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  • 1.
    Andersson, Per
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Sjöberg, Rickard L
    Öhrvik, John
    Leppert, Jerzy
    Effects of family history and personal experience of illness on inclination to change health related behavior2009In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 17, no 1, p. 3-7Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to examine how personal experience of illness and family history of cardiovascular disease (CVD), adjusted for gender, education and nationality, affects risk behaviour. Subjects were 2054 men and women of age 50 from two countries, Sweden (n=1011) and Poland (n=1043), who were recruited from screening program in primary health care. Family history, personal experience and risk behaviours (smoking habits, exercise habits, BMI-level) were self-reported. The results show that smoking behaviour is affected by personal experience of illness but not by family history of CVD. No effects of these variables were found on the remaining risk related variables that were tested in this study.  These results suggest that individuals with a personal experience of illness may be inclined to change smoking behaviour more than the average person. Smoking prevention strategies may thus benefit from targeting this group in particular.

     

  • 2.
    Holmberg, Mats
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Andersson, Henrik
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Winge, Karin
    Ambulance Department, South Älvsborgs Hospital, Borås, Sweden.
    Lundberg, Camilla
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Karlsson, Thomas
    Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Herlitz, Johan
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Wireklint Sundström, Birgitta
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome2018In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 18, no 216Article in journal (Refereed)
    Abstract [en]

    Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development of potentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) are important. The aim of this study has therefore been to explore the possible association between patients' estimated intensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcome before and after arrival in hospital. Methods: Data was collected both prospectively and retrospectively. The inclusion criteria were chest pain raising suspicion of ACS and a reported intensity of pain 4 on the visual analogue scale. Results: All in all, 1603 patients were included in the study. Increased intensity of chest pain was related to: 1) more heart-related complications before hospital admission; 2) a higher proportion of heart failure, anxiety and chest pain after hospital admission; 3) a higher proportion of acute myocardial infarction and 4) a prolonged hospitalisation. However, there was no significant association with mortality neither in 30 days nor in three years. Adjustment for possible confounders including age, a history of smoking and heart failure showed similar results. Conclusion: The estimated intensity of chest pain reported by the patients on admission by the ambulance team was associated with the risk of complications prior to hospital admission, heart failure, anxiety and chest pain after hospital admission, the final diagnosis and the number of days in hospital.

  • 3.
    Mastersong, Siobhan
    et al.
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    McNally, Bryan
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Cullinan, John
    Natl Univ Ireland, JE Cairnes Sch Business & Econ, Galway H91 WN80, Ireland..
    Vellano, Kimberly
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Escutnaire, Josephine
    Univ Lille Law & Hlth, Fac Engn & Hlth Management ILLS, Lille, France..
    Fitzpatrick, David
    Stirling Univ, Scottish Ambulance Serv, NMAHP Res Unit, Unit 13 Scion House, Stirling FK9 4NF, Scotland..
    Perkins, Gavin D.
    Univ Warwick, WMS Warwick Clin Trials Unit, Out Hosp Cardiac Arrest Outcomes OHCAO Trial, Coventry CV4 7AL, W Midlands, England..
    Koster, Rudolph W.
    Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands..
    Nakajima, Yuko
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Pemberton, Katherine
    Queensland Ambulance Serv, GPO Box 1425, Brisbane, Qld 4001, Australia..
    Quinn, Martin
    Natl Univ Ireland Galway, Natl Out Hosp Cardiac Arrest Register OHCAR Steer, Dept Publ Hlth Med, HSE, Letterkenny F92 XK84, Co Donegal, Ireland..
    Smith, Karen
    Ambulance Victoria Ctr Res & Evaluat, POB 2000, Doncaster, Vic 3108, Australia..
    Jonsson, Bergpor Steinn
    Akureyri Hosp, Eyrarlandsvegur 600, Akureyri, Iceland..
    Strömsöe, Anneli
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tandan, Meera
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    Vellinga, Akke
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    Out-of-hospital cardiac arrest survival in international airports2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 127, p. 58-62Article in journal (Refereed)
    Abstract [en]

    Background: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment. Methods: This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio. Results: There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm. In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries. Conclusions: In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival.

  • 4.
    Nahlen Bose, Catarina
    et al.
    Röda Korsets Högskola, Sweden.
    Björling, Gunilla
    Röda Korsets Högskola, Sweden.
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Persson, Hans
    Karolinska Institutet, Sweden.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Sweden.
    Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured2015In: Cardiology Research, ISSN 1923-2829, E-ISSN 1923-2837, Vol. 6, no 2, p. 239-248Article in journal (Refereed)
    Abstract [en]

    Background: Individuals with chronic heart failure (CHF) need to cope with both the physical limitations and the psychological impacts of the disease. Since some coping strategies are beneficial and others are linked to increased mortality and worse health-related quality of life (HRQoL), it is important to have a reliable and valid instrument to detect different coping styles. Brief COPE, a self-reporting questionnaire, has been previously used in the context of CHF. There is, however, currently a lack of consensus about the theoretical or empirical foundations for grouping the multiple coping strategies assessed by Brief COPE into higher order categories of coping. The main purpose of this study was to examine the structure of Brief COPE, founded on the higher order grouping of its subscales in order to establish an assessment model supported by theoretical considerations. Furthermore, the associations between these higher order categories of coping and HRQoL were examined to establish the predictive validity of the selected model in the context of CHF.

    Method: One hundred eighty-three patients diagnosed with CHF were recruited at a heart failure outpatient clinic or at a cardiac ward. Self-reported questionnaires were filled in to measure coping strategies and HRQoL. Confirmatory factor analyses were performed to investigate different hierarchical structures of Brief COPE found in the literature to assess coping strategies in patients with CHF. Regression analyses explored associations of aggregated coping strategies with HRQoL.

    Results: A four factorial structure of Brief COPE displayed the most adequate psychometric properties, consisting of problem focused coping, avoidant coping, socially supported coping and emotion focused coping. Avoidant coping was associated with worse HRQoL in CHF.

    Conclusions: This study provides support for a four-factor model of coping strategies in patients with CHF. This could facilitate assessment of coping both in clinical and research settings.

  • 5.
    Nahlen Bose, Catarina
    et al.
    The Swedish Red Cross University College, Stockholm, Sweden.
    Persson, Hans
    Karolinska Institutet, Stockholm, Sweden.
    Björling, Gunilla
    The Swedish Red Cross University College, Stockholm, Sweden.
    Ljunggren, Gunnar
    Karolinska Institutet, Stockholm, Sweden.
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Stockholm, Sweden.
    Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure: a randomized controlled trial2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 537-548, article id S1-S1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).

    AIMS:

    To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.

    METHODS:

    Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).

    RESULTS:

    No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).

    CONCLUSION:

    CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.

  • 6.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Förbättrade resultat för patienter som drabbats hjärtstopp utanför sjukhus – en uppföljning från 1992 till 20112013Conference paper (Refereed)
    Abstract [sv]

    Syfte: Att beskriva patienter som drabbats av hjärtstopp utanför sjukhus och dess resultatsförändringar i behandling och överlevnad.

    Metod: Patienter (n=59 926) som drabbats av hjärtstopp utanför sjukhus i samtliga Sveriges län och som rapporterats till Svenska hjärt-lungräddningsregistret från 1992 till 2011.

    Resultat: Antalet rapporterade hjärtstopp utanför sjukhus ökade från 27 (1992) till 52 (2011) per 100 000 invånare och år. Vidare så ökade bevittnandegraden av hjärtstopp utanför sjukhus av ambulanspersonalen, en ökad förekomst av hjärtlungräddning innan ambulansen kom fram till patienten samt att tiden ökade från larm till dess att ambulansen kom fram till patienten.

    1-månads-överlevnad ökade från 4,8% (1992) till 10,7% (2011). De som framförallt överlevde 1 månad eller mer var de patienter som levde vid ankomst till sjukhus. Av de patienter som drabbats av hjärtstopp utanför sjukhus mellan 2008 till 2010, var det 41% som genomgick kylbehandling på sjukhus samt 28% som behandlades med ballongvidgning av hjärtats kranskärl. De patienter som överlevde (2008-2011), hade 94% en god eller relativ god hjärnfunktion.

    Sammanfattning: De patienter som drabbats av hjärtstopp utanför sjukhus 1992-2011, påvisar en fördubblad överlevnad. De patienter som framförallt överlever, är de som lever vid ankomst till sjukhus och som senare läggs in på vårdavdelning.   

  • 7.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Validity of reported data in the out-of-hospital cardiac arrest register in chosen parts in Sweden: [HLR-registrets tillförlitlighet]2013Conference paper (Refereed)
    Abstract [en]

    Aim: To describe differences between reported and non reported data in the out-of-hospital cardiac arrest (OHCA) register in Sweden.

    Methods: Prospective and retrospective data of treated OHCA patients in Sweden, 2008-2010 were compared in the Swedish OHCA register. Data were investigated in three Swedish counties with various recording models. Prospective data are those reported by the ambulance crew and retrospective data those missed by the ambulance crew but discovered afterwards by crosschecking with the local ambulance register.

    Result: In 2008-2010, the number of prospective reported cases was n=2, 398 and retrospective cases n=3, 198 which indicates a 25% missing rate.

    When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years versus 67 years; p=0.003). There was no difference between groups with regard to sex, time of day and year of OHCA, witnessed status or initial rhythm.

    However, bystander CPR was more frequent among patients in who were reported prospectively (65% versus 60%; p= 0.023) where as survival to 1 month was higher among patients who were reported retrospectively (9,2% versus 11,9%;p=0.035)

     

    Conclusion: Among 3, 198 cases of OHCA in three regions in Sweden 800 (25%) were not reported prospectively by the ambulance crew but retrospectively when discovered as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, less frequently receiving bystander CPR but having a higher survival. Our data suggest that patients who suffer OHCA and are prospectively reported to a quality register may be influenced by selection bias.

  • 8.
    Trobec, R.
    et al.
    Department of Communication Systems, Jožef Stefan Institute, Ljubljana, Slovenia.
    Jan, M.
    Department of Cardiovascular Surgery, University Medical Centre, Ljubljana, Slovenia.
    Lindén, Maria
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Tomasic, Ivan
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Detection and Treatment of Atrial Irregular Rhythm with Body Gadgets and 35-channel ECG2019In: 2019 42nd International Convention on Information and Communication Technology, Electronics and Microelectronics, MIPRO 2019 - Proceedings, Institute of Electrical and Electronics Engineers Inc. , 2019, p. 301-308Conference paper (Refereed)
    Abstract [en]

    The atrial irregular rhythm, often reflected in atrial fibrillation, undulation or flutter, is recognized as one of the major causes of brain stroke and entails an increased risk of thromboembolic events because it increases the likelihood of blood clots formation. Its early detection is becoming an increasingly important preventive measure. The paper presents a simple methodology for the detection of atrial irregular rhythm by ECG body gadget that can perform long-term measurements, e.g. several weeks or more. Multichannel ECG, on the body surface, gives a more detailed insight into the atrial activity in comparison to standard 12-lead ECG. The information from MECG is compared with single-channel patch ECG. The obtained results suggest that the proposed methodology could be useful in treatments of atrial irregular rhythm. One can obtain a reliable information about the time and duration of fibrillation events, or determine arrhythmic focuses and conductive pathways in heart atria, or study the effects of antiarrhythmic drugs on existing arrhythmias and on an eventual development of new types of arrhythmias. 

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