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Zakrisson, Ann-Britt
Publications (10 of 23) Show all publications
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Ställberg, B. & Theander, K. (2019). A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities: a longitudinal follow-up. Journal of Advanced Nursing, 75(1), 175-186
Open this publication in new window or tab >>A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities: a longitudinal follow-up
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 1, p. 175-186Article in journal (Refereed) Published
Abstract [en]

AIM: To test a self-management intervention in primary health care for patients with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure on self-efficacy, symptoms, functioning and health.

BACKGROUND: Patients with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure experience often the same symptoms such as shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in hands and feet, pain and sleeping problems.

DESIGN: A multicentre randomized control trial.

METHOD: The trial was conducted with one intervention group (n=73) and one control group (n=77). The trial was performed from September 2013 - September 2015 at nine primary health care centres in three county councils in Sweden. At baseline patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure experienced any symptom. Follow-ups were performed after three months and one year. The intervention was structured on Bandura's theory of self-efficacy in six meetings and individual action plans based on personal problems were performed and discussed.

RESULTS: At baseline, there were no differences between the groups except for SF-36 social function. After three months, the intervention group improved performance and satisfaction with regard to own selected activities, otherwise no differences were found.

CONCLUSION: When designing a program, the patient's own difficulties must be taken into consideration if person-centered care is to be established. It is feasible to include both patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure in the same group in primary health care. Health care professionals need supervision in pedagogics during intervention in self-management.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
Chronic heart failure, chronic obstructive pulmonary disease, nurses, patient education, primary health care, self-management support
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-70002 (URN)10.1111/jan.13899 (DOI)000453873300019 ()30375028 (PubMedID)2-s2.0-85057336384 (Scopus ID)
Note

Funding Agency:

Uppsala-Orebro Regional Research Council

Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2019-01-08Bibliographically 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
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
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2019 (English)In: Nursing Open, E-ISSN 2054-1058Article in journal (Refereed) Epub ahead of print
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: 2019-09-05Bibliographically approved
Zakrisson, A.-B., Anerös, T., Eliason, G. & Forsberg, A. (2019). Projekt Region Örebro län: Att använda en mobil app med larm för att motivera till fysisk aktivitet hos patienter med KOL – en mixed method pilot-studie. Lung och Allergi Forum, 32-39
Open this publication in new window or tab >>Projekt Region Örebro län: Att använda en mobil app med larm för att motivera till fysisk aktivitet hos patienter med KOL – en mixed method pilot-studie
2019 (Swedish)In: Lung och Allergi Forum, ISSN 2000-5237, p. 32-39Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Mediahuset i Göteborg AB, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-73737 (URN)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-04-24Bibliographically 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
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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
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
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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
Annika, L., Theander, K., Arne, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Zakrisson, A.-B. (2018). Incorrect inhalation technique is common in patients with COPD in primary care. In: : . Paper presented at 9th IPCRG World Conference, Porto, Portugal, 31 May-2 June, 2018.
Open this publication in new window or tab >>Incorrect inhalation technique is common in patients with COPD in primary care
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

The results show that many patients don’t use the inhaler correctly. Errors related to inhalation technique were twice as common as those related to devices. When teaching patients to use the inhalers it seems like there is a need to focus more on the inhalation technique itself. The checklist used in this study needs to be further improved.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67439 (URN)
Conference
9th IPCRG World Conference, Porto, Portugal, 31 May-2 June, 2018
Available from: 2018-06-21 Created: 2018-06-21 Last updated: 2018-10-08Bibliographically approved
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Sandelowsky, H., Ställberg, B., . . . Theander, K. (2017). A description of requests for self-management support among patients with COPD in Primary Health Care. Paper presented at European-Respiratory-Society (ERS) International Congress, Milan, Italy, Sep. 9-13, 2017. European Respiratory Journal, 50(Sup. 61), Article ID PA1605.
Open this publication in new window or tab >>A description of requests for self-management support among patients with COPD in Primary Health Care
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2017 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 50, no Sup. 61, article id PA1605Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2017
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67266 (URN)10.1183/1393003.congress-2017.PA1605 (DOI)000431748901343 ()
Conference
European-Respiratory-Society (ERS) International Congress, Milan, Italy, Sep. 9-13, 2017
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-14Bibliographically approved
Zakrisson, A.-B., Arne, M., Hasselgren, M., Lisspers, K., Lundh, L., Sandelowsky, H., . . . Theander, K. (2017). Improved quality of care by the PRISMS form in supporting self-management in patients with COPD: A Randomized Controlled Trial (RCT). In: : . Paper presented at IPCRG 5th Scientific Meeting, Ljubljana, Slovenia, May 17-18, 2017.
Open this publication in new window or tab >>Improved quality of care by the PRISMS form in supporting self-management in patients with COPD: A Randomized Controlled Trial (RCT)
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2017 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Patient Report Informing Self-Management Support (PRISMS) could be a useful tool to improve quality of care in supporting self-management. Personal attention is an important part of a person-centered approach.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-67447 (URN)
Conference
IPCRG 5th Scientific Meeting, Ljubljana, Slovenia, May 17-18, 2017
Available from: 2018-06-21 Created: 2018-06-21 Last updated: 2019-04-03Bibliographically approved
Zakrisson, A.-B. (2017). Symptom-reducing actions: a concept analysis in the context of chronic obstructive pulmonary disease. International Journal of Qualitative Studies on Health and Well-being, 12(1), Article ID 1387452.
Open this publication in new window or tab >>Symptom-reducing actions: a concept analysis in the context of chronic obstructive pulmonary disease
2017 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1387452Article, review/survey (Refereed) Published
Abstract [en]

Patients with Chronic Obstructive Pulmonary Disease (COPD) have multiple symptoms. Nursing care is based on six core competencies and one of them is person-centred care that includes the aspect of professional symptom relief. The aim was to clarify a meaning of the concept of Symptom-reducing actions in the context of COPD. Databases MEDLINE and CINAHL were searched between 1982 and February 2016 and 26 publications were found. Two dictionaries and three books were investigated. The method of Walker & Avant was followed. The use of the concept of Symptom-reducing actions may be categorized by the sub-concepts of supervision, information, and patient education. Exploration of defining attributes was symptom management, instructions, support, motivation, explanation, advice, teaching, and learning. Antecedent occurrences were related to factors that affect the patient's level of function such as physical performance and cognitive function. Symptom-reducing actions offer a way to support patients with COPD in self-management. Symptom-reducing actions can mediate facts in a purposeful process performed by the nurse to enable the patient to take control over and manage unpleasant symptoms by a person-centred, planned process. The nurse can achieve this via supervision, information, and patient education with an integrated emotional component. Evaluating the outcomes is needed.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2017
Keywords
Chronic obstructive pulmonary disease, concept analysis, nursing, person-centred care, self-care, self-management
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-64534 (URN)10.1080/17482631.2017.1387452 (DOI)000419649300001 ()
Available from: 2018-01-25 Created: 2018-01-25 Last updated: 2018-08-14Bibliographically approved
Zakrisson, A.-B., Hiyoshi, A. & Theander, K. (2016). A three-year follow-up of a nurse-led multidisciplinary pulmonary rehabilitation programme in primary health care: a quasi-experimental study. Journal of Clinical Nursing, 25(7-8), 962-971
Open this publication in new window or tab >>A three-year follow-up of a nurse-led multidisciplinary pulmonary rehabilitation programme in primary health care: a quasi-experimental study
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 7-8, p. 962-971Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To investigate the effects of a nurse-led multidisciplinary pulmonary rehabilitation programme conducted in primary health care on functional capacity, quality of life and exacerbation frequency over three years among patients with Chronic Obstructive Pulmonary Disease.

Background: Although Chronic Obstructive Pulmonary Disease is a chronic respiratory disease, it has been established that pulmonary rehabilitation has positive effects on patients' everyday functioning. However, the duration of these functional improvements, especially when the rehabilitation programmes are provided in primary health care settings, remains to be established.

Design: A quasi-experimental design.

Method: Primary health care patients with Chronic Obstructive Pulmonary Disease (GOLD stages II and III) were included; 49 in the intervention group and 54 in the control group. The intervention comprised a six-week pulmonary rehabilitation programme. Functional capacity was assessed using a six-minute walking test and quality of life by the Clinical COPD Questionnaire at baseline, after one year and three years. Exacerbation frequency was calculated from one year before to three years after the programme.

Results: No significant differences between the groups were observed in the six-minute walking-test or the Clinical COPD Questionnaire after one year and three years. On average, there were significant improvements in the six-minute walking-test and the Clinical COPD Questionnaire from baseline to the one-year follow-up. Exacerbation frequency tended to decrease in the intervention group and increase in the control group (interaction test was p = 0·091) but increased again in both groups after three years.

Conclusion: There was no evidence of the benefit of the nurse-led multidisciplinary pulmonary rehabilitation programme, although the exacerbation frequency tended to decrease in the intervention group after one year. There is a need for support and coaching at regular follow-ups in primary health care.

Relevance to clinical practice: There is a need to support and coach patients with Chronic Obstructive Pulmonary Disease in primary health care by means of regular follow-ups.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Chronic Obstructive Pulmonary Disease, exacerbations, long-term effects, primary health care, pulmonary rehabilitation, quality of life
National Category
Physiotherapy Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-49640 (URN)10.1111/jocn.13132 (DOI)000372928900008 ()26878838 (PubMedID)
Note

Funding Agency:

Regional Research Council of Uppsala and Örebro

Available from: 2016-04-12 Created: 2016-04-05 Last updated: 2018-07-23Bibliographically approved
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