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Lindgren, Lenita
Publications (10 of 20) Show all publications
Härgestam, M., Lindgren, L. & Jacobsson, M. (2024). Can equity in care be achieved for stigmatized patients? Discourses of ideological dilemmas in perioperative care. BMC Health Services Research, 24(1), Article ID 210.
Open this publication in new window or tab >>Can equity in care be achieved for stigmatized patients? Discourses of ideological dilemmas in perioperative care
2024 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 210Article in journal (Refereed) Published
Abstract [en]

Background: In the perioperative care of individuals with obesity, it is imperative to consider the presence of risk factors that may predispose them to complications. Providing optimal care in such cases proves to be a multifaceted challenge, significantly distinct from the care required for non-obese patients. However, patients with morbidities regarded as self-inflicted, such as obesity, described feelings of being judged and discriminated in healthcare. At the same time, healthcare personnel express difficulties in acting in an appropriate and non-insulting way. In this study, the aim was to analyse how registered nurse anaesthetists positioned themselves regarding obese patients in perioperative care.

Methods: We used discursive psychology to analyse how registered nurse anaesthetists positioned themselves toward obese patients in perioperative care, while striving to provide equitable care. The empirical material was drawn from interviews with 15 registered nurse anaesthetists working in a hospital in northern Sweden.

Results: Obese patients were described as “untypical”, and more “resource-demanding” than for the “normal” patient in perioperative care. This created conflicting feelings, and generated frustration directed toward the patients when the care demanded extra work that had not been accounted for in the schedules created by the organization and managers.

Conclusions: Although the intention of these registered nurse anaesthetists was to offer all patients equitable care, the organization did not always provide the necessary resources. This contributed to the registered nurse anaesthetists either consciously or unconsciously blaming patients who deviated from the “norm”.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Discourse psychology, Discrimination, Equity, Ideological dilemma, Perioperative care, Stigmatization, Weight bias
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-221533 (URN)10.1186/s12913-024-10580-5 (DOI)001163304600005 ()38360678 (PubMedID)2-s2.0-85185237227 (Scopus ID)
Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2024-03-19Bibliographically approved
Olofsson, E., Gustafson, Y., Mukka, S., Tengman, E., Lindgren, L. & Olofsson, B. (2023). Association of depressive disorders and dementia with mortality among older people with hip fracture. BMC Geriatrics, 23(1), Article ID 135.
Open this publication in new window or tab >>Association of depressive disorders and dementia with mortality among older people with hip fracture
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2023 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 135Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions.

AIMS: To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people.

METHODS: Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates.

RESULTS: In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone.

CONCLUSION: DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions.

TRIAL REGISTRATION: RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Dementia, Depressive disorders, Hip fracture, Mortality, Older people
National Category
Orthopaedics Geriatrics
Identifiers
urn:nbn:se:umu:diva-205678 (URN)10.1186/s12877-023-03862-w (DOI)000945613200001 ()36890449 (PubMedID)2-s2.0-85149626612 (Scopus ID)
Funder
Vårdal FoundationVisare NorrThe Kempe FoundationsUmeå UniversityRegion VästerbottenSwedish Research Council, K2005‐27VX‐15357‐01A
Available from: 2023-03-14 Created: 2023-03-14 Last updated: 2023-04-03Bibliographically approved
Dahlberg, K., Månsson, S., Lyckner, S., Lindgren, L. & Alm, F. (2023). The effect of COVID-19 pandemic on perioperative factors: data from the Swedish Perioperative Register. Perioperative Medicine, 12(1), Article ID 50.
Open this publication in new window or tab >>The effect of COVID-19 pandemic on perioperative factors: data from the Swedish Perioperative Register
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2023 (English)In: Perioperative Medicine, E-ISSN 2047-0525, Vol. 12, no 1, article id 50Article in journal (Refereed) Published
Abstract [en]

Background: The COVID-19 pandemic has affected healthcare organizations in many areas. The aim of this study was to describe surgical interventions, anesthesia, and postoperative outcomes in adult patients during the first wave and 1 year into the COVID-19 pandemic in Sweden, and to compare these outcomes with outcomes during the same period the year before the pandemic.

Methods: Data were collected from the Swedish PeriOperative Register, and included 417, 233 perioperative registration of patients = 18 years old between period 1 (March-June 2019), period 2 (March-June 2020), and period 3 (March-June 2021).

Results: Compared with pre-pandemic (period 1), the number of surgical interventions decreased by 28% in the first wave (period 2); 1 year into the pandemic (period 3), the number of interventions was still 7.5% lower than pre-pandemic. The largest drops between periods 1 and 2 were noted in the specialties of ear, nose, and larynx surgery, - 55.6%; teeth, jaws, mouth, and pharynx surgery, - 45.0%; endocrine system surgery, - 38.8%. The number of acute surgeries remained stable during all three periods. Volatiles were more frequently used for the maintenance of general anesthesia in period 2 than in either period 1 or 3 (p < 0.001). Minor differences were noted throughout the periods in postoperative nausea and vomiting as well as postoperative pain.

Conclusions: The COVID-19 pandemic has had an impact on perioperative care in Sweden. During the first wave of the pandemic, the number of surgical interventions decreased, but the number of acute surgeries remained stable compared with pre-pandemic numbers. Perioperative organizations have had and will continue to have challenges handling the increased number of patients needing perioperative care.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
COVID-19 pandemic, Perioperative period, Postoperative outcomes, Anesthesia, Surgical interventions
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-218933 (URN)10.1186/s13741-023-00340-0 (DOI)001068887600001 ()37715220 (PubMedID)
Available from: 2024-01-03 Created: 2024-01-03 Last updated: 2024-01-03Bibliographically approved
Glans, A., Wilén, J., Lindgren, L., Björkman-Burtscher, I. M. & Hansson, B. (2022). Health effects related to exposure of static magnetic fields and acoustic noise—comparison between MR and CT radiographers. European Radiology, 32(11), 7896-7909
Open this publication in new window or tab >>Health effects related to exposure of static magnetic fields and acoustic noise—comparison between MR and CT radiographers
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2022 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 32, no 11, p. 7896-7909Article in journal (Refereed) Published
Abstract [en]

Objectives: We explored the prevalence of health complaints subjectively associated with static magnetic field (SMF) and acoustic noise exposure among MR radiographers in Sweden, using CT radiographers as a control group. Additionally, we explored radiographers’ use of strategies to mitigate adverse health effects.

Methods: A cross-sectional survey was sent to all hospitals with MR units in Sweden. MR and/or CT personnel reported prevalence and attribution of symptoms (vertigo/dizziness, nausea, metallic taste, illusion of movement, ringing sensations/tinnitus, headache, unusual drowsiness/tiredness, forgetfulness, difficulties concentrating, and difficulties sleeping) within the last year. We used logistic regression to test associations between sex, age, stress, SMF strength, working hours, and symptom prevalence. Data regarding hearing function, work-environmental noise, and strategies to mitigate adverse symptoms were also analysed.

Results: In total, 529 out of 546 respondents from 86 hospitals were eligible for participation. A ≥ 20 working hours/week/modality cut-off rendered 342 participants grouped into CT (n = 75), MR (n = 121), or mixed personnel (n = 146). No significant differences in symptom prevalence were seen between groups. Working at ≥ 3T increased SMF-associated symptoms as compared with working at ≤ 1.5T (OR: 2.03, CI95: 1.05–3.93). Stress was a significant confounder. Work-related noise was rated as more troublesome by CT than MR personnel (p < 0.01). MR personnel tended to use more strategies to mitigate adverse symptoms.

Conclusion: No significant differences in symptom prevalence were seen between MR and CT radiographers. However, working at 3T increased the risk of SMF symptoms, and stress increased adverse health effects. Noise nuisance was considered more problematic by CT than MR personnel.

Key Points:

  • No significant differences in symptom prevalence were seen between MR and CT radiographers.
  • Working at ≥ 3 T doubled the odds of experiencing SMF symptoms (vertigo/dizziness, nausea, metallic taste, and/or illusion of movement) as compared to working exclusively at ≤ 1.5 T.
  • Work-related acoustic noise was less well mitigated and was rated as more troublesome by CT personnel than by MR personnel.
Place, publisher, year, edition, pages
Springer, 2022
Keywords
Electromagnetic fields, Magnetic resonance imaging, Occupational health, Surveys and questionnaires, Tomography, X-ray computed
National Category
Radiology, Nuclear Medicine and Medical Imaging Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-203281 (URN)10.1007/s00330-022-08843-y (DOI)000807990400001 ()35674823 (PubMedID)2-s2.0-85131511465 (Scopus ID)
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2023-01-18Bibliographically approved
Fontan, A., Lindgren, L., Pedale, T., Brorsson, C., Bergström, F. & Eriksson, J. (2021). A reduced level of consciousness affects non-conscious processes. NeuroImage, 244, Article ID 118571.
Open this publication in new window or tab >>A reduced level of consciousness affects non-conscious processes
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2021 (English)In: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 244, article id 118571Article in journal (Refereed) Published
Abstract [en]

Being conscious is a profound aspect of human existence, and understanding its function and its inception is considered one of the truly grand scientific challenges. However, the nature of consciousness remains enigmatic, to a large part because “being conscious” can refer to both the content (phenomenology) and the level (arousal) of consciousness, and how these different aspects are related remains unclear. To empirically assess the relation between level and content of consciousness, we manipulated these two aspects by presenting stimuli consciously or non-consciously and by using Propofol sedation, while brain activity was measured using fMRI. We observed that sedation affected both conscious and non-conscious processes but at different hierarchical levels; while conscious processing was altered in higher-order regions (the intraparietal sulcus) and spared sensory areas, the opposite effect was observed for non-conscious processing. The observation that Propofol affected non-conscious processing calls for a reconsideration of what kind of information one can gain on “consciousness” from recording neural responses to sedation without considering both (content) conscious and (content) non-conscious processing.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Brain activity, Consciousness, fMRI, Sedation, Unconscious
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-187741 (URN)10.1016/j.neuroimage.2021.118571 (DOI)000696967000002 ()34509624 (PubMedID)2-s2.0-85114794464 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P17-0772:1
Available from: 2021-09-28 Created: 2021-09-28 Last updated: 2023-05-02Bibliographically approved
Glans, A., Wilén, J. & Lindgren, L. (2021). Maintaining Image Quality While Reducing Acoustic Noise and Switched Gradient Field Exposure During Lumbar MRI. Journal of Magnetic Resonance Imaging, 54(1), 315-325
Open this publication in new window or tab >>Maintaining Image Quality While Reducing Acoustic Noise and Switched Gradient Field Exposure During Lumbar MRI
2021 (English)In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 54, no 1, p. 315-325Article in journal (Refereed) Published
Abstract [en]

Background: MR-generated acoustic noise can contribute to patient discomfort and potentially be harmful. One way to reduce this noise is by altering the gradient output and/or waveform using software optimization. Such modifications might influence image quality and switched gradient field exposure, and different techniques appear to affect sound pressure levels (SPLs) to various degrees.

Purpose: To evaluate SPLs, image quality, switched gradient field exposure, and participants' perceived noise levels during two different acoustic noise reduction (ANR) techniques, Quiet Suite (QS) and Whisper Mode (WM), and to compare them with conventional T2-weighted turbo spin echo (T2W TSE) of the lumbar spine.

Design: Prospective.

Subjects: Forty adults referred for lumbar MRI.

Field strength/sequence: Conventional T2W TSE, T2W TSE with QS, and T2W TSE with WM were acquired at 1.5 T.

Assessment: Peak SPL (A-weighted decibels, dBA), perceived noise levels (Borg CR10®-scale), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), three radiologists' qualitative assessments in image quality on an ordinal scale 1-4, switched gradient field exposure (% general public), and gradient currents were measured. Interobserver reliability was reported as percentage agreement.

Statistical tests: Repeated measures ANOVA, Friedman's ANOVA, and Wilcoxon's Signed-Rank Test for acoustic noise measurements and image quality assessments.

Results: Mean peak SPLs were 89.9 dBA, 74.3 dBA, and 78.8 dBA for conventional, QS, and WM, respectively (P < 0.05). Participants perceived QS as the quietest and conventional as the loudest sequence (P < 0.05). No qualitative differences in image quality were seen (P > 0.05), although QS showed significantly improved SNR and CNR (P < 0.05). Switched gradient field exposure was reduced by 66% and 48% for QS and WM, respectively.

Data conclusion: Without degrading image quality, both QS and WM are viable ANR techniques in lumbar T2W TSE. QS provided the lowest SPL, the lowest gradient field exposure and was perceived as the most silent among the three sequences.

Level of evidence: 1 TECHNICAL EFFICACY STAGE: 5.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
MRI safety, magnetic field, patient comfort, quiet suite, whisper mode
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-179857 (URN)10.1002/jmri.27527 (DOI)000616367300001 ()33565199 (PubMedID)2-s2.0-85100635401 (Scopus ID)
Available from: 2021-02-11 Created: 2021-02-11 Last updated: 2022-05-12Bibliographically approved
Awad, A., Levi, R., Waller, M., Westling, G., Lindgren, L. & Eriksson, J. (2020). Preserved somatosensory conduction in complete spinal cord injury: Discomplete SCI. Clinical Neurophysiology, 131(5), 1059-1067
Open this publication in new window or tab >>Preserved somatosensory conduction in complete spinal cord injury: Discomplete SCI
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2020 (English)In: Clinical Neurophysiology, ISSN 1388-2457, E-ISSN 1872-8952, Vol. 131, no 5, p. 1059-1067Article in journal (Refereed) Published
Abstract [en]

Objective: Spinal cord injury (SCI) disrupts the communication between brain and body parts innervated from below-injury spinal segments, but rarely results in complete anatomical transection of the spinal cord. The aim of this study was to investigate residual somatosensory conduction in clinically complete SCI, to corroborate the concept of sensory discomplete SCI.

Methods: We used fMRI with a somatosensory protocol in which blinded and randomized tactile and nociceptive stimulation was applied on both legs (below-injury level) and one arm (above-injury level) in eleven participants with chronic complete SCI. The experimental design accounts for possible confounding mechanical (e.g. vibration) and cortico-cortical top-down mechanisms (e.g. attention/expectation).

Results: Somatosensory stimulation on below-level insensate body regions activated the somatotopically corresponding part of the contralateral primary somatosensory cortex in six out of eleven participants.

Conclusions: Our results represent afferent-driven cortical activation through preserved somatosensory connections to the brain in a subgroup of participants with clinically complete SCI, i.e. sensory discomplete SCI.

Significance: Identifying patients with residual somatosensory connections might open the door for new rehabilitative and restorative strategies as well as inform research on SCI-related conditions such as neuropathic pain and spasticity.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Spinal cord injury, Functional MRI, Somatosensory, Discomplete, Non-conscious
National Category
Neurology Neurosciences Physiology
Research subject
Neurology; Neurosurgery; Rehabilitation Medicine; Physiology
Identifiers
urn:nbn:se:umu:diva-169138 (URN)10.1016/j.clinph.2020.01.017 (DOI)000525862400011 ()32197128 (PubMedID)2-s2.0-85082123930 (Scopus ID)
Available from: 2020-03-22 Created: 2020-03-22 Last updated: 2022-07-15Bibliographically approved
Sandin, P., Johansson, S., Backman, H., Blomberg, A., Lindgren, L., Lindberg, A. & Nilsson, U. (2019). Elevated serum high sensitive cardiac Troponin I is associated with mortality among adults with Restrictive Spirometric Pattern. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Elevated serum high sensitive cardiac Troponin I is associated with mortality among adults with Restrictive Spirometric Pattern
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168161 (URN)10.1183/13993003.congress-2019.PA2807 (DOI)000507372403304 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA2807.

Available from: 2020-03-18 Created: 2020-03-18 Last updated: 2024-04-08Bibliographically approved
Harris, S. J., Papathanassoglou, E. D. E., Gee, M., Hampshaw, S. M., Lindgren, L. & Haywood, A. (2019). Interpersonal touch interventions for patients in intensive care: A design-oriented realist review. Nursing Open, 6(2), 216-235
Open this publication in new window or tab >>Interpersonal touch interventions for patients in intensive care: A design-oriented realist review
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 216-235Article, review/survey (Refereed) Published
Abstract [en]

Aim: To develop a theoretical framework to inform the design of interpersonal touch interventions intended to reduce stress in adult intensive care unit patients.

Design: Realist review with an intervention design-oriented approach.

Methods: We searched CINAHL, MEDLINE, EMBASE, CENTRAL, Web of Science and grey literature sources without date restrictions. Subject experts suggested additional articles. Evidence synthesis drew on diverse sources of literature and was conducted iteratively with theory testing. We consulted stakeholders to focus the review. We performed systematic searches to corroborate our developing theoretical framework.

Results: We present a theoretical framework based around six intervention construction principles. Theory testing provided some evidence in favour of treatment repetition, dynamic over static touch and lightening sedation. A lack of empirical evidence was identified for construction principles relating to intensity and positive/negative evaluation of emotional experience, moderate pressure touch for sedated patients and intervention delivery by relatives versus healthcare practitioners.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
design propositions, hypnotics and sedatives, ICU, nursing, pain, realist review, stress, touch
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-157940 (URN)10.1002/nop2.200 (DOI)000461835600003 ()30918674 (PubMedID)
Available from: 2019-04-18 Created: 2019-04-18 Last updated: 2019-04-18Bibliographically approved
Lebedeva, A., Sundström, A., Lindgren, L., Stomby, A., Aarsland, D., Westman, E., . . . Nyberg, L. (2018). Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatrica Scandinavica, 167(6), 491-502
Open this publication in new window or tab >>Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus
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2018 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 167, no 6, p. 491-502Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Depression is associated with accelerated aging and age-related diseases. However, mechanisms underlying this relationship remain unclear. The aim of this study was to longitudinally assess the link between depressive symptoms, brain atrophy, and cortisol levels.

METHOD: Participants from the Betula prospective cohort study (mean age = 59 years, SD = 13.4 years) underwent clinical, neuropsychological and brain 3T MRI assessments at baseline and a 4-year follow-up. Cortisol levels were measured at baseline in four saliva samples. Cortical and hippocampal atrophy rates were estimated and compared between participants with and without depressive symptoms (n = 81) and correlated with cortisol levels (n = 49).

RESULTS: Atrophy in the left superior frontal gyrus and right lingual gyrus developed in parallel with depressive symptoms, and in the left temporal pole, superior temporal cortex, and supramarginal cortex after the onset of depressive symptom. Depression-related atrophy was significantly associated with elevated cortisol levels. Elevated cortisol levels were also associated with widespread prefrontal, parietal, lateral, and medial temporal atrophy.

CONCLUSION: Depressive symptoms and elevated cortisol levels are associated with atrophy of the prefrontal and limbic areas of the brain.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
depressive symptomatology, neuroimaging, superior temporal gyrus, superior frontal gyrus, MRI
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-146479 (URN)10.1111/acps.12860 (DOI)000433560700006 ()29457245 (PubMedID)2-s2.0-85042120842 (Scopus ID)
Available from: 2018-04-10 Created: 2018-04-10 Last updated: 2023-03-24Bibliographically approved
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