oru.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Westerdahl, Elisabeth
Publications (10 of 49) Show all publications
Westerdahl, E., Osadnik, C. & Emtner, M. (2019). Airway clearance techniques for patients with acute exacerbations of chronic obstructive pulmonary disease: Physical therapy practice in Sweden. Chronic Respiratory Disease, 16, Article ID UNSP 1479973119855868.
Open this publication in new window or tab >>Airway clearance techniques for patients with acute exacerbations of chronic obstructive pulmonary disease: Physical therapy practice in Sweden
2019 (English)In: Chronic Respiratory Disease, ISSN 1479-9723, E-ISSN 1479-9731, Vol. 16, article id UNSP 1479973119855868Article in journal (Refereed) Published
Abstract [en]

There is considerable global variability in clinical practice regarding the prescription of airway clearance techniques (ACTs) for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Little is known about the physical therapy practice, and no international guidelines are available. The aim of this survey was to identify current physical therapy practice regarding ACT prescription for patients with AECOPD in Sweden. A cross-sectional, descriptive study was conducted via a Web-based questionnaire, sent to all (n = 70) hospitals that offer physical therapy service for patients with AECOPD in Sweden. Responses were received from 117 physical therapists (76%) across all sites. ACTs were prescribed for more than half of all patients with an AECOPD by 75% of physical therapists. The most frequently used ACTs were positive expiratory pressure (PEP) devices (90%), directed huffing (88%) and cough (71%). Most physical therapists (89%) perceived sputum clearance to be an important aspect of the overall management of patients with AECOPD. The main factors influencing choice of ACT were the 'degree of dyspnoea or work of breathing' and 'access to resources/equipment'. Physical therapists prescribe predominantly PEP-based ACTs for patients with AECOPD in Sweden. Several factors come into consideration that influences the choice of treatment technique.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Airway clearance techniques, acute exacerbation, chronic obstructive pulmonary disease, healthcare surveys, mucociliary clearance, physical therapy modalities
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-77086 (URN)10.1177/1479973119855868 (DOI)000487094900001 ()31220934 (PubMedID)
Note

Funding Agency:

Uppsala University, Uppsala, Sweden

Available from: 2019-10-08 Created: 2019-10-08 Last updated: 2019-10-08Bibliographically approved
Nilsagård, Y., Westerdahl, E. & Forsberg, A. (2019). Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists. Physiotherapy Research International, 24(2), Article ID e1767.
Open this publication in new window or tab >>Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists
2019 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, no 2, article id e1767Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The recent increase in physiotherapy research has led to more physiotherapists being involved in research. Consequently, leaders must make a standpoint on whether the department should engage in research, whereas individual physiotherapists have to decide if they want to play an active role in carrying out a research project. The purpose of this study was to explore perceptions and experiences of both participating physiotherapists and their leaders regarding taking part in clinical physiotherapy research projects.

METHODS: A qualitative study using face-to-face interviews was conducted. All (n = 8) leaders were interviewed individually. Physiotherapists (n = 18) were interviewed either individually (n = 5) or in small groups including two to three persons (n = 13). The interviews were analysed using inductive conventional content analysis.

RESULTS: There was a consensus that engagement of the leaders was a prerequisite for entering research projects and that the research had to be in line with the department's regular assignment. For the physiotherapists, the key factors for success were having designated time and having support from their leader, especially when feelings of responsibility became overwhelming. The leaders stressed the importance of being well informed. Participating in clinical research created value such as personal and professional growth for the physiotherapists, who also inspired their colleagues and thus positively affected the organization. Engaging in research contributed to being an attractive employer and gave a boost to evidence-based practice.

CONCLUSION: The study provides perspectives from leaders and physiotherapists on engaging in research. There was a consensus that participating in a research project was beneficial for the organization, the individual physiotherapist, and the patients. However, clinical applicability, support, sufficient time, and early involvement of leaders are significant prerequisites.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Evidence-based practice, physical therapy, professional development, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-71652 (URN)10.1002/pri.1767 (DOI)000463029100007 ()30657235 (PubMedID)
Note

Funding Agency:

Örebro Research Committee, Sweden

Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-06-19Bibliographically approved
Annika, L., Theander, K., Arne, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Zakrisson, A.-B. (2019). Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care. Nursing Open, 6(4), 1519-1527
Open this publication in new window or tab >>Errors in inhaler use related to devices and to inhalation technique among patients with chronic obstructive pulmonary disease in primary health care
Show others...
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 4, p. 1519-1527Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe inhaler use in primary health care patients with chronic obstructive pulmonary disease (COPD) and to categorize these patients into those making errors related to devices, those making errors related to inhalation technique and those making errors related to both.

Design: Observational study. Methods COPD nurses used a checklist to assess the use of inhalers by patients with spirometry-verified COPD (N = 183) from primary healthcare centres. The STROBE checklist has been used.

Results: The mean age of the patients was 71 (SD 9) years. Almost half of them (45%) made at least one error; of these, 50% made errors related to devices, 31% made errors related to inhalation technique and 19% made errors related both to devices and to inhalation technique.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
administration, inhalation, pulmonary disease, chronic obstructive, dry powder inhalers, inhaler technique, metered-dose inhalers, patient education
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-76052 (URN)10.1002/nop2.357 (DOI)000481947200001 ()
Note

Funding Agency:

Uppsala-Örebro Regional Research Council 

Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-11-22Bibliographically approved
Jonsson, M., Ahlsson, A., Hurtig-Wennlöf, A., Vidlund, M., Cao, Y. & Westerdahl, E. (2019). In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery: A Randomized Controlled Trial. Integrative Cancer Therapies, 18, Article ID UNSP 1534735419876346.
Open this publication in new window or tab >>In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery: A Randomized Controlled Trial
Show others...
2019 (English)In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 18, article id UNSP 1534735419876346Article in journal (Refereed) Published
Abstract [en]

Background: Lung cancer is the most frequently diagnosed cancer and one of the leading causes of cancer deaths. Surgery is the primary approach for curative treatment. Postoperative complications are common, and physiotherapy is often routinely provided for their prevention and treatment, even though the evidence is limited. The aim of this study was to examine the effect of in-hospital physiotherapy on postoperative physical capacity, physical activity, and lung function among patients undergoing lung cancer surgery.

Methods: A total of 107 patients undergoing elective thoracic surgery were included in a single-blinded randomized controlled trial, and randomized to a study group, receiving in-hospital physiotherapy treatment, or a control group, not receiving in-hospital physiotherapy treatment. The patients were assessed preoperatively and 3 months after surgery. The in-hospital physiotherapy treatment consisted of early mobilization, ambulation, breathing exercises, and thoracic range of motion exercises. Physical capacity was assessed with the 6-minute walk test. Level of physical activity was objectively assessed with an accelerometer and subjectively assessed with the International Physical Activity Questionnaire Modified for the Elderly.

Results: Physical capacity for the whole sample was significantly decreased 3 months postoperatively compared with preoperative values (P = .047). There were no statistically significant differences between the groups regarding physical capacity, physical activity, spirometric values, or dyspnea. However, patients in the study group increased their level of self-reported physical activity from preoperatively to 3 months postoperatively, while the patients in the control group did not.

Conclusions: No difference in physical capacity, physical activity, or lung function was found 3 months postoperatively in lung cancer surgery patients receiving in-hospital physiotherapy compared with control patients.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
lung cancer, physiotherapy, physical activity, surgery, physical function
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-77077 (URN)10.1177/1534735419876346 (DOI)000486724600001 ()31530046 (PubMedID)
Funder
Swedish Cancer Society, CAN 2015/721
Note

Funding Agencies:

Research Committee of Orebro County Council  OLL-363321 OLL-686781

Swedish Heart and Lung Patients National Association  E o86/13

Available from: 2019-10-08 Created: 2019-10-08 Last updated: 2019-10-08Bibliographically approved
Jonsson, M., Hurtig-Wennlöf, A., Ahlsson, A., Vidlund, M., Cao, Y. & Westerdahl, E. (2019). In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy, 105(4), 434-441
Open this publication in new window or tab >>In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial
Show others...
2019 (English)In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 105, no 4, p. 434-441Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Patients undergoing lung cancer surgery are routinely offered physiotherapy. Despite its routine use, effects on postoperative physical recovery have yet not been demonstrated. The aim of this study was to investigate whether physiotherapy could improve postoperative in-hospital physical activity level and physical capacity.

DESIGN: Single-blind randomized controlled trial.

SETTING: Thoracic surgery department at a University Hospital.

PARTICIPANTS: Patients undergoing elective thoracic surgery (n=94) for confirmed or suspected lung cancer were assessed during hospital stay.

INTERVENTION: Daily physiotherapy, consisting of mobilization, ambulation, shoulder exercises and breathing exercises. The control group received no physiotherapy treatment.

OUTCOMES: In-hospital physical activity assessed with the Actigraph GT3X+ accelerometer, six-minute walk test, spirometry and dyspnea scores.

RESULTS: The treatment group reached significantly more accelerometer counts (2010 (1508) vs 1629 (1146), mean difference 495 [95% CI 44 to 1109]), and steps per hour (49 (47) vs 37 (34), mean difference 14 [95% CI 3 to 30]), compared to the control group, during the first three postoperative days. No significant differences in six-minute walk test (percent of preoperative 71% vs 79%, P=0.13), spirometry (FEV1 percent of preoperative 69% vs 69%, P=0.83) or dyspnoea (M-MRC 2 vs 2, P=0.74) between the groups were found.

CONCLUSIONS: Patients receiving in-hospital physiotherapy showed increased level of physical activity during the first days after lung cancer surgery, compared to an untreated control group. However, no effects on the six-minute walk test or spirometric values were found. The clinical importance of an increased physical activity level during the early postoperative period needs to be further evaluated.

CLINICAL TRIAL REGISTRATION NUMBER: NCT01961700.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Lung cancer, Physical activity, Physical therapy, Randomized clinical trial
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-73624 (URN)10.1016/j.physio.2018.11.001 (DOI)000496916200005 ()30871894 (PubMedID)2-s2.0-85062599637 (Scopus ID)
Funder
Swedish Cancer Society, CAN 2015/721
Note

Funding Agencies:

Research Committee of Örebro County Council  OLL363321 OLL-686781

Swedish Heart and Lung Patients National Association  E o86/13

Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-12-03Bibliographically approved
Westerdahl, E., Engman, K. O., Arne, M. & Larsson, M. (2019). Spirometry to increase smoking cessation rate: A systematic review. Tobacco Induced Diseases, 17, Article ID 31.
Open this publication in new window or tab >>Spirometry to increase smoking cessation rate: A systematic review
2019 (English)In: Tobacco Induced Diseases, ISSN 1617-9625, E-ISSN 1617-9625, Vol. 17, article id 31Article, review/survey (Refereed) Published
Abstract [en]

INTRODUCTION: Addressing tobacco use is an important issue in general health care. In order to improve smoking cessation advice, spirometry values can be displayed to the smoker to demonstrate possible lung function impairment. The estimate of so-called lung age may show a decrease in lung function associated with smoking. It has been suggested that performing spirometry on patients who smoke but are asymptomatic can be a useful way to show the adverse effects of smoking. The aim of this systematic review was to determine if providing spirometry results in combination with smoking cessation counselling can increase smoking cessation rates compared to what is achieved through counselling alone.

METHODS: In this systematic review, we included randomized controlled trials (RCTs) evaluating smoking cessation interventions for adult smokers. The systematic search was performed in PubMed, Medline, Cochrane Library, Cinahl, Embase, Amed and PsycInfo.

RESULTS: The literature search resulted in 946 studies, which, after reading by two independent reviewers, were reduced to seven trials that matched the inclusion criteria. Two RCTs showed significant improvement in smoking cessation when giving patients feedback on spirometry results in combination with smoking cessation counselling, compared to patients who received only smoking cessation counselling. In both studies, the spirometry results were expressed as lung age. In the other five studies no difference was found. Five further published study protocols for ongoing RCT studies in the field have been found, and therefore this systematic overview will likely need to be updated within a few years.

CONCLUSIONS: Few studies have been undertaken to examine the efficacy of spirometry in increasing smoking quit rates. Studies conducted to date have shown mixed results, and there is currently limited evidence in the literature that smoking cessation counselling that includes feedback from spirometry and a demonstration of lung age promotes quit rates.

Place, publisher, year, edition, pages
European Publishing, 2019
Keywords
smoking cessation, prevention, spirometry
National Category
Substance Abuse
Identifiers
urn:nbn:se:oru:diva-75275 (URN)10.18332/tid/106090 (DOI)000471794400008 ()2-s2.0-85068177633 (Scopus ID)
Available from: 2019-07-24 Created: 2019-07-24 Last updated: 2019-07-24Bibliographically approved
Annika, L., Theander, K., Arne, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Zakrisson, A.-B. (2018). A descriptive study of incorrect inhalation technique in patients with COPD in primary care. In: : . Paper presented at The International IRW Conference, Groningen, Netherlands, 15 -16 March, 2018.
Open this publication in new window or tab >>A descriptive study of incorrect inhalation technique in patients with COPD in primary care
Show others...
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67265 (URN)
Conference
The International IRW Conference, Groningen, Netherlands, 15 -16 March, 2018
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-14Bibliographically approved
Brocki, B. C., Westerdahl, E., Andreasen, J. & Andreasen, J. J. (2018). Can the Melbourne Scoring Scale be used to assess postoperative pulmonary complications in high-risk patients following lung resection?. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), Paris, France, September 15-19, 2018. European Respiratory Journal, 52(Suppl. 62), Article ID PA1423.
Open this publication in new window or tab >>Can the Melbourne Scoring Scale be used to assess postoperative pulmonary complications in high-risk patients following lung resection?
2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52, no Suppl. 62, article id PA1423Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: Postoperative pulmonary complications (PPC) are common following lung resections, but there is no consensus in the literature on the definition of a clinically relevant PPC. This study aimed to use the Melbourne Scoring Scale (MGS) to determine the frequency and predictors of PPC in patients scheduled for lung resection on suspicion of or due to cancer.

Methods: In a prospective observational design, we assessed 87 consecutive patients following lung resections in Aalborg University Hospital, Denmark. Patients were preoperatively classified as being at high PPC-risk (n= 68) or low PPC-risk (n=19), based on the presence of one or more of the items: FEV1 or carbon monoxide diffusion capacity (DLCO) ≤70%, age ≥70 years or scheduled pneumonectomy. Data on PPC was collected daily and re-evaluated two weeks postoperatively. Multivariate regression analysis was used to evaluate variables associated with PPC.

Results: The actual frequency of PPC according to the MGS was 11% (n=10), all cases within the predefined high-risk group, with pneumonia accounting for 10% of the cases. We found that preoperative FEV1 and DLCO ≤60% were significantly associated with a higher PPC risk (area under the ROC curve 0.851), 95% CI 2.2-56.6 and 1.1-36.8 for FEV1 and DLCO, respectively.

Conclusions: The MGS can be used to identify patients at high risk of postoperative clinically relevant PPC after lung resections, in particular in patients with preoperative values of FEV1 ≤ 60% or DLCO ≤ 60%. More research is needed to evaluate the effect of preventable interventions targeting patients at high-risk of developing PPC.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-72097 (URN)10.1183/13993003.congress-2018.PA1423 (DOI)000455567101483 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), Paris, France, September 15-19, 2018
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-02-05Bibliographically approved
Annika, L., Theander, K., Arne, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Zakrisson, A.-B. (2018). Description of inhalation technique in patients with COPD in primary care. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), Paris, France, September 15-19, 2018. European Respiratory Journal, 52(Suppl. 62), Article ID PA2070.
Open this publication in new window or tab >>Description of inhalation technique in patients with COPD in primary care
Show others...
2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52, no Suppl. 62, article id PA2070Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: A recent systematic review showed that only about one third of the patients had a correct inhalation technique and the number had not improved the last 40 years¹.

Aim: The aim was to describe errors, separated into errors related to devices and errors related to inhalation technique, that occur when patients with COPD inhale medications.

Method: In this descriptive study, patients with a COPD diagnosis were recruited from a randomized controlled trial performed 2015-2016 in primary care in four county councils in Sweden. A COPD nurse assessed the inhalation technique using a checklist with errors related to devices and to inhalation technique with possibility to write additional comments.

Results: In total, 167 patients using 287 inhalers were assessed, 52% (n = 86) were female, mean age 71 years. A total of 163 errors were noted in the checklist, of which 87 were related to inhalation technique and 76 were related to devices. Except from this the COPD nurse had written comments regarding 53 errors that were not included in the checklist. At least one error (range: 1-7 errors) was made by 46% (n = 76) of the patients.

Conclusion: The results show that many patients do not use the device correctly. Both errors related to inhalation technique and related to devices were present. This implies that there is a need to focus on both aspects when teaching patients how to inhale their medication. The checklist used in this study needs to be further improved.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-72099 (URN)10.1183/13993003.congress-2018.PA2070 (DOI)000455567102275 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), Paris, France, September 15-19, 2018
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-02-05Bibliographically approved
Brocki, B. C., Andreasen, J. J. & Westerdahl, E. (2018). Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level. Integrative Cancer Therapies, 17(4), 1095-1102
Open this publication in new window or tab >>Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level
2018 (English)In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 17, no 4, p. 1095-1102Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To describe postoperative self-reported physical activity (PA) level and assess the effects of 2 weeks of postoperative inspiratory muscle training (IMT) in patients at high risk for postoperative pulmonary complications following lung resection.

METHODS: This is a descriptive study reporting supplementary data from a randomized controlled trial that included 68 patients (mean age = 70 ± 8 years), randomized to an intervention group (IG; n = 34) or a control group (CG; n = 34). The IG underwent 2 weeks of postoperative IMT added to a standard postoperative physiotherapy given to both groups. The standard physiotherapy consisted of breathing exercises, coughing techniques, and early mobilization. We evaluated self-reported physical activity (Physical Activity Scale 2.1 questionnaire) and health status (EuroQol EQ-5D-5L questionnaire), assessed the day before surgery and 2 weeks postoperatively.

RESULTS: A significant percentage of the patients in the IG reported less sedentary activity 2 weeks postoperatively when compared with the CG (sedentary 6% vs 22%, low activity 56% vs 66%, moderate activity 38% vs 12%, respectively; P = .006). The mean difference in EQ-5D-5L between the IG and CG 2 weeks postoperatively was nonsignificant ( P = .80). The overall preoperative EQ-5D-5L index score for the study population was comparable to a reference population.

CONCLUSION: Postoperative IMT seems to prevent a decline in PA level 2 weeks postoperatively in high-risk patients undergoing lung resection. More research is needed to confirm these findings.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Activity level, lung cancer, physiotherapy, postoperative, randomized controlled trial, respiratory muscle training, surgery
National Category
Physiotherapy
Identifiers
urn:nbn:se:oru:diva-68598 (URN)10.1177/1534735418796286 (DOI)000450322400010 ()30136589 (PubMedID)2-s2.0-85056277150 (Scopus ID)
Funder
Swedish Cancer Society, CAN 205/721
Note

Funding agencies:

Danish Cancer Society

Aalborg University Hospital

Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-12-05Bibliographically approved
Organisations

Search in DiVA

Show all publications