av 4
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