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  • 1. Acuña Mora, Mariela
    et al.
    Sparud-Lundin, Carina
    Burström, Åsa
    Hanseus, Katarina
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Moons, Philip
    Bratt, Ewa-Lena
    Patient empowerment and its correlates in young persons with congenital heart disease2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 5, p. 389-398, article id 1474515119835434Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:: The objective of this study was to measure the level of empowerment and identify its correlates in young persons with congenital heart disease.

    STUDY DESIGN:: Patients aged 14-18 years with congenital heart disease, and under active follow-up in one of four paediatric cardiology centres in Sweden were invited to participate in a cross-sectional study. A total of 202 young persons returned the questionnaires. Patient empowerment was measured with the Gothenburg Young Persons Empowerment Scale that allows the calculation of total and subscale scores. Univariate and multivariate linear regression analyses were undertaken to analyse possible correlates, including: sex, age, health behaviours, knowledge of congenital heart disease, quality of life, patient-reported health, congenital heart disease complexity, transition readiness and illness perception.

    RESULTS:: The mean empowerment score was 54.6±10.6 (scale of 15-75). Univariate analyses showed that empowerment was associated with age, quality of life, transition readiness, illness perception, health behaviours and patient-reported health (perceived physical appearance, treatment anxiety, cognitive problems and communication issues). However, multivariable linear regression analyses identified that only transition readiness (β=0.28, P<0.001) and communication (β=0.36, P<0.001) had a positive association with patient empowerment. These variables were also significantly associated with the subscale scores of the empowerment scale of knowledge and understanding ( P<0.001), shared decision-making ( P<0.001) and enabling others ( P<0.01). The overall models' explained variance ranged from 8% to 37%.

    CONCLUSION:: Patient empowerment was associated with transition readiness and fewer problems communicating. While it is not possible to establish the directionality of the associations, interventions looking to increase empowerment could benefit from using these variables (or measurements) for evaluation purposes.

  • 2. Andersson, Per
    et al.
    Sjöberg, Rickard L
    Ohrvik, John
    Leppert, Jerzy
    Knowledge about cardiovascular risk factors among obese individuals.2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Obesity is an important biological risk factor for cardiovascular disease (CVD).

    AIMS: The main aim of this study was to answer the question whether obese individuals differ from individuals with normal weight with regard to knowledge about risk factors for CVD. A further aim was to replicate previous findings that obese individuals are at higher risk of developing other biological risk factors for CVD.

    METHOD: Normal weights, BMI<25 kg/m(2) (n=385), and obese, BMI> or =30 kg/m(2) (n=159), individuals were identified from a screening program conducted among 50-year-old inhabitants of the County of Västmanland, Sweden. Participants answered questions regarding their gender, level of education, and items relating to knowledge about cardiovascular risk factors. Total cholesterol and blood glucose levels, height, weight and blood pressure were measured.

    RESULTS: Obese individuals did not differ significantly from individuals with a normal weight regarding knowledge of cardiovascular risk factors when education was controlled for. Obesity and low level of education are associated with other risk factors for CVD such as high blood pressure and high serum cholesterol.

    CONCLUSION: Obese individuals are at an increased risk of developing other risk factors for CVD but are just as knowledgeable about risk factors for CVD as normal weighting individuals.

  • 3. Arestedt, Kristofer
    et al.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Johansson, Peter
    Blomqvist, Kerstin
    Social support and its association with health-related quality of life among older patients with chronic heart failure2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Background: Social support is generally known to influence health-related quality of life (HRQoL), but this association is not well explored among older patients with chronic heart failure. Aims: (1) To describe social support in older patients with chronic heart failure in relation to gender. (2) To investigate if age, gender, cohabitation, perceived financial situation, and disease severity are associated with social support. (3) To investigate if social support is associated with HRQoL after controlling for age, gender, and disease severity. Methods: Data were collected in a sample of 349 patients (>= 65 years) with chronic heart failure. Patients' HRQoL was measured with the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. The Interview Schedule for Social Interaction measured social support. Data were analysed with descriptive statistics, repeated-measure ANOVA, and multiple linear regression analyses with robust standard errors. Results: Social support was generally rated high, although being a man, living alone, perceiving a problematic financial situation, and high disease severity (NYHA) were associated with lower levels of social support. Age was not associated with social support. Social support was generally associated with HRQoL, in particular the emotional dimensions. Conclusion: Taking social support into account when caring for older patients with heart failure can be of importance for improving or maintaining HRQoL.

  • 4. Blanck, E.
    et al.
    Fors, A.
    Ali, L.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ekman, I.
    Being support for patients with chronic heart failure and/or chronic obstructive pulmonary disease - the relatives perspective2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 98-99Article in journal (Other academic)
  • 5.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    A new model for integrated heart failure and palliative advanced homecare: rationale and design of a prospective randomized study2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 3, p. 269-275Article in journal (Refereed)
    Abstract [en]

    Background: Guidelines have concluded that there is a great need for new models of integrated care, e.g. heart failure and palliative care, in order to facilitate equality of care for dying patients, regardless of diagnosis. We found no evidence in the literature concerning the advantages and effects of integrated heart failure and palliative advanced home care for patients with severe chronic heart failure.

    Aim: The primary aim is to study the effects of integrated Palliative advanced homecarRE and heart FailurE caRE (PREFER) on patients' symptom burden, quality of life, and activities of daily living (ADL) as compared to usual care.

    Method: Prospective, randomized study with an open-evaluation PROBE design. Optimally treated outpatients with chronic heart failure of varying aetiologies in New York Heart Association classes III-IV will be eligible to participate.

    Conclusion: The PREFER study is designed to investigate whether a new concept of managing patients with severe chronic heart failure by integrating palliative homecare and active heart failure treatment will reduce symptom burden, increase quality of life and ADL, and reduce the number of hospitalizations in patients with severe chronic heart failure.

  • 6.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Nursing.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine. Medicin.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Nursing.
    Being a palliative nurse for persons with severe congestive heart failure in advanced homecare.2005In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, no 4, p. 314-323Article in journal (Refereed)
    Abstract [en]

    Advanced homecare for persons with congestive heart failure is a ‘new’ challenge for palliative nurses. The aim of this study is to illuminate the meaning of being a palliative nurse for persons with severe congestive heart failure in advanced homecare. Narrative interviews with 11 nurses were conducted, tape-recorded, and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. One meaning of being a palliative nurse is being firmly rooted and guided by the values of palliative culture. Being adaptable to the patient's way of life carries great weight. On one hand nurses live out this value, facilitating for the patients to live their everydaylife as good as possible. Being a facilitator is revealed as difficult, challenging, but overall positive. On the other hand nurses get into a tight corner when values of palliative culture clash and do not correspond with the nurses interpretation of what is good for the person with congestive heart failure. Being in such a tight corner is revealed as frustrating and giving rise to feelings of inadequacy. Thus, it seems important to reflect critical on the values of palliative culture.

  • 7.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Nursing.
    Ekman, Inger
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Nursing.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine. Medicin.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Nursing.
    Living with severe chronic heart failure in palliative advanced home care.2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 4, p. 295-302Article in journal (Refereed)
    Abstract [en]

    Background - Living with severe chronic heart failure (CHF) in palliative care has been little studied.

    Aim - The aim of this study is to illuminate meaning of living with severe CHF in palliative advanced home care through patients' narratives.

    Methods-Narrative interviews were conducted with 4 patients, tape-recorded and transcribed verbatim. A phenomenological–hermeneutic method was used to interpret the text.

    Results - Meaning of living with severe CHF in palliative advanced home care emerged as ‘knocking on death's door’ although surviving. The course of the illness forces one to live a ‘roller coaster life,’ with an ongoing oscillation between ups and downs. Making it through the downs breeds a kind of confidence in one's ability to survive and the will to live is strong. Being offered a safety belt in the ‘roller coaster’ by the palliative advanced home care team evokes feelings of security.

    Conclusions - Meaning of living with severe CHF in palliative advanced home care is on one hand, being aware of one's imminent death, on the other hand, making it through the downs i.e. surviving life-threatening conditions, breed confidence in also surviving the current down. Being constructively dependent on palliative advanced home care facilitates everyday life at home.

  • 8.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Fischer Grönlund, Catarina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Meeting in a 'free-zone': clinical ethical support in integrated heart-failure and palliative care2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 7, p. 577-583Article in journal (Refereed)
    Abstract [en]

    Background: Integrating heart-failure and palliative care combines expertise from two cultures, life-saving cardiology and palliative care, and involves ethically difficult situations that have to be considered from various perspectives. We found no studies describing experiences of clinical ethical support (CES) in integrated cardiology and palliative care teams.

    Objective: Our aim is to describe experiences of CES among professionals after a period of three years working in a multidisciplinary team in integrated heart-failure and palliative homecare.

    Method: The study design was descriptive qualitative, comprising interviews with seven professionals from one integrated heart-failure and palliative care team who received CES over a three-year period. The interview data were subjected to qualitative content analysis.

    Results: The CES was found to offer possibilities for meeting in an ethical ‘free-zone’ where the participants could relate to each other beyond their various professional roles and specialties. The trust within the team seemed to increase and the participants were confident enough to express their points of view. Together they developed an integrated understanding, and acquired more knowledge and a comprehensive view of the ethically difficult situation of concern. The CES sessions were considered a means of becoming better prepared to deal with ethical care issues and developing action strategies to apply in practice, from shared standpoints.

    Conclusion: Participating in CES was experienced as meeting in an ethical ‘free-zone’ and seemed to be a means of facilitating integration of palliative and heart-failure care.

  • 9.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Forssell, Anna
    Pettersson, Berit
    Physicians' experiences of palliative care for heart failure patients2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 1, p. 64-69Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although heart disease is the single most common cause of death knowledge about palliative care for this group of patients is deficient.

    AIM: The aim of this study was to describe physicians' experiences of palliative care for heart failure patients.

    METHODS: Fifteen physicians at a medical geriatrics clinic were interviewed. The interviews were analysed using thematic content analysis.

    RESULTS: The results show that the physicians are confronted with patients with an unpredictable disease trajectory, including patients with severe symptoms, uncertainty about anticipating the course of dying and encountering close relative's anxiety and frustration. The physicians face difficult situations regarding whether to continue or withdraw care and medical treatment which means deciding concerning 'active' medical treatment, cardio pulmonary resuscitation and an implantable cardioverter-defibrillator (ICD). The physicians acknowledge the necessity for better structured follow-ups and cooperation with outpatient settings. They recognize that there is a lack of follow-ups and continuity of care and treatment at the hospital, involving their passing on or retaining responsibility for the patients' medical care.

    CONCLUSION: From the physicians' view clarification of who is principally responsible for the patient's medical care, being involved throughout the disease trajectory and cooperating more closely with palliative care services are necessary to further improve the way in which care is delivered to patients dying of heart failure.

  • 10.
    Brännström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hägglund, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fürst, Carl Johan
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Unequal care for dying patients in Sweden: a comparative registry study of deaths from heart disease and cancer2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 4, p. 454-459Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Swedish Palliative Registry is a nationwide quality registry aimed at facilitating improvement in end-of-life care. The goal is for the registry to list and report quality indicators related to care during the last week of life in all cases expected death in Sweden.

    AIM: To examine the quality of care during the last week of life as reported to the registry for patients with heart disease compared to those with cancer.

    METHOD: A retrospective registry study.

    RESULTS: Patients dying of heart disease compared to those dying from cancer had more shortness of breath, fewer drugs prescribed as needed against the usual symptoms and often died alone. Furthermore, they and their close relatives received less information about the imminence of death and bereavement follow-up was less common. The healthcare personnel were less aware of the heart disease patients' symptoms and less often knew about where they wished to die.

    CONCLUSION: Great differences were found in registered end-of-life care suggesting that the care given to patients with heart disease and cancer was unequal even after adjustment for age, sex and setting at the time of death. If our observational findings are confirmed in future studies there is obviously a need for new models for end-of-life management in order to facilitate the provision of equal care to dying patients regardless of diagnosis.

  • 11. Ekman, Inger
    et al.
    Swedberg, Karl
    Taft, Charles
    Lindseth, Anders
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brink, Eva
    Carlsson, Jane
    Dahlin-Ivanoff, Synneve
    Johansson, Inga-Lill
    Kjellgren, Karin
    Lidén, Eva
    Öhlén, Joakim
    Olsson, Lars-Eric
    Rosén, Henrik
    Rydmark, Martin
    Sunnerhagen, Katharina Stibrant
    Person-centered care -ready for prime time.2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 4, p. 248-251Article in journal (Refereed)
    Abstract [en]

    Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.

  • 12. Ericsson, Maria
    et al.
    Ängerud, Karin H.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lawesson, Sofia S.
    Strömberg, Anna
    Thylén, Ingela
    Interaction between tele-nurses and callers with an evolving myocardial infarction: consequences for level of directed care2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 7, p. 545-553Article in journal (Refereed)
    Abstract [en]

    Background: Rapid contact with emergency medical services is imperative to save the lives of acute myocardial infarction patients. However, many patients turn to a telehealth advisory nurse instead, where the delivery of urgent and safe care largely depends on how the interaction in the call is established.

    Purpose: The purpose of this study was to explore the interaction between tele-nurses and callers with an evolving myocardial infarction after contacting a national telehealth advisory service number as their first medical contact.

    Method: Twenty men and 10 women (aged 46–89 years) were included. Authentic calls were analysed using inductive content analysis.

    Findings: One overall category, Movement towards directed level of care, labelled the whole interaction between the tele-nurse and the caller. Four categories conceptualised the different interactions: a distinct, reasoning, indecisive or irrational interaction. The interactions described how tele-nurses and callers assessed and elaborated on symptoms, context and actions. The interaction was pivotal for progress in the dialogue and affected the achievement of mutual understanding in the communicative process. An indecisive or irrational interaction could increase the risk of failing to recommend or call for acute care.

    Conclusion: The interaction in the communication could either lead or mislead the level of care directed in the call. This study adds new perspectives to the communicative process in the acute setting in order to identify a myocardial infarction and the level of urgency from both individuals experiencing myocardial infarction and professionals in the health system.

  • 13.
    Falk-Brynhildsen, Karin
    et al.
    Department of Cardiothoracic Surgery, Örebro University Hospital, Sweden.
    Nilsson, Ulrica
    Department of Cardiothoracic Surgery and Centre for Health Care Sciences, Örebro University Hospital.
    Cardiac surgery patients’ evaluation of the quality of theatre nurse postoperative follow-up visit2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 2, p. 105-111Article in journal (Refereed)
    Abstract [en]

    Theatre nurses at the Department of Cardiothoracic Surgery in Örebro, Sweden, have since 2001 routinely conducted a follow-up visit topostoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both aretrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-upvisit conducted by the theatre nurses and find out if the quality was related to gender or type of admission.The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by atheatre nurse in Sweden. The instrument measuring quality, from the patient’s perspective, measured the quality of the visit, and consisted of16 items modified to suit the study.The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who hadundergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higherscores in two items.In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who hadundergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individualwith his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.

  • 14.
    Forsling, Elin
    et al.
    Sunderby Hospital, Sweden.
    Lundqvist, Robert
    Norrbotten County Council, Sweden .
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Medicine, Sunderby Hospital, Sweden.
    Isaksson, Rose-Marie
    Norrbotten County Council, Sweden .
    Health care contact is higher in the week preceding a first myocardial infarction: A review of medical records in Northern Sweden in 20072015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no 5, p. 450-456Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Prodromal symptoms before myocardial infarction (MI) are common, but there are limited data regarding health care contact prior to the acute onset of MI and the impact of gender on early presentation to health care.

    AIMS: The purpose of this study was to describe and analyse prodromal symptoms reported in medical records and study health care contact in the week before the acute onset of MI in comparison to the general population.

    METHODS: From the Northern Sweden MONICA Study we accessed the medical records of 359 patients aged 32-74 years with a first MI in the county of Norrbotten in 2007. We identified those patients' health care contact during the seven days before the MI and compared them with the weekly number of contacts in the general population aged 45-74 years in the county during 2007.

    RESULTS: We found that 23.1% of the women and 17.6% of the men had at least one contact the week before the MI. With the exception of the 14 women aged 45-55 years, health care consumption in both women and men in all age groups between 45- 74 years of age was 75%-165% higher in the week prior to the MI than in the general population of the same ages. In the first health care contact, pain-related symptoms were most frequent (43%), and fatigue was present in 8% of patients. There were no differences between women and men in health care consumption or presenting symptoms.

    CONCLUSION: Both women and men with a first MI are in contact more frequently than the general population in the week prior to the event.

  • 15.
    Hägglund, Lena
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Omvårdnad.
    The experience of fatigue among elderly women with chronic heart failure.2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 4, p. 290-295Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Fatigue is a common and distressing symptom in chronic heart failure (CHF). Most of the current methods for evaluating patients' symptoms fail to consider the meaning or importance that these symptoms have for the patient. AIM: To illuminate the lived experience of fatigue among elderly women with CHF. METHOD: Narrative interviews were conducted with 10 women with CHF, aged 73-89 years. Interviews were analysed with qualitative content analysis. RESULTS: The findings are presented in two themes and five subthemes. The first theme, 'living with the loss of physical energy', was based on three subthemes describing the experience of fatigue: 'experiencing a substantial presence of feebleness and unfamiliar bodily sensations', 'experiencing unpredictable variations in physical ability', and 'needing help from others in daily life'. The second theme, 'striving for independence while being aware of deteriorating health', describes how the women managed their life situation; it was based on two subthemes: 'acknowledging one's remaining abilities', and 'being forced to adjust and struggle for independence'. CONCLUSIONS: Fatigue was experienced as loss of physical energy, leading to discrepancies between intention and capacity. The will to reduce dependency on others involved a daily struggle against fatigue.

  • 16.
    Hägglund, Lena
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine. Medicin.
    Olofsson, Mona
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine. Medicin.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Omvårdnad.
    Fatigue and health-related quality of life in elderly patients with and without heart failure in primary healthcare.2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 3, p. 208-215Article in journal (Refereed)
  • 17.
    Isaksson, Rose-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Holmgren, Lars
    Lundblad, Dan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Time trends in symptoms and prehospital delay time in women vs. men with myocardial infarction over a 15-year period. The Northern Sweden MONICA Study.2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 2, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Background

    Few studies have examined the time between onset of myocardial infarction (MI) symptoms and arrival at hospital (prehospital delay time) and symptoms in men vs. women.

    Aims

    To describe prehospital delay time and symptoms in men vs. women with MI and to analyse trends over time and according to age.

    Methods

    The Northern Sweden MONICA myocardial infarction registry, 1989–2003, included 5072 men and 1470 women with a confirmed MI.

    Results

    Typical pain was present in 86% of the men and 81% of the women. The proportion with typical symptoms decreased over time for men and increased for women. Typical symptoms were more common among younger persons than older persons. Insufficiently reported symptoms was unchanged in men over time and decreased among women. Up to the age of 65, no gender differences were seen in the prehospital delay. In the oldest age group (65–74 years) time to hospital was longer than among the younger groups, especially among women.

    Conclusion

    There were no major gender differences in prehospital delay or type of symptoms. However, over time the proportion with typical symptoms decreased in men and increased in women. Older patients had longer prehospital delay and less typical symptoms.

  • 18.
    Koulaouzidis, George
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Charisopoulou, Dafni
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Mcarthur, T.
    Jenkins, P. J.
    Henein, Michael Y.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Association of aortic valve calcification and mitral annulus calcification with coronary artery calcification2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no Supplement: 1, p. S40-S40, Meeting Abstract: P103Article in journal (Other academic)
  • 19.
    Koulaouzidis, George
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Charisopoulou, Dafni
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Nicoll, Rachel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Jenkins, P. J. J.
    Mcarthur, T.
    Henein, Michael Y.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Comparison of coronary heart disease in South Asian angina pantients and caucasians with the use of CT angiography2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no Supplement: 1, p. S71-S72, Meeting Abstract: P192Article in journal (Other academic)
  • 20.
    Koulaouzidis, George
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Henein, Michael Y.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Guerci, A.
    Schmermund, A.
    The Natural History of Coronary Calcification: A meta-analysis from St Francis and EBEAT trials2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no Supplement: 1, p. S5-S5, Meeting Abstract: P18Article in journal (Other academic)
  • 21.
    Kristofferzon, Marja-Leena
    et al.
    Department of Caring Science and Sociology, University of Gävle, Gävle.
    Johansson, Ingela
    Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Arenhall, Eva
    School of Health and Medical Sciences, Örebro University, Örebro.
    Baigi, Amir
    General Practice and Public Health, Halland County Council, Falkenberg.
    Brunt, David
    School of Health Sciences and Social Work, Växjö University, Växjö.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping.
    Nilsson, Ulrica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Sylvi
    School of Health Sciences and Social Work, Växjö University.
    Rask, Mikael
    School of Health Sciences and Social Work, Växjö University, Växjö.
    Wieslander, Inger
    School of Social and Health Sciences, Halmstad University, Halmstad.
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Lund University Hospital, Lund.
    SAMMI study group, SAMMI
    Evaluation of a Swedish version of the Watts Sexual FunctionQuestionnaire (WSFQ) in persons with heart disease: A pilot study2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    Background

    As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required.

    Aims

    The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

    Methods

    A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

    Results

    Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations” with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test–retest values for all but one question exceeded 0.70.

    Conclusions

    The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

  • 22.
    Nilsson, Ulrica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Effectiveness of Music Interventions for Women with high anxiety during Coronary Angiographic Procedures: A Randomized Controlled2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 2, p. 150-153Article in journal (Refereed)
    Abstract [en]

    The purpose was to investigate if women with high pre-procedural anxiety reported higher degree of relaxation and comfort if listening to music during coronary angiographic procedures. A prospective randomized controlled trial was used included 68 patients undergoing coronary angiography and/or PCI. The women were allocated to receive calmingmusic and standard care or standard care only. Relaxation, environmental sound and discomfort associated with lying still were assessed. There was significantly more positive impression of the sound environment and less discomfort associated with lying still in women listening to music in comparison to women who received only standard care. No effect inrelaxation was found.

  • 23.
    Nilsson, Ulrica
    et al.
    Department of Cardiothoracic Surgery, Örebro University Hospital.
    Lindell, Lena
    Department of Cardiology, Örebro University Hospital, Sweden.
    Eriksson, Annika
    Department of Cardiology, Örebro University Hospital, Sweden.
    Kellerth, Thomas
    Department of Cardiology, Örebro University Hospital, Sweden.
    The effect of music intervention in relation to gender during coronary angiographic procedures: a randomized clinical trial2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 3, p. 200-206Article in journal (Refereed)
    Abstract [en]

    Several studies have evaluated music interventions prior and after coronary angiography and percutaneous coronary intervention (PCI), but there is no clear evidence showing that music has an effect on patients during these procedures. The purpose was to investigate the effects of music on anxiety, angina, pain, relaxation, and comfort in patients during angiographic procedures and to evaluate gender differences. The study was a four-armed, prospective randomized controlled trial included 240 patients undergoing coronary angiography and/or PCI. Patients were allocated to receive relaxing music, MusiCure® or standard care during the procedure. Outcome measures were; puncture pain and the discomfort related to it, angina and the discomfort related to it, anxiety, experience of the sound environment, discomfort of lying still, and the doses of anxiolytics and analgesics during the procedure. No differences were found between the music and control groups regarding any of the trial endpoints or gender-related differences. The overall rating of the sound environment and feeling of relaxation was high. In conclusion, music intervention in patients undergoing angiographic procedures was highly feasible, but not effective in this study though the delivery of music went smoothly and did not disturb the examination and patients and staff alike looked favorably on it.

  • 24.
    Olsson, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Näslund, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Patients’ self-reported function, symptoms and health-related quality of life before and 6 months after transcatheter aortic valve implantation and surgical aortic valve replacement2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 3, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Background: Aortic stenosis is the most common valve disease in western countries and has poor prognosis without treatment. Surgical aortic valve replacement (SAVR) is the gold standard, and transcatheter aortic valve implantation (TAVI) is a new method that is used in high-risk patients who are denied surgery. The purpose of treatment is not only to save life, but also to reduce symptoms and increase health-related quality of life (HRQoL).

    Objective: The aim of this study was to describe patients’ self-reported outcomes in terms of physical function, symptoms, dependence, HRQoL, and cognitive function after TAVI and SAVR.

    Methods: All patients treated with TAVI during 1 year (n = 24) and age-matched patients treated with SAVR (n = 24) were included. Data were collected on the day before and at 6 months after treatment using structural questionnaires.

    Results: Self-rated function was low before treatment and increased at follow-up. A quarter of all patients reported syncope at baseline, and none reported this at follow-up. Breathlessness was reported by all patients to be the most limiting cardiac symptom, but the TAVI patients reported more severe symptoms. At 6 months’ follow-up, symptoms were reduced, but breathlessness and fatigue were still common, especially in the TAVI group. HRQoL, which was very low in the TAVI group at baseline, increased in all dimensions except social function.

    Conclusion: We found no change in cognitive function or dependence at follow-up. There was no difference in the size of improvement between groups. The results could be helpful when informing future patients in order to give them realistic expectations.

  • 25.
    Olsson, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Näslund, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hope and despair: patients' experiences of being ineligible for transcatheter aortic valve implantation2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 7, p. 593-600Article in journal (Refereed)
    Abstract [en]

    Background: Transcatheter aortic valve implantation may be indicated for patients with aortic stenosis and high risk of postoperative mortality. The assessment of suitability for transcatheter aortic valve implantation requires consensus agreement of a team of cardiologists and cardiac surgeons. The burden of comorbidities, frailty and cognitive impairment are factors included when risks for transcatheter aortic valve implantation are balanced against the expected benefits. Although transcatheter aortic valve implantation is a possibility for many, there are still ineligible patients. Knowledge of their experiences of being deemed ineligible are lacking. Aim: The aim of this study was to explore patients' experiences of being considered for transcatheter aortic valve implantation but judged ineligible. Methods: Individual in-depth interviews were performed with eight persons, and qualitative content analysis was used for the analysis. Results: Being ineligible for transcatheter aortic valve implantation may induce both hope and despair. Hope was linked to experiences of acceptance, relief of symptoms, support and control; despair was associated with feelings of being missed and abandoned, and of grief and insecurity. Some expressed great anxiety, since their incurable heart disease meant an imminent death. Others were more concerned over practical problems that affected everyday life. Conclusion: Being ineligible for transcatheter aortic valve implantation does not necessarily lead to despair. Hope is built through relationships, continuity and support. A combination of person-centred care and palliative care during the end-of-life phase should be offered to patients in order to help clients re-conceptualise hope during this stage of their illness. Cardiovascular nurses in the transcatheter aortic valve implantation team are suitable to facilitate continued care based on the patient's needs, desires and local conditions.

  • 26. Strömbäck, U.
    et al.
    Vikman, I.
    Lundblad, Dan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lundqvist, R.
    Engström, É.
    The second myocardial infarction: women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S62-S63Article in journal (Refereed)
  • 27. Strömbäck, Ulrica
    et al.
    Engström, Åsa
    Lundqvist, Robert
    Lundblad, Dan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Vikman, Irene
    The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 7, p. 652-659Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient. Aim: This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays 2 h at second myocardial infarction. Methods: A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry. Results: The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay 2 h at the first myocardial infarction were more likely to have a prehospital delay 2 h at the second myocardial infarction. Conclusions: Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

  • 28. Strömbäck, Ulrica
    et al.
    Vikman, Irene
    Lundblad, Dan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lundqvist, Robert
    Engström, Åsa
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. The Northern Sweden MONICA study.2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 418-424Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

    AIM: To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

    METHODS: A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS: More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

    CONCLUSION: Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

  • 29. Thylén, Ingela
    et al.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Intimate relationships and sexual function in partnered patients in the year before and one year after a myocardial infarction: A longitudinal study2015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no 6, p. 468-477Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Intimate relationships and sexuality are essential to an individual's health and longevity after a myocardial infarction (MI).

    AIMS: To explore and compare partnered first-time MI patients' ratings of intimate relationship satisfaction and sexual function before the MI as compared to one year after the event.

    METHODS: Longitudinal study with 92 men and 36 women, aged 62.4±9.3 years. Self-reported data was collected one year before, and one year after, the MI.

    RESULTS: The majority were sexually active before (86%) as well as after (80%) their MI (ns). High satisfaction was reported with intimate relationships, which were stable over time (Relationship assessment scale score 4.56±0.50 and 4.53±0.52, respectively, ns). No significant differences in intimate relationships between genders were found. Women reported lower ratings in their sexual function than men before the MI (Watts sexual function score 45.92±6.55 and 48.59±4.96, respectively, P<0.05). The year after the event, women described an unchanged sexual function (45.08±7.25), while men (47.10±5.16) had decreased theirs (P<0.05). Both female and male patients enjoyed sexual activity less frequently the subsequent year. Men regarded having sex as being less important in their lives, were less satisfied with the frequency of sexual activity, and felt that they more often ejaculated prematurely the year after the MI.

    CONCLUSIONS: Partnered first-time MI patients continue to be sexually active the year after the event, and are highly satisfied with their intimate relationship. While the MI event seems to have a more negative impact on men's sexual functioning than women's, the women still rate their sexual function lower in comparison.

  • 30. Van Bulck, Liesbet
    et al.
    Luyckx, Koen
    Goossens, Eva
    Apers, SiIke
    Kovacs, Adrienne H.
    Thomet, Corina
    Budts, Werner
    Sluman, Maayke A.
    Eriksen, Katrine
    Dellborg, Mikael
    Berghammer, Malin
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Caruana, Maryanne
    Soufi, Alexandra
    Callus, Edward
    Moons, Philip
    Alday, Luis
    Maisuls, Hector
    Vega, Betina
    Menahem, Samuel
    Eaton, Sarah
    Wang, Qi Feng
    Larion, Ruth
    Van Deyk, Kristien
    Apers, Silke
    Rassart, Jessica
    Rempel, Gwen
    Mackie, Andrew
    Ballantyne, Ross
    Rankin, Kathryn
    Norris, Colleen
    Taylor, Dylan
    Vondermuhll, Isabelle
    Windram, Jonathan
    Heggie, Pamela
    Lasiuk, Gerri
    Khairy, Paul
    Proietti, Anna
    Dore, Annie
    Mercier, Lise-Andree
    Mongeon, Francois-Pierre
    Marcotte, Francois
    Ibrahim, Reda
    Mondesert, Blandine
    Cote, Marie-Claude
    Kovacs, Adrienne
    Oechslin, Erwin
    Bandyopadhyay, Mimi
    Di Filippo, Sylvie
    Sassolas, Francois
    Bozio, Andre
    Chareyras, Cecile
    Chidambarathanu, Shanthi
    Farzana, Farida
    Lakshmi, Nitya
    Quadri, Emilia
    Chessa, Massimo
    Campioni, Giovanna
    Giamberti, Alessandro
    Enomoto, Junko
    Mizuno, Yoshiko
    Grech, Victor
    Vella, Sheena
    Mifsud, Anabel
    Borg, Neville
    Chircop, Daniel
    Balbi, Matthew Mercieca
    Critien, Rachel Vella
    Farrugia, James
    Gatt, Yanika
    Muscat, Darlene
    Estensen, Mette-Elise
    Mattsson, Eva
    Strandberg, Anita
    Karlstrom-Hallberg, Pia
    Kronhamn, Anna-Karin
    Schwerzman, Markus
    Huber, Margrit
    Wang, Jou-Kou
    Lu, Chun-Wei
    Yang, Hsiao-Ling
    Hua, Yu Chuan
    Mulder, Barbara
    Sluman, Maayke
    Post, Marco
    Pieper, Els
    Peels, Kathinka
    Waskowsky, Marc
    Veldtman, Gruschen
    Faust, Michelle
    Lozier, Colin
    Reed, Christy
    Hilfer, Jamie
    Daniels, Curt
    Jackson, Jamie
    Kutty, Shelby
    Chamberlain, Carolyn
    Warta, Sara
    Cook, Stephen
    Hindes, Morgan
    Cedars, Ari
    White, Kamila
    Fernandes, Susan
    Romfh, Anitra
    MacMillen, Kirstie
    Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 465-473Article in journal (Refereed)
    Abstract [en]

    Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries' healthcare system performance are of importance for patient-reported outcomes. Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease. Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences. Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes. Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

  • 31. Van Bulck, Liesbet
    et al.
    Luyckx, Koen
    Goossens, Eva
    Apers, Silke
    Kovacs, Adrienne H.
    Thomet, Corina
    Budts, Werner
    Sluman, Maayke A.
    Eriksen, Katrine
    Dellborg, Mikael
    Berghammer, Malin
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Caruana, Maryanne
    Soufi, Alexandra
    Callus, Edward
    Moons, Philip
    Alday, Luis
    Maisuls, Hector
    Vega, Betina
    Menahem, Samuel
    Eaton, Sarah
    Wang, Qi Feng
    Larion, Ruth
    Van Deyk, Kristien
    Apers, Silke
    Rassart, Jessica
    Rempel, Gwen
    Mackie, Andrew
    Ballantyne, Ross
    Rankin, Kathryn
    Norris, Colleen
    Taylor, Dylan
    Vondermuhll, Isabelle
    Windram, Jonathan
    Heggie, Pamela
    Lasiuk, Gerri
    Khairy, Paul
    Proietti, Anna
    Dore, Annie
    Mercier, Lise-Andree
    Mongeon, Francois-Pierre
    Marcotte, Francois
    Ibrahim, Reda
    Mondesert, Blandine
    Cote, Marie-Claude
    Kovacs, Adrienne
    Oechslin, Erwin
    Bandyopadhyay, Mimi
    Di Filippo, Sylvie
    Sassolas, Francois
    Bozio, Andre
    Chareyras, Cecile
    Chidambarathanu, Shanthi
    Farzana, Farida
    Lakshmi, Nitya
    Quadri, Emilia
    Chessa, Massimo
    Campioni, Giovanna
    Giamberti, Alessandro
    Enomoto, Junko
    Mizuno, Yoshiko
    Grech, Victor
    Vella, Sheena
    Mifsud, Anabel
    Borg, Neville
    Chircop, Daniel
    Balbi, Matthew Mercieca
    Critien, Rachel Vella
    Farrugia, James
    Gatt, Yanika
    Muscat, Darlene
    Estensen, Mette-Elise
    Mattsson, Eva
    Strandberg, Anita
    Karlstrom-Hallberg, Pia
    Kronhamn, Anna-Karin
    Schwerzman, Markus
    Huber, Margrit
    Wang, Jou-Kou
    Lu, Chun-Wei
    Yang, Hsiao-Ling
    Hua, Yu Chuan
    Mulder, Barbara
    Sluman, Maayke
    Post, Marco
    Pieper, Els
    Peels, Kathinka
    Waskowsky, Marc
    Veldtman, Gruschen
    Faust, Michelle
    Lozier, Colin
    Reed, Christy
    Hilfer, Jamie
    Daniels, Curt
    Jackson, Jamie
    Kutty, Shelby
    Chamberlain, Carolyn
    Warta, Sara
    Cook, Stephen
    Hindes, Morgan
    Cedars, Ari
    White, Kamila
    Fernandes, Susan
    Romfh, Anitra
    MacMillen, Kirstie
    Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 465-473Article in journal (Refereed)
    Abstract [en]

    Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries’ healthcare system performance are of importance for patient-reported outcomes.

    Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease.

    Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

    Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes.

    Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

  • 32. Weeks, Birgit
    et al.
    Nilsson, Ulrica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Music intervention in patients during coronary angiographic procedures: a randomized controlled study of the effect on patients’ anxiety and well-being2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 2, p. 88-93Article in journal (Refereed)
    Abstract [en]

    Background

    A cardiac catheterization laboratory can be a frightening environment and music can be a supportive source of environmental sound that stimulates and maintains relaxation.

    Aim

    To test the effects of patient focused music versus loudspeaker music versus standard sound on patient's experiences of anxiety and well-being during coronary angiographic procedures.

    Methods

    A prospective, randomized, controlled trial of 98 subjects undergoing elective coronary angiogram and/or percutaneous coronary intervention. The subjects were randomly allocated to three different groups of sound environments: a control group (the usual sound environment), a patient focused music group (audio pillow) or to a loudspeaker music group.

    Results

    Anxiety decreased significantly and well-being increased significantly in the two music groups compared to the control group. There was a significantly more positive impression of the sound environment in the patient focused music group compared to the two other groups.

    Conclusion

    This study showed that the use of a specially designed music reduced anxiety and increased well-being in patients during coronary angiographic procedures. However, patient focused music seemed to be more preferable. The sound environment was rated more positively by the subjects listening to music via audio pillow. The music delivered via loudspeakers seemed to distract the staff during the examination at the cardiac catheterization laboratory.

  • 33. Årestedt, K.
    et al.
    Alvariza, A.
    Håkansson, C.
    Ohlen, J.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Goliath, I.
    Furst, C-J
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Symptom relief and palliative care during the last week of life among patients with heart failure2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S58-S59Article in journal (Refereed)
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