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Lindahl, Elisabeth
Publications (9 of 9) Show all publications
Claesson Lingehall, H., Smulter, N., Lindahl, E., Lindkvist, M., Engström, K. G., Gustavsson, Y. & Olofsson, B. (2017). Preoperative Cognitive Performance and Postoperative Delirium Are independently Associated With Future Dementia in Older People Who Have Undergone Cardiac Surgery: A Longitudinal Cohort Study. Critical Care Medicine, 45(8), 1295-1303
Open this publication in new window or tab >>Preoperative Cognitive Performance and Postoperative Delirium Are independently Associated With Future Dementia in Older People Who Have Undergone Cardiac Surgery: A Longitudinal Cohort Study
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2017 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 45, no 8, p. 1295-1303Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery.

Design: Longitudinal cohort study.

Setting: Cardiothoracic Division, Umeå University Hospital, Sweden.

Patients: Patients aged 70 years old or older (n = 114) scheduled for routine cardiac procedures with cardiopulmonary bypass without documented dementia were enrolled in 2009.

Intervention: Structured assessments were performed preoperatively, 1 and 4 days after extubation, and 1, 3, and 5 years postoperatively.

Measurements and Main Results: Patients were assessed comprehensively, including cognitive and physical function, coexisting medical conditions, demographic characteristics, and medications. Diagnoses of delirium, depression, and dementia were made according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria. During the 5-year period, 30 of 114 participants (26.3%) developed dementia. Postoperative delirium had occurred in 87% of those who later developed dementia. A multivariable logistic regression model showed a lower preoperative Mini-Mental State Examination score (p < 0.001; odds ratio, 0.68; 95% CI, 0.54–0.84) and the occurrence of postoperative delirium (p = 0.002; odds ratio, 7.57; 95% CI, 2.15–26.65) were associated with dementia occurrence.

Conclusions: Our findings suggest that older patients with reduced preoperative cognitive functions or who develop postoperative delirium are at risk of developing dementia within 5 years after cardiac surgery. Cognitive functions should be screened for preoperatively, those who develop postoperative delirium should be followed up to enable early detection of dementia symptoms, and management should be implemented.

Keywords
cardiac surgery, cardiovascular disease, delirium, dementia, older people
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-135501 (URN)10.1097/CCM.0000000000002483 (DOI)000405469600027 ()
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2018-06-09Bibliographically approved
Claesson Lingehall, H., Smulter, N., Olofsson, B. & Lindahl, E. (2015). Experiences of undergoing cardiac surgery among older people diagnosed with postoperative delirium: one year follow-up. BMC Nursing, 14, Article ID 17.
Open this publication in new window or tab >>Experiences of undergoing cardiac surgery among older people diagnosed with postoperative delirium: one year follow-up
2015 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, article id 17Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiovascular disease is common among old people and many undergo cardiac surgery. Scientific knowledge is available on cardiac surgery from several perspectives. However, we found few studies focusing on older patients' experiences of cardiac surgery. The aim of this study was to illuminate experiences of undergoing cardiac surgery among older people diagnosed with postoperative delirium, a one year follow-up.

METHODS: Qualitative interviews were conducted with 49 participants (aged ≥70 years) diagnosed with delirium after cardiac surgery. Data were collected in Sweden during 2010 through individual, semi-structured interviews in participants' homes one year after surgery. The interviews were analyzed using qualitative content analysis.

RESULTS: Four themes with sub-themes were formulated: Feeling drained of viability includes having a body under attack, losing strength and being close to death. Feeling trapped in a weird world describes participants having hallucinations, being in a nightmare and being remorseful for their behavior. Being met with disrespect includes feeling disappointed, being forced, and feeling like cargo. On the other hand, Feeling safe, including being in supportive hands and feeling grateful, points to participants' experiences of good care and the gift of getting a second chance in life.

CONCLUSIONS: Even one year after cardiac surgery, participants described in detail feelings of extreme vulnerability and frailty. They also had felt completely in the hands of the health care professionals. Participants described experiences of hallucinations and nightmares during hospitalization. Cardiac surgery was a unique, fearful, traumatic and unpleasant experience yet could also include pleasant or rewarding aspects. It seems that health care professionals need deeper knowledge on postoperative delirium in order to prevent, detect and treat delirium to avoid and relieve the suffering these experiences might cause.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keywords
Cardiac surgery, Delirium, Lived experience, Nursing, Older people, Patient’s experience, Perioperative period
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-101857 (URN)10.1186/s12912-015-0069-7 (DOI)000210484900016 ()25866476 (PubMedID)
Available from: 2015-04-23 Created: 2015-04-15 Last updated: 2018-06-07Bibliographically approved
Lindahl, E., Gilje, F., Norberg, A. & Söderberg, A. (2010). Nurses' ethical reflections on caring for people with malodorous exuding ulcers. Nursing Ethics, 17(6), 777-790
Open this publication in new window or tab >>Nurses' ethical reflections on caring for people with malodorous exuding ulcers
2010 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 6, p. 777-790Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to illuminate nurses' reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants' reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to 'do good' and 'be good'. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to 'do good' for patients and 'be good' nurses.

Keywords
Caring, ‘being good’, ‘doing good’, malodour, qualitative content analysis, ulcers
Identifiers
urn:nbn:se:umu:diva-38237 (URN)10.1177/0969733010379181 (DOI)000284462700012 ()21097976 (PubMedID)
Available from: 2010-12-01 Created: 2010-12-01 Last updated: 2018-06-08Bibliographically approved
Lindahl, E., Norberg, A. & Söderberg, A. (2008). The meaning of caring for people with malodorous exuding ulcers.. Journal of Advanced Nursing, 62(2), 163-71
Open this publication in new window or tab >>The meaning of caring for people with malodorous exuding ulcers.
2008 (English)In: Journal of Advanced Nursing, ISSN 1365-2648, Vol. 62, no 2, p. 163-71Article in journal (Refereed) Published
Keywords
exuding ulcers, hermeneutics, interviews, narrative, nursing, phenomenology, wound care
Identifiers
urn:nbn:se:umu:diva-9461 (URN)10.1111/j.1365-2648.2007.04551.x (DOI)18328043 (PubMedID)
Available from: 2008-04-08 Created: 2008-04-08 Last updated: 2018-06-09Bibliographically approved
Dahlqvist, V., Eriksson, S., Glasberg, A.-L., Lindahl, E., Lützén, K., Strandberg, G., . . . Norberg, A. (2007). Development of the perceptions of conscience questionnaire.. Nursing Ethics, 14(2), 181-193
Open this publication in new window or tab >>Development of the perceptions of conscience questionnaire.
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2007 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 2, p. 181-193Article in journal (Refereed) Published
Abstract [en]

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses' assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers.

Keywords
Adult, Aged, Attitude of Health Personnel, Conscience, Female, Humans, Male, Middle Aged, Nurses/*psychology, Nursing Care/*psychology, Questionnaires
Identifiers
urn:nbn:se:umu:diva-6951 (URN)17425147 (PubMedID)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
Lindahl, E., Norberg, A. & Söderberg, A. (2007). The meaning of living with malodorous exuding ulcers.. Journal of Nursing and Healthcare of Chronic Illnes in association with Journal of Clinical Nursing, 16(3A), 68-75
Open this publication in new window or tab >>The meaning of living with malodorous exuding ulcers.
2007 (English)In: Journal of Nursing and Healthcare of Chronic Illnes in association with Journal of Clinical Nursing, ISSN 0962-1067, Vol. 16, no 3A, p. 68-75Article in journal (Refereed) Published
Keywords
consolation, Gabriel Marcel, malodorous ulcers, phenomenological hermeneutics, Simone Weil
Identifiers
urn:nbn:se:umu:diva-6866 (URN)doi:10.1111/j.1365-2702.2005.01550.x (DOI)17518871 (PubMedID)
Available from: 2008-01-07 Created: 2008-01-07 Last updated: 2018-06-09Bibliographically approved
Glasberg, A.-L., Eriksson, S., Dahlqvist, V., Lindahl, E., Strandberg, G., Söderberg, A., . . . Norberg, A. (2006). Development and initial validation of the Stress of Conscience Questionnaire. Nursing Ethics, 13(6), 633-648
Open this publication in new window or tab >>Development and initial validation of the Stress of Conscience Questionnaire
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2006 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 6, p. 633-648Article in journal (Refereed) Published
Abstract [en]

Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.

Keywords
Adult, Aged, Conscience, Ethics; Professional, Factor Analysis; Statistical, Female, Health Personnel/ethics/*psychology, Humans, Male, Middle Aged, Questionnaires, Reproducibility of Results, Stress; Psychological/etiology/*psychology, Sweden
Identifiers
urn:nbn:se:umu:diva-6689 (URN)10.1177/0969733006069698 (DOI)17193804 (PubMedID)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
Lindahl, E., Gilje, F. & Norberg, A. (2004). Striving for purity: shared understandings in retired Swedish care providers' narratives on nursing care around 1950.. Journal of Holistic Nursing, 22(4), 333-350
Open this publication in new window or tab >>Striving for purity: shared understandings in retired Swedish care providers' narratives on nursing care around 1950.
2004 (English)In: Journal of Holistic Nursing, ISSN 0898-0101, Vol. 22, no 4, p. 333-350Article in journal (Refereed) Published
Keywords
Aged, Aged; 80 and over, Anecdotes as Topic, Empathy, Ethics; Nursing, Female, Holistic Nursing, Humans, Job Description, Male, Narration, Nurse's Role, Nurse-Patient Relations, Nursing Methodology Research, Questionnaires, Retirement, Sweden
Identifiers
urn:nbn:se:umu:diva-6690 (URN)doi:10.1177/0898010104269243 (DOI)15486153 (PubMedID)
Available from: 2008-01-10 Created: 2008-01-10 Last updated: 2018-06-09Bibliographically approved
Claesson Lingehall, H., Smulter, N., Lindahl, E., Lindkvist, M., Engström, K. G., Gustafson, Y. & Olofsson, B.Dementia after postoperative delirium in older people who have undergone cardiac surgery: a longitudinal cohort study.
Open this publication in new window or tab >>Dementia after postoperative delirium in older people who have undergone cardiac surgery: a longitudinal cohort study
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(English)Manuscript (preprint) (Other academic)
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:umu:diva-118450 (URN)
Available from: 2016-03-18 Created: 2016-03-18 Last updated: 2018-06-07
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