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Samuelsson, Eva
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Publications (10 of 52) Show all publications
Wadensten, T., Nyström, E., Franzen, K., Stenzelius, K., Lindam, A. & Samuelsson, E. (2019). A SMARTPHONE APP FOR SELF-MANAGEMENT OF URGENCY AND MIXED URINARY INCONTINENCE: A RANDOMIZED CONTROLLED TRIAL. Paper presented at 49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN. Neurourology and Urodynamics, 38, S361-S363
Open this publication in new window or tab >>A SMARTPHONE APP FOR SELF-MANAGEMENT OF URGENCY AND MIXED URINARY INCONTINENCE: A RANDOMIZED CONTROLLED TRIAL
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2019 (English)In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 38, p. S361-S363Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-162316 (URN)000477753000250 ()
Conference
49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN
Available from: 2019-09-03 Created: 2019-09-03 Last updated: 2019-09-03Bibliographically approved
Wahlberg, K., Alpstal, G. & Samuelsson, E. (2019). A SMARTPHONE APP MAY FACILITATE PELVIC FLOOR MUSCLE TRAINING, FOR MEN PRIOR TO AND AFTER RADICAL PROSTATECTOMY.. Paper presented at 49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN. Neurourology and Urodynamics, 38, S450-S452
Open this publication in new window or tab >>A SMARTPHONE APP MAY FACILITATE PELVIC FLOOR MUSCLE TRAINING, FOR MEN PRIOR TO AND AFTER RADICAL PROSTATECTOMY.
2019 (English)In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 38, p. S450-S452Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-162312 (URN)000477753000311 ()
Conference
49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN
Note

Supplement: 3

Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10
Nilsson, G., Soderstrom, L., Alverlind, K., Samuelsson, E. & Mooe, T. (2019). Hand-held cardiac ultrasound examinations performed in primary care patients by nonexperts to identify reduced ejection fraction. BMC Medical Education, 19, Article ID 282.
Open this publication in new window or tab >>Hand-held cardiac ultrasound examinations performed in primary care patients by nonexperts to identify reduced ejection fraction
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2019 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, article id 282Article in journal (Refereed) Published
Abstract [en]

BackgroundEarly identification of patients with reduced left ventricular ejection fraction (LVEF) could facilitate the care of patients with suspected heart failure (HF). We examined if (1) focused cardiac ultrasound (FCU) performed with a hand-held device (Vscan 1.2) could identify patients with LVEF <50%, and (2) the distribution of HF types among patients with suspected HF seen at primary care clinics.MethodsFCU performed by general practitioners (GPs)/GP registrars after a training programme comprising 20 supervised FCU examinations were compared with the corresponding results from conventional cardiac ultrasound by specialists. The agreement between groups of estimated LVEF <50%, after visual assessment of global left ventricular function, was compared. Types of HF were determined according to the outcomes from the reference examinations and serum levels of natriuretic peptides (NT-proBNP).ResultsOne hundred patients were examined by FCU that was performed by 1-4 independent examiners as well as by the reference method, contributing to 140 examinations (false positive rate, 19.0%; false negative rate, 52.6%; sensitivity, 47.4% [95% confidence interval [CI]: 27.3-68.3]; specificity, 81.0% [95% CI: 73.1-87.0]; Cohen's kappa measure for agreement=0.22 [95% CI: 0.03-0.40]). Among patients with false negative examinations, 1/7 had HF with LVEF <40%, while the others had HF with LVEF 40-49% or did not meet the full criteria for HF. In patients with NT-proBNP >125ng/L and fulfilling the criteria for HF (68/94), HF with preserved LVEF (>= 50%) predominated, followed by mid-range (40-49%) or reduced LVEF (<40%) HF types (53.2, 11.7 and 7.4%, respectively).ConclusionsThere was poor agreement between expert examiners using standard ultrasound equipment and non-experts using a handheld ultrasound device to identify patients with reduced LVEF. Asides from possible shortcomings of the training programme, the poor performance of non-experts could be explained by their limited experience in identifying left ventricular dysfunction because of the low percentage of patients with HF and reduced ejection fraction seen in the primary care setting.Trial registrationThe study was registered at ClinicalTrials.gov (NCT02939157). Registered 19 October 2016.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Echocardiography, Heart failure, Primary care, Clinical trial
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-161987 (URN)10.1186/s12909-019-1713-9 (DOI)000477596100003 ()31345207 (PubMedID)
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-08-14Bibliographically approved
Bokne, K., Sjöström, M. & Samuelsson, E. (2019). Self-management of stress urinary incontinence: effectiveness of two treatment programmes focused on pelvic floor muscle training, one booklet and one Internet-based. Scandinavian Journal of Primary Health Care
Open this publication in new window or tab >>Self-management of stress urinary incontinence: effectiveness of two treatment programmes focused on pelvic floor muscle training, one booklet and one Internet-based
2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: In a previous study, self-management of stress urinary incontinence (SUI), via an Internet-based programme or a booklet improved symptoms and quality of life. We wanted to evaluate the effectiveness of these programmes when implemented for free use, as well as to characterize the users.

Design: Pragmatic prospective cohort study.

Setting and subjects: Information about the Internet programme and the booklet was provided at www.tät.nu and by nurse midwives. Both programmes included a three-month pelvic floor muscle training (PFMT) programme. Questionnaires were used at the start and after three months.

Main outcome measures: Characteristics of the participants regarding age and education. Reductions in symptom severity was measured using the validated ICIQ-UI SF.

Results: 109 women using the booklet, and 166 women using the Internet-based programme responded to the pre-treatment questionnaire. Of these, 53 (48.6%) in the booklet group and 27 (16.3%) in the Internet group responded to the follow-up. The mean age of booklet users was higher, 59.4 years vs. 54.5 years (p = .005). The proportion of women with post-secondary education was high, 59% in the booklet group and 67% in the Internet group. The mean reduction in the symptom score was 2.6 points (SD 3.4) in the booklet group, and 3.4 (SD 2.9) in the Internet group. These reductions were significant within both groups, with no difference between the groups, and in the same order of magnitude as in the previous randomised controlled study.

Conclusion: Two self-management programmes for SUI, one provided as a booklet and one as an Internet-based programme, also rendered clinically relevant improvements when made freely available.

Key points:

  • Female stress urinary incontinence can be treated using self-management programmes focused on pelvic floor muscle training. This study evaluates the effect of two different programmes, one provided as a booklet and one Internet-based, when made freely available to the public.
  • Both programmes rendered clinically relevant improvements, in the same order of magnitude as in the previous randomised controlled study.
  • Self-management of stress urinary incontinence should be recommended to women that request treatment.
Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Stress, urinary incontinence, pelvic floor exercises, self-management, e-health
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-161894 (URN)10.1080/02813432.2019.1640921 (DOI)000476291900001 ()31317808 (PubMedID)
Available from: 2019-08-08 Created: 2019-08-08 Last updated: 2019-08-08
Asklund, I. & Samuelsson, E. (2019). THE USE OF AN APP WITH A PFMT PROGRAMME AMONG PREGNANT AND POSTNATAL WOMEN FOR PREVENTIVE USE AND TREATMENT OF URINARY INCONTINENCE. Paper presented at 49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN. Neurourology and Urodynamics, 38, S452-S453
Open this publication in new window or tab >>THE USE OF AN APP WITH A PFMT PROGRAMME AMONG PREGNANT AND POSTNATAL WOMEN FOR PREVENTIVE USE AND TREATMENT OF URINARY INCONTINENCE
2019 (English)In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 38, p. S452-S453Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2019
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-162313 (URN)000477753000312 ()
Conference
49th Annual Meeting of the International-Continence-Society (ICS), SEP 03-06, 2019, Gothenburg, SWEDEN
Note

Supplement: 3

Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05Bibliographically approved
Asklund, I., Samuelsson, E., Hamberg, K., Umefjord, G. & Sjöström, M. (2019). User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualitative Interview Study. Journal of Medical Internet Research, 21(3), Article ID e11296.
Open this publication in new window or tab >>User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualitative Interview Study
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2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 3, article id e11296Article in journal (Refereed) Published
Abstract [en]

Background: Stress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment.

Objective: This study aimed to explore women’s experiences of using an app-based treatment program for SUI.

Methods: This qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory.

Results: The results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment.

Conclusions: Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program.

Trial Registration: ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)

Keywords
mobile applications, urinary incontinence, stress, pelvic floor muscle training, self-management, qualitative research, grounded theory, women’s health
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-157751 (URN)10.2196/11296 (DOI)000461286800001 ()30869644 (PubMedID)2-s2.0-85062859247 (Scopus ID)
Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-04-09Bibliographically approved
Nyström, E., Asklund, I., Sjöström, M., Stenlund, H. & Samuelsson, E. (2018). Re: Treatment of stress urinary incontinence with a mobile app: factors associated with success [Letter to the editor]. International Urogynecology Journal, 29(6), 925-925
Open this publication in new window or tab >>Re: Treatment of stress urinary incontinence with a mobile app: factors associated with success
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2018 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 6, p. 925-925Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Springer, 2018
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-148011 (URN)10.1007/s00192-018-3632-4 (DOI)000431930700023 ()29594320 (PubMedID)
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2018-06-09Bibliographically approved
Nyström, E., Asklund, I., Sjöström, M., Stenlund, H. & Samuelsson, E. (2018). Treatment of stress urinary incontinence with a mobile app: factors associated with success. International Urogynecology Journal, 29(9), 1325-1333
Open this publication in new window or tab >>Treatment of stress urinary incontinence with a mobile app: factors associated with success
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2018 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 9, p. 1325-1333Article in journal (Refereed) Published
Abstract [en]

Introduction and hypothesis: Stress urinary incontinence is common among women. First-line treatment includes pelvic floor muscle training (PFMT) and lifestyle advice, which can be provided via a mobile app. The efficacy of app-based treatment has been demonstrated in a randomized controlled trial (RCT). In this study, we aimed to analyze factors associated with successful treatment.

Methods: Secondary analysis of data from the RCT. At baseline and 3-month follow-up, participants (n = 61) answered questions about symptoms, quality of life, background, and PFMT. Success was defined as rating the condition as much or very much better according to the validated Patient Global Impression of Improvement questionnaire. Factors possibly associated with success were analyzed with univariate logistic regression; if p < 0.20, the factor was entered into a multivariate model that was adjusted for age. Variables were then removed stepwise.

Results: At follow-up, 34 out of 61 (56%) of participants stated that their condition was much or very much better. Three factors were significantly associated with success: higher expectations for treatment (odds ratio [OR] 11.38, 95% confidence interval [CI] 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.25-0.79), and self-rated improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61). Together, these factors accounted for 61.4% (Nagelkerke R-2) of the variability in success.

Conclusion: These results indicate that app-based treatment effects are better in women who are interested in and have high expectations of such treatment. Also, the findings underline the importance of strengthening the pelvic floor muscles and offering lifestyle advice.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Mobile applications, Pelvic floor muscle training, Stress urinary incontinence, Self-management
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-152224 (URN)10.1007/s00192-017-3514-1 (DOI)000443429400014 ()29222718 (PubMedID)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2019-05-16Bibliographically approved
Sjöström, M., Lindholm, L. & Samuelsson, E. (2017). Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis. Journal of Medical Internet Research, 19(5), Article ID e154.
Open this publication in new window or tab >>Mobile App for Treatment of Stress Urinary Incontinence: A Cost-Effectiveness Analysis
2017 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 19, no 5, article id e154Article in journal (Refereed) Published
Abstract [en]

Background: Mobile apps can increase access to care, facilitate self-management, and improve adherence to treatment. Stress urinary incontinence (SUI) affects 10-35% of women and, currently, an app with instructions for pelvic floor muscle training (PFMT) is available as first-line treatment. A previous randomized controlled study demonstrated that the app benefitted symptom severity and quality of life (QoL); in this study we investigate the cost-effectiveness of the app. Objective: The objective of this study was to evaluate the health economy of the app for treating SUI. Methods: This deterministic cost-utility analysis, with a 1-year societal perspective, compared the app treatment with no treatment. Health economic data were collected alongside a randomized controlled trial performed in Sweden from March 2013 to October 2014. This study included 123 community-dwelling women participants of 18 years and above, with stress urinary incontinence >= 1 time per week. Participants were self-assessed with validated questionnaires and 2-day leakage diaries, and then randomized to 3 months of treatment (app group, n=62) or no treatment (controls, n=61). The app focused on pelvic floor muscle training, prescribed 3 times daily. We continuously registered treatment delivery costs. Data were collected on each participant's training time, incontinence aids, and laundry at baseline and at a 3-month follow-up. We measured quality of life with the International Consultation on Incontinence Modular Questionnaire on Lower Urinary Tract Symptoms and Quality of Life, and calculated the quality-adjusted life years (QALYs) gained. Data from the 3-month follow-up were extrapolated to 1 year for the calculations. Our main outcome was the incremental cost-effectiveness ratios compared between app and control groups. One-way and multiway sensitivity analyses were performed. Results: The mean age of participants was 44.7 years (SD 9.4). Annual costs were (sic)547.0 for the app group and (sic)482.4 for the control group. Annual gains in quality-adjusted life years for app and control groups were 0.0101 and 0.0016, respectively. Compared with controls, the extra cost per quality-adjusted life year for the app group ranged from -(sic) 2425.7 to (sic) 14,870.6, which indicated greater gains in quality-adjusted life years at similar or slightly higher cost. Conclusions: The app for treating stress urinary incontinence is a new, cost-effective, first-line treatment with potential for increasing access to care in a sustainable way for this patient group.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC, 2017
Keywords
mobile application, pelvic floor, urinary incontinence, stress, self care, cost-benefit analysis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy General Practice
Identifiers
urn:nbn:se:umu:diva-136069 (URN)10.2196/jmir.7383 (DOI)000401008500013 ()28483745 (PubMedID)
Available from: 2017-06-16 Created: 2017-06-16 Last updated: 2019-05-21Bibliographically approved
Asklund, I., Nyström, E., Sjöström, M., Umefjord, G., Stenlund, H. & Samuelsson, E. (2017). Mobile app for treatment of stress urinary incontinence: a randomized controlled trial. Neurourology and Urodynamics, 36(5), 1369-1376
Open this publication in new window or tab >>Mobile app for treatment of stress urinary incontinence: a randomized controlled trial
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2017 (English)In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 36, no 5, p. 1369-1376Article in journal (Refereed) Published
Abstract [en]

AIMS: To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women.

METHODS: Randomized controlled trial, conducted 2013-2014 in Sweden. Community-dwelling adult women with ≥1 SUI episode/week recruited through our website and randomized to app treatment (n = 62) or control group (postponed treatment, n = 61). One participant from each group was lost to follow-up. Intervention was the mobile app Tät(®) with a treatment program focused on pelvic floor muscle training (PFMT), and information about SUI and lifestyle factors. Primary outcomes, 3 months after randomization: symptom severity (International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form [ICIQ-UI SF]); and condition-specific quality of life (ICIQ Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]).

RESULTS: One hundred and twenty-three women were included (mean age 44.7), with moderate/severe SUI (97.5%, 120/123), mean ICIQ-UI SF score 11.1 (SD 2.8) and mean ICIQ-LUTSqol score 34.4 (SD 6.1) at baseline. At follow-up, the app group reported improvements in symptom severity (mean ICIQ-UI SF score reduction: 3.9, 95% confidence interval 3.0-4.7) and condition-specific quality of life (mean ICIQ-LUTSqol score reduction: 4.8, 3.4-6.2) and the groups were significantly different (mean ICIQ-UI SF score difference: -3.2, -4.3to -2.1; mean ICIQ-LUTSqol score difference: -4.6, -7.8 to -1.4). In the app group, 98.4% (60/61) performed PFMT at follow-up, and 41.0% (25/61) performed it daily.

CONCLUSIONS: The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
mobile applications, pelvic floor muscle training, randomized controlled trial, self-management, stress urinary incontinence
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-127492 (URN)10.1002/nau.23116 (DOI)000404361100020 ()27611958 (PubMedID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2019-05-16Bibliographically approved
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