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  • 1. Hrisanfow, Elisabet
    et al.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 1-2, p. 97-105Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aim of this study was to investigate the impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease in primary health care.

    Background. Existing information on the impact of cough and urinary incontinence on quality of life in patients with chronic obstructive pulmonary disease is scant.

    Design. A questionnaire survey.

    Method. The study included 391 women and 337 men, aged 5075 years, with chronic obstructive pulmonary disease. A self-administered questionnaire consisted of CCQ and SF-12 questionnaires. A response rate of 66% was obtained. Most patients had been diagnosed with moderate (Stage II) chronic obstructive pulmonary disease.

    Results. Women and men with urinary incontinence showed a significantly higher presence of symptomatic cough and phlegm production than did women and men without incontinence. Women with incontinence had a significantly higher burden of CCQ symptoms, functional and mental state than did women without incontinence. Concerning quality-of-life scores, women with incontinence had lower physical state scores (37.6 +/- 10.4 vs. 41.4 +/- 9.9; p < 0.001) and mental state scores (44.3 +/- 10.2 vs. 47.1 +/- 10.5; p < 0.007) than did women without incontinence. Men with incontinence had a significantly higher burden of CCQ symptoms and mental state than did men without incontinence. When examining the quality-of-life scores, men with incontinence had lower mental state scores than did men without incontinence (46.0 +/- 9.7 vs. 49.8 +/- 9.7; p < 0.001).

    Conclusion. The present results indicate that cough and urinary incontinence lead to poor quality of life in women and men with chronic obstructive pulmonary disease.

    Relevance to clinical practice. In the context of primary health care, appropriate questions concerning urinary incontinence and quality of life should be included in care plans for women and men living with chronic obstructive pulmonary disease.

  • 2.
    Hrisanfow, Elisabeth
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    The prevalence of urinary incontinence among women and med with chronic obstructive pulmonary disease in Sweden2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 13-14, p. 1895-1905Article in journal (Refereed)
    Abstract [en]

    Aim.  The aims of the present study were to investigate the prevalence, characteristics and status of urinary incontinence among women and men with chronic obstructive pulmonary disease in primary health care.

    Background.  Information on the prevalence of urinary incontinence in women and men with chronic obstructive pulmonary disease is scant. Such knowledge may be important to the development of care for patients with chronic obstructive pulmonary disease.

    Design.  A questionnaire survey.

    Method.  The study included 391 women and 337 men, aged 50–75 years, with chronic obstructive pulmonary disease. A self-administered, evidence-based questionnaire for incontinence was used. A response rate of 66% was obtained, of which 89·3% had spirometry-confirmed chronic obstructive pulmonary disease, and most patients had been diagnosed with moderate (Stage II) chronic obstructive pulmonary disease.

    Results.  The prevalence of urinary incontinence in women and men with chronic obstructive pulmonary disease was 49·6 and 30·3%, respectively. Women and men with urinary incontinence had a significantly higher body mass index than did women and men without urinary incontinence. The most common type of incontinence in women was stress incontinence (52·4%) and in men postmicturition dribbling (66·3%). Women with urinary incontinence had a higher presence of a symptomatic cough than did women without urinary incontinence (p < 0·001). On the whole, incontinence affected women more than men concerning experienced bothersomeness of incontinence (p < 0·001). More women than men with urinary incontinence refrained from activities (p < 0·021) and had sought help for incontinence (p < 0·012).

    Conclusion.  The present results indicate that urinary incontinence content should be included in care plans for patients living with chronic obstructive pulmonary disease. In addition, the results imply that nurses and physicians working in primary health care should ask patients with chronic obstructive pulmonary disease about urinary incontinence and then offer appropriate assessment and management of it.

  • 3.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    A systematic literature review of incontinence care for persons with dementia: the research evidence2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 3-4, p. 303-312Article, review/survey (Refereed)
    Abstract [en]

    Backgroud. Urinary/faecal incontinence in persons with dementia is a potentially treatable condition. However, which type of incontinence care is most appropriate for persons with dementia remains undecided. Aim. The aim of this study was to perform a systematic review of literature on incontinence care in persons with dementia focusing on assessment/management and prevention. Design. A systematic search of the literature. Method. The search was performed in the CINAHL, PubMed and Cochrane Library databases. Results. Of the 48 papers analysed, two were systematic literature reviews of management of urinary incontinence including persons with dementia. These reviews showed that the best-documented effect of toilet assistance for urinary incontinence in elderly persons with/without dementia had prompted voiding. However, prompted voiding in persons with dementia raises ethical concerns related to the person's integrity and autonomy. Timed voiding in combination with additional interventions like incontinence aids, staff training on the technique of transferring participants from bed to commode and pharmacological treatment decreased the number of urinary incontinence episodes in older persons with/without dementia. There is good scientific evidence that prevention of urinary incontinence in elders with/without dementia decreases incontinence or maintains continence. However, the evidence is insufficient to describe the state of knowledge of faecal incontinence. Conclusions. Toilet assistance, including timed voiding in combination with additional interventions and prompted voiding, are the available evidence-based interventions; however, nursing incontinence care is an experience-based endeavour for persons with dementia. Relevance to clinical practice. There is a lack of evidence-based nursing interventions related to incontinence care for persons with dementia. More research is needed to show whether experience-based incontinence care is effective and which activities are most appropriate for persons with dementia. However, the practice of effective nursing will only be realised by using several sources of evidence, namely research, clinical experience and patient experience.

  • 4.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    District continence nurses' experiences of their continence service in primary health care2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 2, p. 225-233Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to describe district continence nurses' experiences of providing continence services in primary care. Background It has been stated that there is too little research on the experiences of district care nurses who provide continence services. Method Twenty-two district continence nurses answered a written questionnaire containing three open-ended main questions. A qualitative content analysis method was used to analyse the texts. Results The district continence nurses' feelings of maintaining their professionalism were promoted by scheduled patient encounters, patients who participate in assessment of urinary incontinence (UI) and functioning teamwork. The opposite situation, nurses' feelings of having a lesser degree of professionalism, was associated with not having scheduled patient appointments, patients not participating in assessment of UI and lack of teamwork. Conclusions The district continence nurses lacked the authority to start nurse-led continence clinics because of the lack of collaborative teamwork, an organization that did not enable nurse-led scheduled appointments and nurses' limited view of their own profession. Implications for nursing management Primary health care managers and policy-makers need to provide an environment that enables interprofessional collaboration so that nurses' skills can be used to advance patient services; such initiatives could enable district continence nurses to reach their full potential.

  • 5.
    Hägglund, Doris
    et al.
    Örebro University, Department of Clinical Medicine.
    Ahlström, Gerd
    Örebro University.
    The meaning of women's experience of living with long-term urinary incontinence is powerless2009Conference paper (Refereed)
  • 6.
    Hägglund, Doris
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ahlström, Gerd
    The meaning of women's experience of living with long-term urinary incontinence is powerlessness2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1946-1954Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to illuminate the meaning of women's experiences of living with urinary incontinence (UI).

    BACKGROUND: Living with long-term UI means a variety of consequences for everyday life. Women's narratives about their lived experiences are important in enabling nurses to better understand and to help women achieve symptom control. No previous study could be found that has focused on the meaning of women's experience of living with UI from a symptom management perspective.

    METHOD: Fourteen women with UI (range: 34-52 years) who had sought professional help were interviewed. A phenomenological hermeneutic method was used to analyse and interpret the interview texts.

    FINDINGS: The women's experiences of living with UI are presented in terms of two interlaced themes of being in a vulnerable situation and striving for adjustment. Being in a vulnerable situation means that the women had no control over UI and experienced powerlessness. The sub-themes in this case were living with an uncontrolled body, living with incontinence as taboo and experiencing a less satisfying encounter. Striving for adjustment means that the women tried to handle their incontinence in different ways to regain power and continue to live as normal. The sub-themes here were living in readiness, making urine leakage comprehensible, accepting living with UI and being familiar with the situation. Conclusion. The meaning of women's experience of living with UI is powerlessness.

    RELEVANCE TO CLINICAL PRACTICE: Nurses should supervise women in pelvic floor muscle training to achieve control over incontinence, thereby helping them regain power. Additionally, Integrated Approach to Symptom Management can help nurses enhance women's self-care abilities

  • 7.
    Hägglund, Doris
    et al.
    Örebro University, School of Health and Medical Sciences.
    Olsson, Henny
    Leppert, Jerzy
    Urinary incontinence: an unexpected large problem among young females. Results from a population-based study1999In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 16, no 5, p. 506-509Article in journal (Refereed)
    Abstract [en]

    Background. The International Continence Society has defined urinary incontinence as a condition in which involuntary loss of urine is objectively demonstrable and is a social or hygiene problem. Urinary incontinence is presumably a common health problem among women even in younger ages.

    Objectives.The primary aim was to investigate the prevalence of urinary incontinence (UI) in a female population with a special focus on younger women (18–30 years old). The secondary aim was to investigate the association between UI and number of deliveries, use of contraceptives or oestrogen substitutions, and urinary tract infections (UTIs).

    Methods.A population-based study with a self-administered questionnaire was set in the community of Surahammar, Sweden. Subjects were all women (3493) aged 18–70 years living in Surahammar during 1995. The main outcome measures were the prevalence of UI and variables such as number of deliveries, use of contraceptives or oestrogen substitutions, and UTIs.

    Results. Twenty-six per cent of the women reported problems of UI. The prevalence of UI in younger women was 12%. The number of reported complaints of UTIs was significantly higher in the women with UI compared with women without urinary incontinence (wUI). In the younger women UTI, nulliparous or having given birth to one or two children were most frequent in those with UI. The use of contraceptives was more common in younger women without UI (P < 0.05). However, the use of oestrogen was more common in older women in the age group 51–70 years with UI (P < 0.01).

    Conclusion.Our findings have shown that 26% of the women who took part in the survey reported problems of UI. Among women below 30 years of age, 12% reported complaints of UI. We found a high prevalence of UI in younger women with a UTI, not taking oestrogen, nulliparous or having given birth to one or two children. There are needs for further investigations with a special focus on younger women

  • 8.
    Hägglund, Doris
    et al.
    Örebro University, School of Health and Medical Sciences.
    Wadensten, Barbro
    Fear of humiliation inhibits women's care-seeking behaviour for long-term urinary incontinence2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 305-312Article in journal (Refereed)
    Abstract [en]

    Most women with urinary incontinence (UI) do not seek professional help. Women's experiences of their behaviour when seeking care for incontinence are important to improve understanding by nurses and encourage as well as enable women to seek help. The aim of this study was to illuminate the meaning of women's lived experiences of their behaviour when seeking care for long-term UI. Thirteen women were interviewed (range 37–52 years) who had not sought professional help for incontinence. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Three themes evolved from data: being in an affected situation, having personal beliefs about seeking care and having desired expectations about care. Being in an affected situation, means that the women were negatively affected by their long-term incontinence. Living with shame, altered sexual relationships and a need for distancing have negatively influenced their care-seeking behaviour (CSB). Having personal beliefs about seeking care means that the women had their own beliefs regarding morally acceptable behaviour for seeking care because of incontinence. This led to a toning down of their problem and a minimization of the problem associated with incontinence as it was considered to be a normal consequence of pregnancy and childbirth. Having desired expectations about care means that the women had opinions relevant to the care and felt being asked about incontinence and an understanding atmosphere should be included. The conclusion is that fear of humiliation inhibited women from seeking care for long-term UI. The findings suggest that nurses should be precise when asking about women's experiences of UI because otherwise they do not bring it up. Additionally, CSB can help nurses to explain the experience and enable women to seek help for this manageable condition.

  • 9.
    Hägglund, Doris
    et al.
    Örebro University, School of Health and Medical Sciences.
    Wadensten, Barbro
    Örebro University, School of Health and Medical Sciences.
    Andersson, Catarina
    Aflarenko, Margareta
    Örebro University, School of Health and Medical Sciences.
    Effekten av tranbärsjuice och personalutbildning i vårdhygien för att förebygga urinvägsinfektioner inom särskilt boende2009In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 29, no 2, p. 28-32Article in journal (Refereed)
    Abstract [en]

    Cranberry juice is often given to elderly persons in nursing homes to prevent urinary tract infections; still there is little evidence to support its use. Basic hygiene routines are important for preventing urinary tract infections. The aim of this study was to investigate whether cranberry juice and staff education in hygiene care can prevent symptomatic urinary tract infections among elderly persons living in nursing homes. A quasiexperimental study with three intervention groups and one control group was conducted involving 257 elderly women and men. A total of 48 symptomatic urinary tract infections were documented over the six months of the study: 21 (43.7%) in the cranberry group, 11 (22.9%) in the control group, 9 (18.7%) in the cranberry/hygiene care group and 7 (14.5%) in the hygiene care group. These between-group differences were not statistic significant. Hence, our study showed no preventive effect from cranberry juice, alone or in combination with staff education in hygiene care, on the incidence of symptomatic urinary tract infections. However, more and better research with larger randomised trials or cranberry capsules is needed to study its potential use to prevent urinary tract infections in elderly persons.

  • 10.
    Hägglund, Doris
    et al.
    Örebro University, Department of Health Sciences.
    Walker-Engström, Marie-Louise
    Larsson, Gregor
    Leppert, Jerzy
    Changes in urinary incontinence and quality of life after four years: a population-based study of women aged 22-50 years2004In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 22, p. 112-117Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To investigate (a) the incidence and remission rates of female urinary incontinence (UI), (b) changes in type of UI and quality of life (QoL), and (c) whether professional help had been consulted regarding UI.

    DESIGN:

    A 4-year follow-up population-based cohort study.

    SETTING:

    Surahammar, Sweden, a community of 10,500 inhabitants.

    SUBJECTS:

    All 118 incontinent and 130 continent women aged between 22 and 50 years.

    MAIN OUTCOME MEASURES:

    Changes in type of UI were measured using the Detrusor Instability Score (DIS), which was used to distinguish between the stress incontinent and the urge incontinent women. Changes in QoL were measured using the SF-36 Health Survey.

    RESULTS:

    The mean annual incidence and remission rates of UI were the same (4%). The majority of women (83%) reported unchanged UI after 4 years and 77% of these women had stress incontinence. At follow-up, the changes in QoL scores were significantly greater in five out of eight dimensions in the persistently incontinent group compared with the persistently continent group. QoL scores did not change significantly from baseline to the 4-year follow-up within the incidence and remission groups. Three of four women with UI had not sought professional help.

    CONCLUSIONS:

    At 4-year follow-up the type of UI is fairly stable in women below 50 years of age. The QoL decreases in five dimensions, but the clinical relevance of this might be questioned. Most women with UI had not sought professional help.

  • 11.
    Hägglund, Doris
    et al.
    Örebro University, School of Health and Medical Sciences.
    Walker-Engström, Marie-Louise
    Larsson, Gregor
    Leppert, Jerzy
    Quality of life and seeking help in women with urinary incontinence2001In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 80, no 11, p. 1051-1055Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The aims of this population-based study were to compare the quality of life (QoL) in; (a) women with urinary incontinence (UI) and women without urinary incontinence (wUI) in relation to age, (b) women with stress incontinence and women with urge incontinence, and (c) women who had, vs. women who had not, consulted a health care service because of UI.

    METHODS:

    Totally, 787 women who reported symptoms of UI and 787 women who did not report symptoms of UI, aged 18-72 years, were mailed the Short Form-36 QoL questionnaire (SF-36) and a question concerning professional consultation. They were also mailed the Detrusor Instability Score questionnaire, which was used to clarify the women as being stress vs. urge incontinent.

    RESULTS:

    Women with UI had significantly lower scores on all eight dimensions of the SF-36. There were low correlations between age and the QoL scores in women with or without UI. Both women with stress incontinence and women with urge incontinence had significantly lower scores on all eight QoL dimensions compared with the women without UI. However, the absolute difference was smaller for women with stress incontinence. Women with urge incontinence consult health care service more often than women with stress incontinence. Women with UI who had consulted health care had significantly lower QoL scores than women with UI who had not consulted health care in seven out of eight dimensions.

    CONCLUSIONS:

    The QoL, in this female general population, is more affected by women with urge incontinence than women with stress incontinence. Help seeking is associated with substantially lower QoL scores and with urge incontinence.

  • 12.
    Hägglund, Doris
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Walker-Engström, Marie-Louise
    Larsson, Gregor
    Leppert, Jerzy
    Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study2003In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 14, no 5, p. 296-304Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate the reasons why some women with long-term urinary incontinence (UI) seek professional help whereas others do not, their experiences and satisfactions with the healthcare services, and how women deal with their incontinence. In total, 95 women aged 23–51 years with persistent UI (median 10 years, range 6–20 years) were included in this telephone interview survey. Seventy-four percent of the women with long-term UI had not sought help. The most common reason given was that the disorder was considered a minor problem, which they felt they could cope with on their own. When women did consult professional help they did so because they were afraid of the odor of urine and that they perceived the leakage as shameful and embarrassing. These women felt that the healthcare service offered appropriate care for their condition. Pelvic floor exercises were the most commonly used management methods for all participants.

  • 13. Roman-Emanuel, C.
    et al.
    Hägglund, Doris
    Örebro University, Department of Clinical Medicine.
    The operating room nurses experiences of the medical equipment in their daily work2009Conference paper (Refereed)
  • 14.
    Wadensten, Barbro
    et al.
    Örebro University, School of Health and Medical Sciences.
    Engholm, Rosa
    Örebro University, School of Health and Medical Sciences.
    Fahlström, Gunilla
    Örebro University, School of Health and Medical Sciences.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    Nursing staff's description of a good encounter in nursing homes2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 3, p. 203-210Article in journal (Refereed)
    Abstract [en]

    Background. It has been stated that there is too little research on what constitutes good communication and good encounters in nursing homes.

    Aim and objectives. The aim of the present study was to examine nursing staff members’ views on what is important in caring encounters with older people living in nursing homes.

    Design. A qualitative descriptive study using focus group interviews with staff in a nursing home in Sweden.

    Method. Focus group interviews, analysed using qualitative content analysis.

    Results. Three main themes emerged describing nursing staff members’ opinions about the content of good encounters: ‘Caring encounters from the perspective of equality’, ‘Caring encounters from the perspective of integrity’ and ‘Caring encounters from the perspective of promoting security’.

    Conclusions. The nursing staff had theoretical knowledge of what constitutes a good caring encounter, but they seemed to need more supervision and training to develop their ways of encountering older people as well as to become stronger in their professional role. When performing such training with staff, the methodology of appreciative inquiry could be a powerful tool.

    Relevance to clinical practice. It is important to help staff become empowered and to help them develop and improve their encounters with older care recipients.

  • 15. Wadensten, Barbro
    et al.
    Hägglund, Doris
    Örebro University, Department of Health Sciences.
    Older people´s experience of participating in a reminiscence group with a gerotranscendental perspective: reminiscence group with a gerotranscendental perspective in practice2006In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 1, no 3, p. 159-167Article in journal (Refereed)
    Abstract [en]

    Tornstam's theory of gerotranscendence provides the theoretical underpinning for two small reminiscence groups that met for eight weekly sessions in a Swedish daycentre. Tornstams's theoretical perspective provides a developmental model for understanding positive progressive changes in values, attitudes and behaviour in the second half of life. Practical guidelines derived from this theory informed the group-work approach used. Participants’ opinions about their reminiscence experience were analysed to determine the relevance of gerotranscendental theory as a basis for understanding older people's use of reminiscence in the ageing process. The study aimed at investigating older peoples’ experiences of participating in a reminiscence group with a gerotranscendental perspective. The study used a qualitative approach. Older people were invited to participate in reminiscence group sessions arranged at a daycentre. When the sessions were finished, participants were interviewed about their experience of the reminiscence group. Data were analysed and categorized by using qualitative methods. The participants were satisfied with the arrangement of the group sessions. All participants believed they had reminisced and thought much more about their childhood and also recalled other memories from their lives during the period. Three quite different views emerged of the recall experience and effects of participating in the reminiscence group: ‘An activity like any other; an activity that led to thoughts about memories from life or an activity that influenced my thoughts about life.’ Findings suggest that it is possible to arrange reminiscence groups from a gerotranscendental perspective that serve as an intervention in gerontological nursing. This paper provides some guidance concerning how this type of group may be arranged and the various categories of participant response that may be expected.

  • 16.
    Wätterbjörk, Inger
    et al.
    Örebro University, School of Health and Medical Sciences.
    Häggström-Nordin, Elisabet
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    Provider strategies for contraceptive counselling among Swedish midwives2011In: British journal of midwifery, ISSN 0969-4900, E-ISSN 2052-4307, Vol. 19, no 5, p. 296-301Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown that in contraceptive counselling the provider sets the agenda. The aim of this study was to describe how a group of Swedish nurse-midwives think and act in their role as contraceptive counsellors. Semi-structured questions were put to a convenience sample of 16 nurse-midwives. Data were analysed using qualitative content analysis. Five categories were identified: exploring the woman's situation; providing information about contraceptive methods; performing medical evaluation; guiding the decision-making process; and following up on the counselling. Results showed that the providers had developed their own strategies and suggest the use of interventions which combine counselling methods to provide information, with a theory for decision-making, to help in giving advice. This study could contribute to personal reflection on contraceptive counselling in practice, both for experienced counsellors and those new to the task

  • 17.
    Zakrisson, Ann-Britt
    et al.
    Örebro University, School of Health and Medical Sciences.
    Engfeldt, Peter
    Örebro University, School of Health and Medical Sciences.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    Odencrants, Sigrid
    Örebro University, School of Health and Medical Sciences.
    Hasselgren, Mikael
    Arne, Mats
    Theander, Kersti
    Nurse-led multidisciplinary programme for patients with COPD in primary health care: a controlled trial2011In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, no 4, p. 427-433Article in journal (Refereed)
    Abstract [en]

    AIM:To investigate the effects of a nurse-led multidisciplinary programme (NMP) of pulmonary rehabilitation in primary health care with regard to functional capacity, quality of life (QoL), and exacerbations among patients with chronic obstructive pulmonary disease (COPD).

    METHOD:A 1-year longitudinal study with a quasi-experimental design was undertaken in patients with COPD, 49 in the intervention group and 54 in the control group. Functional capacity was assessed using the 6-minute walking test, and quality of life (QoL) was assessed using the Clinical COPD Questionnaire. Exacerbations were calculated by examination of patient records.

    RESULTS:No significant differences were found between the groups in functional capacity and QoL after 1 year. The exacerbations decreased in the intervention group (n = -0.2) and increased in the control group (n = 0.3) during the year after NMP. The mean difference of change in exacerbation frequency between the groups was statistically significant after one year (p=0.009).

    CONCLUSIONS:The NMP in primary care produced a significant reduction in exacerbation frequency, but functional capacity and QoL were unchanged. More and larger studies are needed to evaluate potential benefits in functional capacity and QoL.

  • 18.
    Zakrisson, Ann-Britt
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hägglund, Doris
    Örebro University, School of Health and Medical Sciences.
    The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, p. 147-155Article in journal (Refereed)
    Abstract [en]

    The number of patients with chronic obstructive pulmonary disease (COPD) is increasing. These patients need nursing care, including education in self-care, which has a positive effect on their physical and psychoemotional well-being. The aim of this study was to describe the experiences of asthma/COPD nurses' in primary health care (PHC) of educating patients with COPD. A descriptive, qualitative study was conducted, with interviews of 12 asthma/COPD nurses. The data were analysed using qualitative content analysis. The findings are presented in two themes: Theme 1, receiving support results in a feeling of security, which enables the development of patient education; and Theme 2, a lack of support results in a feeling of insecurity, which makes it difficult to develop patient education. The asthma/COPD nurses were individual orientated with individualization of care, but the patient's mood, the varying support of those around and the nurses' varying degrees of security affected the education. The conclusion is that the asthma/COPD nurses' experience of patient education fluctuated between insecurity and security. The nurses' feeling of insecurity in their patient education can be strengthened through support from colleagues and by increased knowledge in promoting the learning of others. Collaborative teamwork with a well-functioning asthma/COPD clinic in PHC can facilitate and improve patient services; these initiatives can enable the asthma/COPD nurses to reach their full potential.

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