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Welin, Elisabet, professorORCID iD iconorcid.org/0000-0002-4258-5348
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Publications (10 of 48) Show all publications
Elvén, M., Welin, E., Wiegleb Edström, D., Petreski, T., Szopa, M., Durning, S. J. & Edelbring, S. (2023). Clinical Reasoning Curricula in Health Professions Education: A Scoping Review. Journal of medical education and curricular development, 10, Article ID 23821205231209093.
Open this publication in new window or tab >>Clinical Reasoning Curricula in Health Professions Education: A Scoping Review
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2023 (English)In: Journal of medical education and curricular development, E-ISSN 2382-1205, Vol. 10, article id 23821205231209093Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVES: This scoping review aimed to explore and synthesize current literature to advance the understanding of how to design clinical reasoning (CR) curricula for students in health professions education.

METHODS: Arksey and O'Malley's 6-stage framework was applied. Peer-reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies.

RESULTS: Twenty-six articles were included on CR in medical, nursing, physical therapy, occupational therapy, midwifery, dentistry, and speech language therapy education. The results describe: features of CR curriculum design; CR theories, models, and frameworks that inform curricula; and teaching content, methods, and assessments that inform CR curricula.

CONCLUSIONS: Several CR theories, teaching, and assessment methods are integrated into CR curricula, reflecting the multidimensionality of CR among professions. Specific CR elements are addressed in several curricula; however, no all-encompassing CR curriculum design has been identified. These findings offer useful insights for educators into how CR can be taught and assessed, but they also suggest the need for further guidance on educational strategies and assessments while learners progress through an educational program.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Clinical decision-making, clinical reasoning, curriculum design, health professions education
National Category
Pedagogy
Identifiers
urn:nbn:se:oru:diva-109495 (URN)10.1177/23821205231209093 (DOI)001090681600001 ()37900617 (PubMedID)
Note

Funding Agency:

Erasmus+ Knowledge Alliance project DID-ACT 

Available from: 2023-10-31 Created: 2023-10-31 Last updated: 2023-11-20Bibliographically approved
Parodis, I., Girard-Guyonvarc'h, C., Arnaud, L., Distler, O., Domján, A., Van den Ende, C. H. M., . . . Boström, C. (2023). EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis. Annals of the Rheumatic Diseases, Article ID ard-2023-224416.
Open this publication in new window or tab >>EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis
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2023 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, article id ard-2023-224416Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).

METHODS: A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting.

RESULTS: Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc.

CONCLUSIONS: The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes.

Place, publisher, year, edition, pages
HighWire Press, 2023
Keywords
Patient Care Team, Patient Reported Outcome Measures, Patient perspective, Systemic Lupus Erythematosus, Systemic Sclerosis
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:oru:diva-107076 (URN)10.1136/ard-2023-224416 (DOI)001029549500001 ()37433575 (PubMedID)2-s2.0-85165128866 (Scopus ID)
Available from: 2023-07-12 Created: 2023-07-12 Last updated: 2023-12-08Bibliographically approved
Granath, A., Pettersson, S., Gunnarsson, I., Welin, E. & Dahlberg, K. (2023). How is the patient perspective captured in ANCA-associated vasculitis research? An integrative review. Rheumatology: Advances in Practice, 7(3), Article ID rkad092.
Open this publication in new window or tab >>How is the patient perspective captured in ANCA-associated vasculitis research? An integrative review
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2023 (English)In: Rheumatology: Advances in Practice, E-ISSN 2514-1775, Vol. 7, no 3, article id rkad092Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE: The aim was to describe how the patient perspective is captured in clinical research on ANCA-associated vasculitis (AAV).

METHODS: This integrative review included 2149 publications found in four different databases and manual searches. After screening, 156 articles remained. All articles were sorted and categorized, and 77 original articles were analysed further.

RESULTS: The patient perspective was captured with patient-reported outcome measures (PROMs), single-item questionnaires, project-specific questionnaires and interviews. The most common aspects measured were health-related quality of life, anxiety and depression, and fatigue, and the least common were lifestyle habits, relationships and self-management.

CONCLUSION: The patient perspective was captured predominantly with generic PROMs and occasionally with a qualitative approach. AVV is a lifelong disease, and the results from this review show that not all aspects of importance to patients are covered with the PROMs used in research. Future studies should include the areas that are the most important for patients.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
ANCA-associated vasculitis, integrative review, patient perspective, patient-reported outcome measures
National Category
Urology and Nephrology Rheumatology and Autoimmunity Nursing
Identifiers
urn:nbn:se:oru:diva-109750 (URN)10.1093/rap/rkad092 (DOI)001100866600001 ()37954916 (PubMedID)2-s2.0-85177753599 (Scopus ID)
Funder
Swedish Rheumatism Association, ST-202111
Available from: 2023-11-17 Created: 2023-11-17 Last updated: 2024-01-26Bibliographically approved
Bejerot, S., Sigra, S., Welin, E., Eklund, D., Hylén, U. & Humble, M. B. (2023). Rituximab as an adjunctive treatment for schizophrenia spectrum disorder or obsessive-compulsive disorder: Two open-label pilot studies on treatment-resistant patients. Journal of Psychiatric Research, 158, 319-329
Open this publication in new window or tab >>Rituximab as an adjunctive treatment for schizophrenia spectrum disorder or obsessive-compulsive disorder: Two open-label pilot studies on treatment-resistant patients
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2023 (English)In: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 158, p. 319-329Article in journal (Refereed) Published
Abstract [en]

In this explorative study, we investigated if an adjunctive treatment with one single dose of the monoclonal antibody rituximab would improve symptoms and function in treatment-resistant patients with schizophrenia spectrum disorder (SSD, n = 9) or obsessive-compulsive disorder (OCD, n = 10), based on the inflammatory hypothesis for mental disorders. Patients were followed for one year. Disability was measured with the Personal and Social Performance score (PSP). At baseline, the mean PANSS score in the SSD group was 99 ± 32 and the mean Y-BOCS score in the OCD group was 27.5 ± 7. Mean PSP scores were 32 ± 10.2 and 42.5 ± 9.9 in the SSD and OCD groups, respectively. Seven had Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS) in retrospect, and 3 SSD patients had schizo-obsessive subtype. 4/8 SSD patients showed a ≥40% reduction in PANSS at endpoint I week 20, however, 7/9 were similarly improved already at week 12. Among the OCD patients, 2/10 showed a ≥35% reduction in Y-BOCS at week 20. Disability was significantly improved only in the SSD group. The percentual decrease of PANSS scores in SSD patients was associated with the increase in immunoglobulin levels week 20 (n = 8: IgG r = 0.85, p = .007; IgA r = 0.79, p = .019; IgM r = 0.73, p = .038). Rituximab was generally well tolerated in these patients. Self-rated improvements since baseline were reported for psychic (p = .021), neurological (p = .059), and autonomic (p < .001) side effects (UKU-SERS-Pat side-effect scale). Anxiety was commonly reported by OCD patients, while an initial increase in psychotic symptoms was seen in a few SSD patients. An RCT is underway to evaluate rituximab in SSD.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
B-Cells, Clinical trial, Monoclonal antibody, Neuroinflammation, Obsessive-compulsive disorder, Schizophrenia, Treatment-resistant
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-103171 (URN)10.1016/j.jpsychires.2022.12.003 (DOI)000976718200001 ()36638622 (PubMedID)2-s2.0-85146076210 (Scopus ID)
Funder
Nyckelfonden, OLL-878311 OLL-779081Torsten Söderbergs stiftelse, M84/19The Swedish Brain Foundation, FO2019-0094
Available from: 2023-01-17 Created: 2023-01-17 Last updated: 2024-02-23Bibliographically approved
Brolin, S., Welin, E., Lövström, B., Bruchfeld, A., Gunnarsson, I. & Pettersson, S. (2022). Exploring the educational needs of patients with systemic vasculitis using the educational needs assessment tool. Rheumatology: Advances in Practice, 6(2), Article ID rkac062.
Open this publication in new window or tab >>Exploring the educational needs of patients with systemic vasculitis using the educational needs assessment tool
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2022 (English)In: Rheumatology: Advances in Practice, E-ISSN 2514-1775, Vol. 6, no 2, article id rkac062Article in journal (Refereed) Published
Abstract [en]

Objectives: Knowledge and health literacy enable patients to monitor symptoms and disease impact. Educational needs have previously been explored in rheumatology, but scarcely for patients with ANCA-associated vasculitis (AAV). The aim of the study was to assess the educational needs among patients with AAV using the educational needs assessment tool (ENAT).

Methods: This was a cross-sectional observational study including adults with AAV. Educational needs were captured by ENAT. Total ENAT (0-117 points, with higher numbers indicating higher educational need) and the seven domains (managing pain, movement, feelings, disease process, treatment, self-management and support systems) were explored regarding sex, age, education, diagnosis, disease duration and disease activity. To compare domains, a percentage response (0-100%) was calculated.

Results: One hundred and seventy-eight individuals (50% men; 34% with disease duration ≤2 years) were included. The total ENAT mean was 66.5 (s.d. 26.6; 57%), with domains as follows: disease process, 78%; self-management, 69%; treatments, 64%; feelings, 56%; managing pain, 48%; support systems, 47%; and movement, 41%. Higher educational needs were found among women in the domains movement, feelings and disease process and in total ENAT (all P < 0.04) compared with men. Higher educational needs were also seen in patients with disease duration ≤2 years regarding disease process, self-management and support systems and in total ENAT compared with patients with longer disease duration (all P < 0.03).

Conclusion: This study revealed great educational needs among AAV patients. Some groups expressed higher needs (women and those with shorter disease duration). Increased education for patients with AAV might lead to improved self-care and treatment adherence.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
ANCA-associated vasculitis, educational needs, health literacy, nursing, outcome measures, patient experience
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-100746 (URN)10.1093/rap/rkac062 (DOI)000841394700001 ()35993015 (PubMedID)2-s2.0-85141243845 (Scopus ID)
Funder
Swedish Rheumatism AssociationKing Gustaf V Jubilee FundStockholm County CouncilKarolinska Institute
Note

Funding agency:

Swedish Kidney Foundation

Available from: 2022-08-23 Created: 2022-08-23 Last updated: 2023-12-08Bibliographically approved
Björk, M., Dragioti, E., Alexandersson, H., Esbensen, B. A., Boström, C., Friden, C., . . . Brodin, N. (2022). Inflammatory Arthritis and the Effect of Physical Activity on Quality of Life and Self-reported Function: A Systematic Review and Meta-analysis. Arthritis care & research, 74(1), 31-43
Open this publication in new window or tab >>Inflammatory Arthritis and the Effect of Physical Activity on Quality of Life and Self-reported Function: A Systematic Review and Meta-analysis
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2022 (English)In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 74, no 1, p. 31-43Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE: Although physical activity (PA) is an evidence-based intervention that reduces disease-related symptoms and comorbidity in rheumatoid arthritis (RA), PA's effect on self-reported function and Quality of Life (QoL) has not been analyzed. This study synthesizes the evidence for the effectiveness of PA on QoL and self-reported function in adults with RA, spondyloarthritis (SpA), and psoriatic arthritis (PsA).

METHODS: The databases PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify relevant randomized controlled trials (RCTs). Screening, risk of bias assessment (using RoB 2.0 tool), and data extraction were independently performed by two or more of the authors. The meta-analyses were conducted with a random-effects model.

RESULTS: The systematic review included 55 RCTs and the meta-analysis included 37 RCTs. In 55 studies included, 76% investigated RA, 20% investigated SpA, and 4% investigated PsA. In RA effects were found on QoL and function compared to inactive controls, effects not sustained in comparison to active controls. In SpA the effects of PA on QoL were in favor of the control group. Effects on function were found compared to inactive controls and sustained in fatigue and pain when compared to active controls. In PsA no effects on QoL were found but on function compared to inactive controls. The effect size was below 0.30 in the majority of the comparisons.

CONCLUSION: PA may improve QoL and self-reported function in RA, SpA, and PsA. However, larger trials are needed, especially in SpA and PsA.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:oru:diva-94956 (URN)10.1002/acr.24805 (DOI)000736128900008 ()34632707 (PubMedID)2-s2.0-85122123610 (Scopus ID)
Available from: 2021-10-12 Created: 2021-10-12 Last updated: 2022-01-17Bibliographically approved
Welin, E. (2021). Omvårdnad vid reumatiska sjukdomar (3ed.). In: Dag-Gunnar Stubberud; Randi Grønseth; Hallbjørg Almås (Ed.), Klinisk omvårdnad 2: (pp. 215-236). Stockholm: Liber
Open this publication in new window or tab >>Omvårdnad vid reumatiska sjukdomar
2021 (Swedish)In: Klinisk omvårdnad 2 / [ed] Dag-Gunnar Stubberud; Randi Grønseth; Hallbjørg Almås, Stockholm: Liber, 2021, 3, p. 215-236Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2021 Edition: 3
National Category
Health Sciences
Identifiers
urn:nbn:se:oru:diva-89129 (URN)9789147113606 (ISBN)
Available from: 2021-01-31 Created: 2021-01-31 Last updated: 2021-02-09Bibliographically approved
Brolin, S., Lövström, B., Welin, E., Gunnarsson, I. & Pettersson, S. (2021). THE NEED FOR INFORMATION AMONG PATIENTS WITH ANCA ASSOCIATED VASCULITIS DIFFERS BETWEEN GROUPS. Annals of the Rheumatic Diseases, 80(Suppl. 1), 1023-1023, Article ID POS1476-HP.
Open this publication in new window or tab >>THE NEED FOR INFORMATION AMONG PATIENTS WITH ANCA ASSOCIATED VASCULITIS DIFFERS BETWEEN GROUPS
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2021 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 80, no Suppl. 1, p. 1023-1023, article id POS1476-HPArticle in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:oru:diva-94524 (URN)10.1136/annrheumdis-2021-eular.765 (DOI)000692653200371 ()
Available from: 2021-09-27 Created: 2021-09-27 Last updated: 2021-09-27Bibliographically approved
Welin, E. & Lampa, J. (2020). Smärta och trötthet är vanligt, men kan behandlas. Bulletinen (4), 10-12
Open this publication in new window or tab >>Smärta och trötthet är vanligt, men kan behandlas
2020 (Swedish)In: Bulletinen, ISSN 2000-4613, no 4, p. 10-12Article, review/survey (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Stockholm: Reumatikerförbundet, 2020
National Category
Health Sciences
Identifiers
urn:nbn:se:oru:diva-89128 (URN)
Available from: 2021-01-31 Created: 2021-01-31 Last updated: 2022-06-22Bibliographically approved
Georg, C., Welin, E., Jirwe, M., Karlgren, K. & Ulfvarson, J. (2019). Psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric. Nurse Education in Practice, 38, 14-20
Open this publication in new window or tab >>Psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric
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2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 38, p. 14-20Article in journal (Refereed) Published
Abstract [en]

A number of studies attest to the effectiveness of virtual patients in fostering and assessing students' development of clinical reasoning. An objective assessment of students' clinical reasoning is, however, challenging. This study focused on determining the psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric, a rubric that is aimed at assessing nursing students' clinical reasoning processes when encountering virtual patients. A nonexperimental design was used in which data from 125 students' reflections on solving two different virtual patient scenarios were included in the analysis. First, a deductive content analysis was conducted using the categories of the rubric as a lens. After that, each student's performance was quantified according to the different levels of the rubric. Exploratory factor analysis and test of normality and reliability, including the Kaiser-Meyer-Olkin test, Bartlett's test, the Shapiro-Wilk test, and Cronbach's alpha were used in the analysis. The result suggested three factors: "Understanding the patient", "Care planning" and "Reflecting" that explained 81.8% of the variance. Cronbach's alpha was 0.931. The result showed the rubric to be a valid assessment instrument for assessing nursing students' clinical reasoning when encountering virtual patients.

Place, publisher, year, edition, pages
Churchill Livingstone, 2019
Keywords
Clinical reasoning, Nursing education, Rubric, Virtual patients
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-75630 (URN)10.1016/j.nepr.2019.05.016 (DOI)000481564200003 ()31174134 (PubMedID)2-s2.0-85067042329 (Scopus ID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2020-02-03Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-4258-5348

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