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Haile, S. T., Johansson, U.-B., Lööf, H., Linné, A. & Joelsson-Alm, E. (2023). Patient Related Outcomes After Receiving a Person Centred, Nurse Led Follow Up Programme Among Patients Undergoing Revascularisation for Intermittent Claudication: A Secondary Analysis of a Randomised Clinical Trial. European Journal of Vascular and Endovascular Surgery, 66(3), 371-379, Article ID S1078-5884(23)00514-2.
Open this publication in new window or tab >>Patient Related Outcomes After Receiving a Person Centred, Nurse Led Follow Up Programme Among Patients Undergoing Revascularisation for Intermittent Claudication: A Secondary Analysis of a Randomised Clinical Trial
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2023 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 66, no 3, p. 371-379, article id S1078-5884(23)00514-2Article in journal (Refereed) Published
Abstract [en]

Objective:  The aim was to evaluate the effect of a person centred, nurse led follow up programme on health related quality of life (HRQoL), health literacy, and general self efficacy in comparison with standard care for patients undergoing revascularisation for intermittent claudication (IC), and to describe factors associated with HRQoL one year after revascularisation.

Methods:  This was secondary analysis of a randomised controlled trial. Patients with IC scheduled for revascularisation at two vascular surgery centres in Sweden between 2016 and 2018 were randomised to intervention or control. During the first year after surgery, the intervention group received a person centred follow up programme with three visits and two telephone calls with a vascular nurse, while the control group received standard follow up with two visits to a vascular surgeon or vascular nurse. Outcomes were HRQoL measured by VascuQol-6, health literacy, and general self efficacy measured by validated questionnaires.

Results:  Overall, 214 patients were included in the trial; this secondary analysis comprised 183 patients who completed the questionnaires. One year after revascularisation, HRQoL had improved with a mean increase in VascuQol-6 of 7.0 scale steps (95% CI 5.9 - 8.0) for the intervention and 6.0 scale steps (95% CI 4.9 - 7.0) for the control group; the difference between the groups was not significant (p = .18). In an adjusted regression analysis, the intervention was associated with higher VascuQoL-6 (2.0 scale steps, 95% CI 0.08 - 3.93). There was no significant difference between the groups regarding health literacy or general self efficacy. The prevalence of insufficient health literacy among all participants was 39.7% (46/119) at baseline and 43.2% (51/118) at one year.

Conclusion:  In this study, a person centred, nurse led follow up programme had no significant impact on HRQoL, health literacy, or general self efficacy among patients undergoing revascularisation for IC. The prevalence of insufficient health literacy was high and should be addressed by healthcare givers and researchers.

Keywords
Health literacy, Health related quality of life, Intermittent claudication, Person centred care, Self efficacy
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-63906 (URN)10.1016/j.ejvs.2023.06.030 (DOI)001074149500001 ()37391012 (PubMedID)2-s2.0-85166636964 (Scopus ID)
Available from: 2023-07-19 Created: 2023-07-19 Last updated: 2023-10-18Bibliographically approved
Haile, S. T., Joelsson-Alm, E., Johansson, U. B., Lööf, H., Palmer-Kazen, U., Gillgren, P. & Linne, A. (2022). Effects of a person-centred, nurse-led follow-up programme on adherence to prescribed medication among patients surgically treated for intermittent claudication: randomized clinical trial. British Journal of Surgery, 109(9), 846-856
Open this publication in new window or tab >>Effects of a person-centred, nurse-led follow-up programme on adherence to prescribed medication among patients surgically treated for intermittent claudication: randomized clinical trial
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2022 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 109, no 9, p. 846-856Article in journal (Refereed) Published
Abstract [en]

Background Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. Patient adherence to secondary prevention is a challenge. The aim of this study was to investigate whether a person-centred, nurse-led follow-up programme could improve adherence to medication compared with standard care. Methods A non-blinded RCT was conducted at two vascular surgery centres in Sweden. Patients with intermittent claudication and scheduled for revascularization were randomized to the intervention or control (standard care) follow-up programme. The primary outcome, adherence to prescribed secondary preventive medication, was based on registry data on dispensed medication and self-reported intake of medication. Secondary outcomes were risk factors for cardiocerebrovascular disease according to the Framingham risk score. Results Some 214 patients were randomized and analysed on an intention-to-treat basis. The mean proportion of days covered (PDC) at 1 year for lipid-modifying agents was 79 per cent in the intervention and 82 per cent in the control group, whereas it was 92 versus 91 per cent for antiplatelet and/or anticoagulant agents. The groups did not differ in mean PDC (lipid-modifying P = 0.464; antiplatelets and/or anticoagulants P = 0.700) or in change in adherence over time. Self-reported adherence to prescribed medication was higher than registry-based adherence regardless of allocation or medication group (minimum P < 0.001, maximum P = 0.034). There was no difference in median Framingham risk score at 1 year between the groups. Conclusion Compared with the standard follow-up programme, a person-centred, nurse-led follow-up programme did not improve adherence to secondary preventive medication. Adherence was overestimated when self-reported compared with registry-reported. Management of intermittent claudication should include secondary prevention to reduce the risk of cardiocerebrovascular disease. This RCT aimed to investigate whether a person-centred, nurse-led follow-up programme, compared with standard care, after surgery could increase adherence to lipid-modifying and antiplatelet/anticoagulant agents. The results showed no difference between the intervention and standard follow-up programme on terms of patients' adherence to secondary preventive medication.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2022
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-59609 (URN)10.1093/bjs/znac241 (DOI)000826593000001 ()35848783 (PubMedID)2-s2.0-85136908897 (Scopus ID)
Available from: 2022-08-03 Created: 2022-08-03 Last updated: 2022-09-14Bibliographically approved
Haile, S., Lööf, H., Johansson, U.-B., Linné, A. & Joelsson-Alm, E. (2022). Increasing patients’ awareness of their own health: Experiences of participating in follow-up programs after surgical treatment for intermittent claudication. Journal of Vascular Nursing, 40(1), 47-53
Open this publication in new window or tab >>Increasing patients’ awareness of their own health: Experiences of participating in follow-up programs after surgical treatment for intermittent claudication
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2022 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 40, no 1, p. 47-53Article in journal (Refereed) Published
Abstract [en]

Introduction

Claudication is the most usual symptom of peripheral artery disease, it is described as painful contractions in the leg when walking and alleviated upon resting. People with claudication have an added risk of cardiocerebrovascular events, amputation, and death. Adherence to medical treatment and changes in lifestyles can lower this risk, but this secondary prevention therapy requires engagement, participation, and adherence from the patient.

Objective

To explore patients’ experiences of participating in a 1-year multicentre clinical trial with two follow-up programs evaluating a nurse-led, patient-centered health-promoting programme after surgical treatment for claudication, the FASTIC study.

Methods

A descriptive design with qualitative semi-structured interviews was used among participants in the FASTIC study. The study was conducted at two centres for vascular surgery in the city of Stockholm, Sweden. In all, 17 patients (nine men and eight women) who had completed the FASTIC study participated. Data was analysed using qualitative content analysis with an inductive approach.

Results

Two main categories were identified, ‘Patient-Professional collaboration’ and ‘Experience of one´s health’, which were associated with four subcategories: facing opportunities and obstacles, cooperating based on the illness experience, increasing awareness of one's own health, and maintaining a healthy lifestyle.

Conclusions

Patients' participation in follow-up programs after surgical treatment for claudication is highly valuable for an increased awareness of one's own health. A person-centered care with patient-professional collaboration is experienced as important for maintaining a health-promoting lifestyle.

National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-56809 (URN)10.1016/j.jvn.2021.11.004 (DOI)000778633000008 ()2-s2.0-85121748634 (Scopus ID)
Available from: 2021-12-22 Created: 2021-12-22 Last updated: 2022-05-04Bibliographically approved
Lööf, H. (Ed.). (2022). Långvarig smärta ur ett vårdande perspektiv (1:1ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Långvarig smärta ur ett vårdande perspektiv
2022 (Swedish)Collection (editor) (Other academic)
Abstract [sv]

Som vårdgivare kommer man att möta patienter med olika typer av smärtproblematik. Det är av stor betydelse att uppmärksamma och bemöta kontexten, situationen och de medicinska omständigheter som omgärdar personen med smärta. Smärta är ett mänskligt fenomen. En smärtupplevelse är därmed alltid sann. Det betyder att det patienten berättar äger legitimitet. 

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022 Edition: 1:1
Keywords
Långvarig smärta
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences; Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-61106 (URN)978-91-44-13820-6 (ISBN)
Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2022-12-08Bibliographically approved
Lööf, H. (2022). Långvarig smärta ur ett vårdande perspektiv. (1:1ed.). In: Helena Lööf (Ed.), Långvarig smärta ur ett vårdande perspektiv: (pp. 41-60). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Långvarig smärta ur ett vårdande perspektiv.
2022 (Swedish)In: Långvarig smärta ur ett vårdande perspektiv / [ed] Helena Lööf, Lund: Studentlitteratur AB, 2022, 1:1, , p. 213p. 41-60Chapter in book (Other academic)
Abstract [sv]

Långvarig smärta leder ofta till minskat välbefinnande och till minskad generell upplevd hälsa. Inom primärvården är smärta den vanligaste orsaken till att personer söker vård. Därför måste alla som arbetar inom vården ha en bred kunskap om vad smärta är för att på bästa sätt bemöta personer med långvarig smärta. Smärta är ett mänskligt fenomen och förekommer i alla åldrar. Boken tar därför upp alltifrån smärta hos små barn till smärta hos de allra äldsta personerna. Betydelsen av att uppmärksamma och ta till vara patienters inneboende kunskap och kompetens i vårdmötet beskrivs också. Samtliga kapitel illustreras av fallbeskrivningar där utgångspunkten är olika situationer och vårdkontexter med förslag på adekvata omvårdnads- och stödåtgärder.

Sjuksköterskans kärnkompetenser förankrar boken i det vårdande perspektivet. Boken riktar sig i första hand till studenter på grundutbildningar, främst till de som studerar till sjuksköterska, men även studenter inom fysioterapi och arbetsterapi kan ha stor nytta av bokens innehåll. Boken kan användas av andra professioner, liksom av studerande på olika vidareutbildningar som berör ämnet långvarig smärta.

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022. p. 213 Edition: 1:1
Keywords
Långvarig smärta, Long-term pain
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences; Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-61105 (URN)978-91-44-13820-6 (ISBN)
Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2022-12-08Bibliographically approved
Söderman, M. & Lööf, H. (2022). Återhämtningsprocessen vid långvarig smärta. In: Helena Lööf (Ed.), Långvarig smärta ur ett vårdande perspektiv: (pp. 175-192). Studentlitteratur AB
Open this publication in new window or tab >>Återhämtningsprocessen vid långvarig smärta
2022 (Swedish)In: Långvarig smärta ur ett vårdande perspektiv / [ed] Helena Lööf, Studentlitteratur AB, 2022, p. 175-192Chapter in book (Other academic)
Place, publisher, year, edition, pages
Studentlitteratur AB, 2022
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-61094 (URN)978-91-44-13820-6 (ISBN)
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2022-12-02Bibliographically approved
Eklund, C., Elfström, M., von Heideken Wågert, P., Söderlund, A., Gustavsson, C., Cederborn, S., . . . Lööf, H. (2021). The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study. Physical Therapy, 101(8), Article ID pzab117.
Open this publication in new window or tab >>The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study
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2021 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 101, no 8, article id pzab117Article in journal (Refereed) Published
Abstract [en]

Objective

Sedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.

Methods

The study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.

Results

The participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.

Conclusions

Increased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.

Impact

This knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.

Keywords
Healthy Aging, Lifestyle, Phenomenology, Physical Activity, Sedentary
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-54120 (URN)10.1093/ptj/pzab117 (DOI)000736132800010 ()2-s2.0-85115445763 (Scopus ID)
Available from: 2021-05-10 Created: 2021-05-10 Last updated: 2022-10-31Bibliographically approved
Lööf, H. & Johansson, U.-B. (2019). “A body in transformation”: - An Empirical phenomenological study about fear-avoidance beliefs towards physical activity among persons experiencing moderate to severe rheumatic pain. Journal of Clinical Nursing, 8(1-2), 321-329
Open this publication in new window or tab >>“A body in transformation”: - An Empirical phenomenological study about fear-avoidance beliefs towards physical activity among persons experiencing moderate to severe rheumatic pain
2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 1-2, p. 321-329Article in journal (Refereed) Published
Abstract [en]

Aims. To gain a better understanding of fear-avoidance beliefs towards physical activity and body awareness in people experiencing moderate to severe rheumatic pain.  Background. Rheumatoid arthritis and psoriatic arthritis are long-term conditions with pain as the prominent symptom. Health-promoting physical activity is recommended, and can have an analgesic effect. High self-rated pain has previously been reported to be associated with increased fear-avoidance behaviour in relation to physical activity. Body awareness, which includes attentional focus and awareness of internal body sensations, could be valuable in the nursing care of long-term diseases.   Design. Empirical phenomenological.  Methods. An empirical phenomenological psychological method was applied. Interviews were undertaken in 2016 with 11 informants (eight females and three males, age range 44–71 years) who were diagnosed with rheumatoid arthritis (n = 7) or psoriatic arthritis (n = 4), with a disease duration ranging from 3–35 years. The mean visual analogue scale score in the study sample was 60 mm.   Results. Three typologies were identified: “My relatively fragile physical status”, “I am an active creator” and “Part of something bigger than myself.” Conclusions. The current findings indicated that pain anticipation and fear-avoidance beliefs towards physical activity sometimes affected the behaviour of individuals with long-term rheumatic pain syndromes. People experiencing moderate to high rheumatic pain tended to focus on their fragile physical and emotional state. By adopting a more favourable attitude towards the self, the body could be restored to a state of calm and balance.  Relevance to clinical practice. The current findings are relevant for healthcare professionals engaged in health-promotion clinical practice.

Keywords
Fear-avoidance beliefs, Body awareness, Pain, Rheumatic diseases, Nursing
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40184 (URN)10.1111/jocn.14606 (DOI)000453228000030 ()29971848 (PubMedID)2-s2.0-85058432875 (Scopus ID)
Available from: 2018-07-04 Created: 2018-07-04 Last updated: 2020-12-22Bibliographically approved
Lööf, H. (2019). “Let me be a meaningful part in the outside world”: A caring perspective on long-term rheumatic pain and fear-avoidance beliefs in relation to body awareness and physical activities. In: Simon van Rysewyk (Ed.), Meanings of pain: Common types of pain and language (pp. 103-115). Springer
Open this publication in new window or tab >>“Let me be a meaningful part in the outside world”: A caring perspective on long-term rheumatic pain and fear-avoidance beliefs in relation to body awareness and physical activities
2019 (English)In: Meanings of pain: Common types of pain and language / [ed] Simon van Rysewyk, Springer , 2019, p. 103-115Chapter in book (Other academic)
Place, publisher, year, edition, pages
Springer, 2019
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-45207 (URN)10.1007/978-3-030-24154-4_6 (DOI)2-s2.0-85126828170 (Scopus ID)978-3-030-24154-4 (ISBN)
Available from: 2019-09-13 Created: 2019-09-13 Last updated: 2024-01-04Bibliographically approved
Lööf, H. & Johansson, U.-B. (2018). Long-term rheumatic pain, body awareness and fear-avoidance beliefs. In: Nordic Conference in Nursing Research 2018, June 13-15th, Oslo.: . Paper presented at Nordic Conference in Nursing Research. Stockholm
Open this publication in new window or tab >>Long-term rheumatic pain, body awareness and fear-avoidance beliefs
2018 (English)In: Nordic Conference in Nursing Research 2018, June 13-15th, Oslo., Stockholm, 2018Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
Stockholm: , 2018
Keywords
Pain, Body awareness, Fear-avoidance, Health-promoting, Phenomenology
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40189 (URN)
Conference
Nordic Conference in Nursing Research
Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-08-14Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7018-2706

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