Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ e...Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.展开更多
Background: Discrimination and stigmatization of people with mental illness are a global and complex phenomenon and there is evidence that negative attitudes and discrimination are also prevalent among health care sta...Background: Discrimination and stigmatization of people with mental illness are a global and complex phenomenon and there is evidence that negative attitudes and discrimination are also prevalent among health care staff and health care students. Methods: Attitudes towards people with schizophrenia among 1101 students in eight different university programs providing training for work in the health care and social sectors were explored, using a cross-sectional design. Results: In five of the eight training programs the majority of the students’ perceived people with schizophrenia as a danger to others. In several aspects police students were found to hold more negative attitudes than students from other programs. Students with previous experiences of work in mental health services and students knowing a person with schizophrenia showed more positive attitudes. Discussion: In order to decrease negative attitudes and prejudices towards people with schizophrenia among students, it is essential that the training includes personal contact with people with experience of being mental illness.展开更多
Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has prog...Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.展开更多
Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation(EECP)in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory...Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation(EECP)in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory angina were divided into EECP(n=10)or no EECP(n=10)groups.The data were compared to matched healthy subjects(n=20).The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry.The vascular responsiveness to iontophoretic administration of acetylcholine(ACh),sodium nitroprusside(SNP)and local skin warming were studied.Measurements of Canadian Cardiovascular Society(CCS)-class,blood pressure and plasma samples were registered.Results EECP patients showed reduced CCS-class compared to no EECP(P<0.05).Both EECP and no EECP(P<0.05)groups had decreased systolic blood pressure(SBP)as compared to SBP at baseline(P<0.05).There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up.Responses to heating,the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects(P<0.05).EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class.Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh,SNP and heat compared to healthy subjects.Although EECP reduced the CCS-class,this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.展开更多
Little is known about the psychosocial work situation among staff working with people with cognitive restrictions, and research is needed. Aim: The aim of this study was to describe the symptom panorama and psychosoci...Little is known about the psychosocial work situation among staff working with people with cognitive restrictions, and research is needed. Aim: The aim of this study was to describe the symptom panorama and psychosocial work situation of staff working with people with cognitive restrictions and to identify predictors for their job satisfaction and workability. A cross sectional study was performed. Method: The Questionnaire Psycho Social Nordic (QPS-Nordic questionnaire) was used. Results: The results showed that the majority of the staff working with people with cognitive restrictions were satisfied with their job, but musculoskeletal symptoms were described by 40%. Decision demands at work were high compared to quantitative and learning demands. Musculoskeletal symptoms were related to low ability to master the work, low job control and high job demands. Symptoms from the neck region were correlated to stress. A low level of neck pain was related to a high level of job satisfaction. Predictors for workability were positive challenges in work and not being hindered by musculoskeletal symptoms in work. Predictors for job satisfaction were mastery, workability and not having pain during the last 7 days. Conclusion: Due to the relatively small sample the results should be interpreted with caution. The results indicated that positive challenges in work and not being hindered by musculoskeletal disorders predicted workability in this group and that mastery, workability and not having pain during the last 7 days predicted job satisfaction.展开更多
Prostate cancer and its treatment have long-term implications for men’s lives. We aimed to describe the content, extent, and frequency of written comments to the open-ended question, “Further comments?” in the pati...Prostate cancer and its treatment have long-term implications for men’s lives. We aimed to describe the content, extent, and frequency of written comments to the open-ended question, “Further comments?” in the patient-reported outcome measures questionnaire. During the study period, 897 men participated;372 wrote 747 free-text comments in the questionnaire. These comments were analysed using qualitative content analysis and were grouped into four categories: 1) prostate cancer’s influence on health;2) clarifications of answers to the survey;3) descriptions of well-being despite the cancer;and 4) experiences of care and the need for contact with health care. The distribution of the comments shifted over time. The open-ended question not only allowed the participants to explain their other responses and describe important aspects of their lives during and after treatment, something not normally covered by a questionnaire, but it also indicated their experiences of health care services along the patients’ PC-trajectory. This further raises the issue of including an open-ended item in a forced-choice survey into the ethical realm to ensure that proper care is taken of participants’ answers and thoughts.展开更多
The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to in...The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to investigate if social factors, registered at diagnosis, had an impact on metabolic control two years after diagnosis. During the years 1997-2006, 247 children and adolescents were diagnosed with type 1 diabetes at a University Hospital in Sweden. The analysed data included HbA1c, pH at diagnosis, initial intravenous insulin infusion and length of hospital stay at diag?nosis, subcutaneous insulin type, number of diabetes check-up visits, emergency visits, re-admissions and social factors. Length of hospital stay decreased significantly over the ten year period. Neither hospital stay nor differences in insulin treatment was significantly correlated with children’s metabolic control over time. Length of hospital stay was not re?lated with families’ social stress situation. However, girls in families with more family stress at the time of diagnosis had higher HbA1c during follow-up than girls with less family stress or boys. Factors of importance for the child’s long-term metabolic control need to be further investigated so the initial management can be tailored to each individual family’s needs. This would imply an effective utilization of both families’ and health care resources.展开更多
Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essenti...Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.展开更多
Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor ...Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.展开更多
Background The knowledge about the prevalence of schizophrenia among people with intellectual disabilities(ID)is sparse,particularly concerning the distribution in different age groups.Aims To investigate the prevalen...Background The knowledge about the prevalence of schizophrenia among people with intellectual disabilities(ID)is sparse,particularly concerning the distribution in different age groups.Aims To investigate the prevalence of diagnoses in the schizophrenia spectrum among people with ID compared with the general population(gPop).Methods This was an 8-year longitudinal register study.The participants were all residents of Skane on 1 January 2014.People with a diagnosis of ID(F7 in International Statistical Classificationof Diseases and RelatedHealth Problems 10th Revision)or Down syndrome(DS;Q90),or service and support for people with ID/autism spectrum disorder(ASD)comprised the ID cohort(n=14716).After excluding family members of people in the ID cohort,the remaining population of Skane comprised the gPop cohort(n=1226955).The primary outcome measure was having at least one diagnosis in the schizophrenia spectrum(F20-F29).Secondary outcomes were single diagnoses within the schizophrenia spectrum.Results The prevalence of schizophrenia spectrum diagnoses was 7.2%in the ID cohort.This was more than an eightfold increase compared with the gPop(relative risk(RR)8.45;95%CI 7.94 to 9.00).The risk was also high among children(aged 0-18 years at the start of the study period;RR 9.42;95%CI 7.36 to 12.05).In the subcohort comprising those with a diagnosis of DS,the risk of schizophrenia diagnosis was more than twice as high as in gPop.Concomitant ASD or genetic syndrome did not carry an excess risk among people with ID when compared with the gPop.Conclusions The findings of the present study support earlier assumptions that people with vulnerable brains develop psychotic disorders more frequently and that the onset age is lower than among people in the gPop.Habilitation services for children and adolescents,as well as general mental health services,should keep in mind that schizophrenia may be present when children and adolescents show severely decreased functioning,anxiety oraggressive behaviour.展开更多
<正>In a recent paper,Donaldson et al.~1 argued that lower extremity injuries can be prevented.Evidence-based sports injury preventive exercise programs usually have limited impact on public health because they ...<正>In a recent paper,Donaldson et al.~1 argued that lower extremity injuries can be prevented.Evidence-based sports injury preventive exercise programs usually have limited impact on public health because they are not widely adopted or sustained into regular training routines.One reason for this is that the intervention program may not seem relevant for the展开更多
Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at re...Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at relatives’ of a person with schizophrenia to alleviate daily life. Aim: The aim of the present study was to explore participants’ use of the web based tool with focus on the forum and its potential health and psychosocial benefits. Methods: Nineteen persons participated in this explorative open trial. The forum posts were analyzed using content analysis. Self-rating instruments assessing caregiver burden, stigma and the tool’s usability were analyzed with descriptive statistics. Results: The qualitative analysis resulted in four main categories and subcategories describing relatives’ situation and interaction in the forum: Caring for a Person with Schizophrenia, Crisis and Care, Secrecy vs Openness, and Interaction and Social Support. Experiences of caregiver burden, but also fulfillment with caregiving tasks were reported. Concealing or hiding the family’s mental illness was common, but also the ability to use inner strength to cope with stigma and discrimination. The mean usability score was 59 (70 = good). Conclusion: Web based support can help address some of the families’ needs of support, although it encompasses certain limitations. Patient rights and the availability of resources, especially in cases of emergency, need to be made easily visible and accessible to alleviate families’ burden.展开更多
Purpose: To describe how patients living with psoriatic arthritis experience long-term hydrotherapy group treatment. Studies for this group of patients are lacking. Method: Qualitative in terviews were conducted with ...Purpose: To describe how patients living with psoriatic arthritis experience long-term hydrotherapy group treatment. Studies for this group of patients are lacking. Method: Qualitative in terviews were conducted with ten informants after hydrotherapy treatment. The treatment included exercises for increased mobility, coordination, endurance, aerobic fitness, stretching and relaxation. The interviews were analysed with content analysis. Results: A theme “hydrotherapy—a multidimensional experience” and two categories emerged: situational factors and effects of hydrotherapy. The category “situ- ational factors” comprised the subcategories: warm water, training factors and a competent instructor, and the category “effects of hydro- therapy” comprised the subcategories: psy- chological effects, improved physical capacity, social effects, changed pain experience and changes in work and participation in daily life. Conclusion: Positive effects of regular hydro- therapy in a group setting were shown in physical ability, energy, sleep, cognitive function, work and participation in daily life. The instruc- tors had an important coaching role, which needs to be promoted.展开更多
Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes,and sport classification.Our aim is to synthesis...Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes,and sport classification.Our aim is to synthesise evidence related to assessing muscle strength in para-athletes.Four databases were searched from January 1990 to July 2021 for observational studies focusing on strength assessment.Independent screening,data extraction,and quality assessment were performed in duplicate.A total of 1764 potential studies were identified.Thirty met the inclusion criteria and were included in the review.The mean age of participants was 30.7 years(standard deviation[SD]:2.4).The majority were men(88%)participating in wheelchair sports,including basketball,rugby,and tennis(23/30:76%).Overall quality varied,with more than half of the studies failing to identify strategies for dealing with confounding variables.Despite manual muscle testing being a standard component of para-sport classification systems,evidence examining strength characteristics in para-athletes is derived primarily from isometric and isokinetic testing.In studies that included comparative strength data,findings were mixed.Some studies found strength values were similar to or lower than able-bodied athletic controls.However,an important observation was that others reported higher shoulder strength in para-athletes taking part in wheelchair sports than both able-bodied and disabled non-athletes.Studies need to develop accessible,standardised strength testing methods that account for training influence and establish normative strength values in para-athletes.There is also a need for additional studies that include female para-athletes and para-athletes with greater functional impairments.展开更多
文摘Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.
基金the Swedish Council for Working Life Social Research
文摘Background: Discrimination and stigmatization of people with mental illness are a global and complex phenomenon and there is evidence that negative attitudes and discrimination are also prevalent among health care staff and health care students. Methods: Attitudes towards people with schizophrenia among 1101 students in eight different university programs providing training for work in the health care and social sectors were explored, using a cross-sectional design. Results: In five of the eight training programs the majority of the students’ perceived people with schizophrenia as a danger to others. In several aspects police students were found to hold more negative attitudes than students from other programs. Students with previous experiences of work in mental health services and students knowing a person with schizophrenia showed more positive attitudes. Discussion: In order to decrease negative attitudes and prejudices towards people with schizophrenia among students, it is essential that the training includes personal contact with people with experience of being mental illness.
文摘Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.
文摘Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation(EECP)in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory angina were divided into EECP(n=10)or no EECP(n=10)groups.The data were compared to matched healthy subjects(n=20).The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry.The vascular responsiveness to iontophoretic administration of acetylcholine(ACh),sodium nitroprusside(SNP)and local skin warming were studied.Measurements of Canadian Cardiovascular Society(CCS)-class,blood pressure and plasma samples were registered.Results EECP patients showed reduced CCS-class compared to no EECP(P<0.05).Both EECP and no EECP(P<0.05)groups had decreased systolic blood pressure(SBP)as compared to SBP at baseline(P<0.05).There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up.Responses to heating,the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects(P<0.05).EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class.Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh,SNP and heat compared to healthy subjects.Although EECP reduced the CCS-class,this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.
文摘Little is known about the psychosocial work situation among staff working with people with cognitive restrictions, and research is needed. Aim: The aim of this study was to describe the symptom panorama and psychosocial work situation of staff working with people with cognitive restrictions and to identify predictors for their job satisfaction and workability. A cross sectional study was performed. Method: The Questionnaire Psycho Social Nordic (QPS-Nordic questionnaire) was used. Results: The results showed that the majority of the staff working with people with cognitive restrictions were satisfied with their job, but musculoskeletal symptoms were described by 40%. Decision demands at work were high compared to quantitative and learning demands. Musculoskeletal symptoms were related to low ability to master the work, low job control and high job demands. Symptoms from the neck region were correlated to stress. A low level of neck pain was related to a high level of job satisfaction. Predictors for workability were positive challenges in work and not being hindered by musculoskeletal symptoms in work. Predictors for job satisfaction were mastery, workability and not having pain during the last 7 days. Conclusion: Due to the relatively small sample the results should be interpreted with caution. The results indicated that positive challenges in work and not being hindered by musculoskeletal disorders predicted workability in this group and that mastery, workability and not having pain during the last 7 days predicted job satisfaction.
文摘Prostate cancer and its treatment have long-term implications for men’s lives. We aimed to describe the content, extent, and frequency of written comments to the open-ended question, “Further comments?” in the patient-reported outcome measures questionnaire. During the study period, 897 men participated;372 wrote 747 free-text comments in the questionnaire. These comments were analysed using qualitative content analysis and were grouped into four categories: 1) prostate cancer’s influence on health;2) clarifications of answers to the survey;3) descriptions of well-being despite the cancer;and 4) experiences of care and the need for contact with health care. The distribution of the comments shifted over time. The open-ended question not only allowed the participants to explain their other responses and describe important aspects of their lives during and after treatment, something not normally covered by a questionnaire, but it also indicated their experiences of health care services along the patients’ PC-trajectory. This further raises the issue of including an open-ended item in a forced-choice survey into the ethical realm to ensure that proper care is taken of participants’ answers and thoughts.
文摘The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to investigate if social factors, registered at diagnosis, had an impact on metabolic control two years after diagnosis. During the years 1997-2006, 247 children and adolescents were diagnosed with type 1 diabetes at a University Hospital in Sweden. The analysed data included HbA1c, pH at diagnosis, initial intravenous insulin infusion and length of hospital stay at diag?nosis, subcutaneous insulin type, number of diabetes check-up visits, emergency visits, re-admissions and social factors. Length of hospital stay decreased significantly over the ten year period. Neither hospital stay nor differences in insulin treatment was significantly correlated with children’s metabolic control over time. Length of hospital stay was not re?lated with families’ social stress situation. However, girls in families with more family stress at the time of diagnosis had higher HbA1c during follow-up than girls with less family stress or boys. Factors of importance for the child’s long-term metabolic control need to be further investigated so the initial management can be tailored to each individual family’s needs. This would imply an effective utilization of both families’ and health care resources.
文摘Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.
基金Linnaeus University,Lund University and Blekinge Institute of Technology for financial support.
文摘Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
基金study was funded by F0RTE(2019-00105 and 2021-01862).
文摘Background The knowledge about the prevalence of schizophrenia among people with intellectual disabilities(ID)is sparse,particularly concerning the distribution in different age groups.Aims To investigate the prevalence of diagnoses in the schizophrenia spectrum among people with ID compared with the general population(gPop).Methods This was an 8-year longitudinal register study.The participants were all residents of Skane on 1 January 2014.People with a diagnosis of ID(F7 in International Statistical Classificationof Diseases and RelatedHealth Problems 10th Revision)or Down syndrome(DS;Q90),or service and support for people with ID/autism spectrum disorder(ASD)comprised the ID cohort(n=14716).After excluding family members of people in the ID cohort,the remaining population of Skane comprised the gPop cohort(n=1226955).The primary outcome measure was having at least one diagnosis in the schizophrenia spectrum(F20-F29).Secondary outcomes were single diagnoses within the schizophrenia spectrum.Results The prevalence of schizophrenia spectrum diagnoses was 7.2%in the ID cohort.This was more than an eightfold increase compared with the gPop(relative risk(RR)8.45;95%CI 7.94 to 9.00).The risk was also high among children(aged 0-18 years at the start of the study period;RR 9.42;95%CI 7.36 to 12.05).In the subcohort comprising those with a diagnosis of DS,the risk of schizophrenia diagnosis was more than twice as high as in gPop.Concomitant ASD or genetic syndrome did not carry an excess risk among people with ID when compared with the gPop.Conclusions The findings of the present study support earlier assumptions that people with vulnerable brains develop psychotic disorders more frequently and that the onset age is lower than among people in the gPop.Habilitation services for children and adolescents,as well as general mental health services,should keep in mind that schizophrenia may be present when children and adolescents show severely decreased functioning,anxiety oraggressive behaviour.
文摘<正>In a recent paper,Donaldson et al.~1 argued that lower extremity injuries can be prevented.Evidence-based sports injury preventive exercise programs usually have limited impact on public health because they are not widely adopted or sustained into regular training routines.One reason for this is that the intervention program may not seem relevant for the
文摘Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at relatives’ of a person with schizophrenia to alleviate daily life. Aim: The aim of the present study was to explore participants’ use of the web based tool with focus on the forum and its potential health and psychosocial benefits. Methods: Nineteen persons participated in this explorative open trial. The forum posts were analyzed using content analysis. Self-rating instruments assessing caregiver burden, stigma and the tool’s usability were analyzed with descriptive statistics. Results: The qualitative analysis resulted in four main categories and subcategories describing relatives’ situation and interaction in the forum: Caring for a Person with Schizophrenia, Crisis and Care, Secrecy vs Openness, and Interaction and Social Support. Experiences of caregiver burden, but also fulfillment with caregiving tasks were reported. Concealing or hiding the family’s mental illness was common, but also the ability to use inner strength to cope with stigma and discrimination. The mean usability score was 59 (70 = good). Conclusion: Web based support can help address some of the families’ needs of support, although it encompasses certain limitations. Patient rights and the availability of resources, especially in cases of emergency, need to be made easily visible and accessible to alleviate families’ burden.
文摘Purpose: To describe how patients living with psoriatic arthritis experience long-term hydrotherapy group treatment. Studies for this group of patients are lacking. Method: Qualitative in terviews were conducted with ten informants after hydrotherapy treatment. The treatment included exercises for increased mobility, coordination, endurance, aerobic fitness, stretching and relaxation. The interviews were analysed with content analysis. Results: A theme “hydrotherapy—a multidimensional experience” and two categories emerged: situational factors and effects of hydrotherapy. The category “situ- ational factors” comprised the subcategories: warm water, training factors and a competent instructor, and the category “effects of hydro- therapy” comprised the subcategories: psy- chological effects, improved physical capacity, social effects, changed pain experience and changes in work and participation in daily life. Conclusion: Positive effects of regular hydro- therapy in a group setting were shown in physical ability, energy, sleep, cognitive function, work and participation in daily life. The instruc- tors had an important coaching role, which needs to be promoted.
文摘Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes,and sport classification.Our aim is to synthesise evidence related to assessing muscle strength in para-athletes.Four databases were searched from January 1990 to July 2021 for observational studies focusing on strength assessment.Independent screening,data extraction,and quality assessment were performed in duplicate.A total of 1764 potential studies were identified.Thirty met the inclusion criteria and were included in the review.The mean age of participants was 30.7 years(standard deviation[SD]:2.4).The majority were men(88%)participating in wheelchair sports,including basketball,rugby,and tennis(23/30:76%).Overall quality varied,with more than half of the studies failing to identify strategies for dealing with confounding variables.Despite manual muscle testing being a standard component of para-sport classification systems,evidence examining strength characteristics in para-athletes is derived primarily from isometric and isokinetic testing.In studies that included comparative strength data,findings were mixed.Some studies found strength values were similar to or lower than able-bodied athletic controls.However,an important observation was that others reported higher shoulder strength in para-athletes taking part in wheelchair sports than both able-bodied and disabled non-athletes.Studies need to develop accessible,standardised strength testing methods that account for training influence and establish normative strength values in para-athletes.There is also a need for additional studies that include female para-athletes and para-athletes with greater functional impairments.
