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Karlsson, Stig
Publications (10 of 41) Show all publications
Hemmingsson, E.-S., Gustavsson, M., Isaksson, U., Karlsson, S., Gustavsson, Y., Sandman, P.-O. & Lövheim, H. (2018). Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013. European Journal of Clinical Pharmacology, 74(4), 483-488
Open this publication in new window or tab >>Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013
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2018 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 4, p. 483-488Article in journal (Refereed) Published
Abstract [en]

Purpose: Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.

Methods: Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.

Results: The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.

Conclusions: There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
pain, elderly, nursing home, analgesic drugs, dementia
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-144537 (URN)10.1007/s00228-017-2384-2 (DOI)000427468600011 ()29260276 (PubMedID)
Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-06-09Bibliographically approved
Lämås, K., Karlsson, S., Nolén, A., Lövheim, H. & Sandman, P.-O. (2017). Prevalence of constipation among persons living in institutional geriatric-care settings - a cross-sectional study. Scandinavian Journal of Caring Sciences, 31(1), 157-163
Open this publication in new window or tab >>Prevalence of constipation among persons living in institutional geriatric-care settings - a cross-sectional study
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2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 1, p. 157-163Article in journal (Refereed) Published
Abstract [en]

RATIONAL: The current state of knowledge about the prevalence of constipation among persons living in institutional geriatric-care settings is limited.

AIM: The aim was to investigate the prevalence of constipation among institutional geriatric-care residents and identify resident characteristics related to constipation.

METHODOLOGICAL DESIGN: In a cross-sectional study of all the institutional geriatric-care settings in a county in northern Sweden, 2970 residents were assessed. The member of staff who knew each resident best used the Multi-Dimensional Dementia Assessment Scale and the resident's records of prescribed medication to monitor cognitive function, activities in daily life, behavioural and psychological symptoms, physical restraints, speech ability, nutrition and pharmacologic agents. The study was approved by the Regional Ethical Review Board.

RESULT: The prevalence of constipation was 67%. The mean age was higher among those with constipation. A significantly higher proportion of the constipated had cognitive and/or physical impairments, physical restraints, impaired speech, problems with nutrition, and higher numbers of drugs for regular use. Of those with constipation, 68% were prescribed laxatives for regular use. Twenty-three per cent of the constipated residents were prescribed opioid analgesics (n = 465), and 29% (n = 134) of these were not prescribed any laxatives.

STUDY LIMITATION: Due to the cross-sectional design, the results should be interpreted with caution in terms of causal reasoning, generalisation and conclusions about risk factors. Another limitation is the use of proxy assessments of constipation.

CONCLUSION: The results show that constipation is common among residents in institutional geriatric-care settings in Sweden, which is in line with previous studies from other Western countries. Despite being constipated when having prescribed opioid analgesics, a large number did not have prescribed laxatives. The results indicate the urgency of finding strategies and implementing suitable interventions to improve bowel management in residents in institutional geriatric-care settings.

Keywords
aged, constipation, nursing homes (residential facilities), prevalence
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127093 (URN)10.1111/scs.12345 (DOI)000394988700017 ()27327073 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
Gustafsson, M., Isaksson, U., Karlsson, S., Sandman, P.-O. & Lövheim, H. (2016). Behavioral and psychological symptoms and psychotropic drugs among people with cognitive impairment in nursing homes in 2007 and 2013. European Journal of Clinical Pharmacology, 72(8), 987-994
Open this publication in new window or tab >>Behavioral and psychological symptoms and psychotropic drugs among people with cognitive impairment in nursing homes in 2007 and 2013
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2016 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 72, no 8, p. 987-994Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The use of psychotropic drugs to treat behavioral and psychological symptoms among people with dementia has been widely questioned because of its limited efficacy and risk of harmful side-effects. The objectives of this study was to compare the prevalence of behavioral and psychological symptoms and the use of psychotropic drug treatments among old people with cognitive impairment living in geriatric care units in 2007 and 2013.

METHODS: Two questionnaire surveys were performed in 2007 and 2013, comprising all those living in geriatric care units in the county of Västerbotten in northern Sweden. A comparison was made between 1971 people from 2007 and 1511 people from 2013. Data were collected concerning psychotropic and antidementia drug use, functioning in the activities of daily living (ADL), cognition, and behavioral and psychological symptoms, using the Multi-Dimensional Dementia Assessment Scale (MDDAS).

RESULTS: Between 2007 and 2013, the use of antipsychotic drugs declined from 25.4 to 18.9 %, and of anxiolytic, hypnotic, and sedative drugs from 35.5 to 29.4 %. The prevalence of people prescribed antidepressant drugs remained unchanged while antidementia drug prescription increased from 17.9 to 21.5 %. When controlled for demographic changes, 36 out of 39 behavioral and psychological symptoms showed no difference in prevalence between the years.

CONCLUSIONS: The use of antipsychotic, anxiolytic, hypnotic, and sedative drugs declined considerably between 2007 and 2013 among old people with cognitive impairment living in geriatric care units. Despite this reduction, the prevalences of behavioral and psychological symptoms remained largely unchanged.

Keywords
Dementia, Nursing home, Behavioral and psychological symptoms, Alzheimer’s disease, Psychotropic drugs, Antipsychotics
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-119443 (URN)10.1007/s00228-016-2058-5 (DOI)000379750500009 ()27071994 (PubMedID)
Available from: 2016-04-19 Created: 2016-04-19 Last updated: 2019-04-26Bibliographically approved
Ringnér, A., Karlsson, S. & Hällgren Graneheim, U. (2015). A person-centred intervention for providing information to parents of children with cancer: experiences and effects. European Journal of Oncology Nursing, 19(3), 318-324
Open this publication in new window or tab >>A person-centred intervention for providing information to parents of children with cancer: experiences and effects
2015 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, no 3, p. 318-324Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this paper is to describe the experiences of participating in a person-centred information intervention aimed at parents of children with cancer.

Methods: Eight parents participated in the intervention, beginning two months after their child's diagnosis. The intervention was based upon the representational approach to patient education and a mixed method approach was employed in the study. The experiences of parents and intervention nurses were captured via qualitative interviews and the effects of the intervention on parental psychosocial measures, primarily perceived stress, were evaluated using a single-case design with web-based questionnaires.

Results: Parents expressed high satisfaction with the intervention, as reported in the follow-up interviews and on the scale measuring satisfaction. However, no changes were seen in the quantitative measures of psychosocial distress. The nurses performing the intervention felt it was useful and feasible.

Conclusions: A representational approach to providing person-centred information to parents of children with cancer was appreciated and considered feasible by both the parents and the intervention nurses. However, further research is needed considering the lack of effect on the parents' perceived stress.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
information, interventions, mixed methods, parents, patient-centred information, paediatric oncology, single-case design
National Category
Nursing
Research subject
omvårdnadsforskning med samhällsvetenskaplig inriktning
Identifiers
urn:nbn:se:umu:diva-105686 (URN)10.1016/j.ejon.2014.10.012 (DOI)000357905900016 ()25466827 (PubMedID)
Available from: 2015-06-28 Created: 2015-06-28 Last updated: 2018-06-07Bibliographically approved
Aléx, J., Karlsson, S., Björnstig, U. & Saveman, B.-I. (2015). Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study. International Journal of Circumpolar Health, 74, Article ID 28878.
Open this publication in new window or tab >>Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study
2015 (English)In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 74, article id 28878Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care.

METHODS: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures.

RESULTS: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes.

CONCLUSIONS: The use of active heat from underneath increases the patients' thermal comfort and may prevent the negative consequences of cold stress.

Keywords
thermal comfort, thermal discomfort, finger temperature, cold exposure, Cold Discomfort Scale, cold stress, active heat, heat transfer
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-109969 (URN)10.3402/ijch.v74.28878 (DOI)000369578900001 ()26374468 (PubMedID)
Available from: 2015-10-09 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Gustafsson, M., Sandman, P.-O., Karlsson, S., Isaksson, U., Schneede, J., Sjölander, M. & Lövheim, H. (2015). Reduction in the use of potentially inappropriate drugs among old people living in geriatric care units between 2007 and 2013. European Journal of Clinical Pharmacology, 71(4), 507-515
Open this publication in new window or tab >>Reduction in the use of potentially inappropriate drugs among old people living in geriatric care units between 2007 and 2013
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2015 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 71, no 4, p. 507-515Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aims of this study were to investigate trends in the prevalence of potentially inappropriate drug use among old people living in geriatric care units in the county of Västerbotten between 2007 and 2013 using six national quality indicators and to assess the impact of medication reviews on those quality indicators.

METHODS: Data were collected concerning potentially inappropriate drug use, function in the activities of daily living (ADL) and cognitive function, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). A comparison was made between the years 2007 and 2013, comprising 2772 and 1902 people, respectively, living in geriatric care in the county of Västerbotten, Sweden. We conducted a parallel investigation of a separate corresponding population in Västerbotten County from 2012, where potentially inappropriate drug use was measured before and after 895 medication reviews which involved a clinical pharmacist.

RESULTS: After controlling for age, sex, ADL and cognitive impairment, there was a significant improvement in five out of six quality indicators between 2007 and 2013. While 44 % of the people were exposed to one or more potentially inappropriate medications in 2007, this number had declined to 26 % by 2013. In the separate population from 2012, the frequency of potentially inappropriate drug use was significantly reduced amongst the people who had a medication review performed.

CONCLUSION: The extent of potentially inappropriate drug use declined between 2007 and 2013 according to the quality indicators used. Medication reviews involving clinical pharmacists might be an important factor in reducing potentially inappropriate drug use and improving drug treatment among old people.

Keywords
Potentially inappropriate drug use, Medication reviews, Clinical pharmacist, Nursing home, Dementia
National Category
Nursing Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-100807 (URN)10.1007/s00228-015-1825-z (DOI)000351224600013 ()25716889 (PubMedID)
Available from: 2015-03-10 Created: 2015-03-10 Last updated: 2018-06-07Bibliographically approved
Alex, J., Karlsson, S. & Saveman, B.-I. (2014). Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort - an experimental study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22, 43
Open this publication in new window or tab >>Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort - an experimental study
2014 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, p. 43-Article in journal (Refereed) Published
Abstract [en]

Background:

Exposure to cold temperatures is, often, a neglected problem in prehospital care. One of the leading influences of the overall sensation of cold discomfort is the cooling of the back. The aim of this study was to evaluate the effect of a heated ambulance mattress-prototype on body temperatures and thermal comfort in an experimental study.

Method: Data were collected during four days in November, 2011 inside and outside of a cold chamber. All participants (n = 23) participated in two trials each. In one trial, they were lying on a stretcher with a supplied heated mattress and in the other trial without a heated mattress. Outcomes were back temperature, finger temperature, core body temperature, Cold Discomfort Scale (CDS), four statements from the state-trait anxiety - inventory (STAI), and short notes of their experiences of the two mattresses. Data were analysed both quantitatively and qualitatively. A repeated measure design was used to evaluate the effect of the two mattresses.

Results:

A statistical difference between the regular mattress and the heated mattress was found in the back temperature. In the heated mattress trial, the statement "I am tense" was fewer whereas the statements "I feel comfortable", "I am relaxed" and "I feel content" were higher in the heated mattress trial. The qualitative analyses of the short notes showed that the heated mattress, when compared to the unheated mattress, was experienced as warm, comfortable, providing security and was easier to relax on.

Conclusions:

Heat supply from underneath the body results in increased comfort and may prevent hypothermia which is important for injured and sick patients in ambulance care.

Keywords
Thermal comfort, Cold discomfort, Cold exposure
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-93830 (URN)10.1186/s13049-014-0043-5 (DOI)000341155300001 ()25103366 (PubMedID)
Available from: 2014-10-08 Created: 2014-10-01 Last updated: 2018-06-07Bibliographically approved
Fallbjörk, U., Rasmussen, B. H., Karlsson, S. & Salander, P. (2013). Aspects of body image after mastectomy due to breast cancer: a two-year follow up study. European Journal of Oncology Nursing, 17(3), 340-345
Open this publication in new window or tab >>Aspects of body image after mastectomy due to breast cancer: a two-year follow up study
2013 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 3, p. 340-345Article in journal (Refereed) Published
Abstract [en]

Purpose: This 2-year follow-up study explores aspects of body image after mastectomy due to breast cancer.

Materials and Methods: This population-based study included 76 women living in northern Sweden who, during November 2006 to October 2007, underwent mastectomy due to breast cancer. The women completed a questionnaire entitled “Life After Mastectomy (LAM)” 10 months after the mastectomy and again 2 years later. We used SPSS version 18.0 for data processing and analysis.

Results:The findings indicate that few significant changes in body image had taken place during the 2-year interval between the first and second completion of the questionnaire. An exception was a significant decrease in feelings of sexual attractiveness and comfort during sexual intimacy. At follow-up, 21% of the women had undergone breast reconstruction (BR). They were significantly younger than the women who had not had BR (53 v. 63 years). Besides being younger, no other significant differences could be found between those women who had undergone BR and those who had not. The fact that the decrease in sexual attractiveness and feelings of comfort during sexual intimacy also applied to the subgroup of women who had had BR may therefore be surprising. A better understanding of issues related to breast cancer treatment and sexual function is vital.

Conclusion: It is important for health care professionals to be aware of problems related to sexual intimacy and to be prepared not just to provide information about these, but also to reflect on expectations v. reality together with the women.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
body image, breast cancer, breast reconstruction, femininity, mastectomy
National Category
Nursing Cancer and Oncology
Research subject
omvårdnadsforskning med samhällsvetenskaplig inriktning
Identifiers
urn:nbn:se:umu:diva-58312 (URN)10.1016/j.ejon.2012.09.002 (DOI)000318466500012 ()23083641 (PubMedID)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2018-06-08Bibliographically approved
Gustafsson, M., Sandman, P.-O., Karlsson, S., Gustafson, Y. & Lövheim, H. (2013). Association between behavioral and psychological symptoms and psychotropic drug use among old people with cognitive impairment living in geriatric care settings. International psychogeriatrics, 25(9), 1415-23
Open this publication in new window or tab >>Association between behavioral and psychological symptoms and psychotropic drug use among old people with cognitive impairment living in geriatric care settings
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2013 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 25, no 9, p. 1415-23Article in journal (Refereed) Published
Abstract [en]

Background: Behavioral and psychological symptoms are common among cognitively impaired individuals and psychotropic drugs are widely used for their treatment. The aim of this study was to describe the prevalence and associated factors of psychotropic and anti-dementia drug use among old people with cognitive impairment living in geriatric care settings. Methods: The study comprised 2,019 cognitively impaired people living in geriatric care units in the county of Västerbotten, Sweden. Data concerning psychotropic and anti-dementia drug use, function in activities of daily living, cognitive function, and prevalence of behavioral and psychological symptoms were collected, using the Multi-Dimensional Dementia Assessment Scale. Results: Of the study population, 1,442 individuals (71%) were prescribed at least one psychotropic drug (antidepressants (49%), anxiolytics, hypnotics, and sedatives (36%), antipsychotics (25%)). Furthermore, 363 individuals (18%) received anti-dementia drugs. Associations between various behavioral and psychological symptoms were found for all psychotropic drug classes and anti-dementia drugs. Verbally disruptive/attention-seeking behavior was associated with all psychotropic drugs. Use of antipsychotics was associated with several behavioral and psychological symptoms, including aggressive behavior. Conclusion: The associations between behavioral and psychological symptoms and psychotropic drug use found in this study indicate that these drugs are prescribed to treat behavioral and psychological symptoms among cognitively impaired individuals despite limited evidence of their efficacy. Given the significant risk of adverse effects among old people with cognitive impairment, it is important to ensure that any medication used is both appropriate and safe.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-79491 (URN)10.1017/S1041610213000859 (DOI)000322397600004 ()23782794 (PubMedID)
Available from: 2013-08-20 Created: 2013-08-20 Last updated: 2018-06-08Bibliographically approved
Gustafsson, M., Karlsson, S. & Lövheim, H. (2013). Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care units. BMC pharmacology & toxicology, 14, 10
Open this publication in new window or tab >>Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care units
2013 (English)In: BMC pharmacology & toxicology, ISSN 2050-6511, Vol. 14, p. 10-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Antipsychotic drugs are widely used for the treatment of Behavioral and Psychological Symptoms of Dementia (BPSD), despite their limited efficacy and concerns about safety. The aim of this study was to describe antipsychotic drug therapy among people with dementia living in specialized care units in northern Sweden.

METHODS: This study was conducted in 40 specialized care units in northern Sweden, with a total study population of 344 people with dementia. The study population was described in regard to antipsychotic drug use, ADL function, cognitive function and BPSD, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). These data were collected at baseline and six months later. Detailed data about antipsychotic prescribing were collected from prescription records.

RESULTS: This study showed that 132 persons (38%) in the study population used antipsychotic drugs at the start of the study. Of these, 52/132 (39%) had prescriptions that followed national guidelines with regard to dose and substance.After six months, there were 111 of 132 persons left because of deaths and dropouts. Of these 111 people, 80 (72%) were still being treated with antipsychotics, 63/111 (57%) with the same dose. People who exhibited aggressive behavior (OR: 1.980, CI: 1.515-2.588), or passiveness (OR: 1.548, CI: 1.150-2.083), or had mild cognitive impairment (OR: 2.284 CI: 1.046-4.988), were at increased risk of being prescribed antipsychotics.

CONCLUSION: The prevalence of antipsychotic drug use among people with dementia living in specialized care units was high and inappropriate long-term use of antipsychotic drugs was common.

Keywords
Antipsychotic prescribing, Dementia, BPSD, Inappropriate prescribing, Aggression, Passiveness
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-70117 (URN)10.1186/2050-6511-14-10 (DOI)000319696500001 ()23391323 (PubMedID)
Available from: 2013-05-06 Created: 2013-05-06 Last updated: 2018-06-08Bibliographically approved
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