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1.
Eur Arch Otorhinolaryngol ; 281(7): 3717-3726, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38587650

RESUMO

PURPOSE: This study aimed to explore the experiences of head and neck cancer (HNC) survivors with postradiation trismus, specifically how oncological treatment affected their lives, rehabilitation, use of coping strategies, and healthcare experiences. METHODS: A qualitative descriptive approach was used and semi-structured interviews of 10 HNC survivors with postradiation trismus were conducted 6-30 months after completing oncological treatment. The interviews were transcribed verbatim and analyzed by qualitative content analysis. RESULTS: The analysis of interviews yielded four main categories: Bodily symptoms, Effects on life, Support from the healthcare system, and Strategies to handle life and symptoms. Participants reported ongoing problems with xerostomia, dysgeusia, eating, and limited physical fitness. Pain related to trismus was not a major issue in this cohort. Participants expressed limitations in their social lives due to their eating difficulties, yet a sense of thankfulness for life and overall satisfaction with the healthcare they received. Psychological and practical coping strategies developed by the participants were also revealed. CONCLUSION: The results highlight areas of unmet need among HNC survivors that healthcare providers can target by establishing multi-professional teams dedicated to individualizing post-cancer rehabilitation care.


Assuntos
Adaptação Psicológica , Sobreviventes de Câncer , Neoplasias de Cabeça e Pescoço , Pesquisa Qualitativa , Qualidade de Vida , Trismo , Humanos , Trismo/etiologia , Trismo/psicologia , Trismo/reabilitação , Masculino , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/psicologia , Pessoa de Meia-Idade , Sobreviventes de Câncer/psicologia , Idoso , Adulto , Apoio Social , Lesões por Radiação/psicologia , Lesões por Radiação/etiologia , Lesões por Radiação/reabilitação , Capacidades de Enfrentamento
2.
J Adv Nurs ; 80(7): 2905-2916, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38130055

RESUMO

AIM: The study aimed to explore the experiences of care and recovery among older patients treated for physical trauma. DESIGN: A qualitative study with a constructivist grounded theory design. METHODS: Fifteen in-depth interviews with older adults recovering from physical trauma were conducted and analysed between 2019 and 2023, in accordance with grounded theory methodology. RESULTS: The findings show that for older patients who suffered physical trauma, the core category was the strive to recapture autonomy. This was achieved by means of Adaptation, Reflection and Interactions, which constitute the three main categories. Recovery involves facing and navigating various new life challenges, such as increased dependency on others, managing difficult symptoms and adapting in various ways to everyday life. The recovery process was influenced by fear, hope and the attitude towards new challenges. CONCLUSION: Older adults being cared for after a traumatic event have a difficult path to recovery ahead of them. Dealing with increased unwanted dependency on others was a main concern for the participants. Undertreated symptoms can lead to undesired isolation, delayed recovery and further increase unwanted dependency. On the other hand, hope, which was defined as having a positive approach to life and longing for the future, was a strong accelerating factor in the recovery process. IMPACT: As a result of this study, we have established that older patients experience the initial period after trauma as difficult and that support in the initial phase can be helpful when returning home. As healthcare services are under increasing pressure because of an ageing population, this study contributes by addressing an understudied population and clarifying their concerns. REPORTING METHOD: Reporting adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.


Assuntos
Adaptação Psicológica , Teoria Fundamentada , Autonomia Pessoal , Pesquisa Qualitativa , Humanos , Feminino , Masculino , Idoso , Idoso de 80 Anos ou mais , Ferimentos e Lesões/psicologia , Pessoa de Meia-Idade
3.
Cleft Palate Craniofac J ; 61(1): 52-60, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-35979595

RESUMO

The aim of the present study was to describe the experiences of young adults living with cleft lip and palate (CLP) and to explore potential gender differences.A descriptive qualitative study was designed involving semi-structured interviews. The interviews were analyzed using qualitative content analysis, as described by Graneheim and Lundman.A total of 9 women and 8 men, aged 22 to 26 years with UCLP.The main theme identified was: the duality of living with a cleft-being normal yet different, and 2 subcategories: "My cleft and me" and "My cleft and the World." The participants described themselves as normal yet different, both in relation to themselves and in relation to others. They also stated that gender norms regarding appearance affected their lives and how they saw the cleft.This study adds to the growing body of qualitative research on CLP. It highlights the dualistic experiences of feeling normal and different at the same time. The interviews indicated that this dualism was based on context and gender, showing the psychological complexity of an individual. The clinical implications of this study emphasizes the need of a person-centered care approach in the cleft care setting where the clinicians are aware of the potential dualistic experience that also may differ over time that individuals with cleft can experience. This can also help clinicians better understand and help patients reduce distress and strengthen positive coping mechanisms.


Assuntos
Fenda Labial , Fissura Palatina , Masculino , Adulto Jovem , Humanos , Feminino , Fenda Labial/cirurgia , Fenda Labial/psicologia , Fissura Palatina/cirurgia , Fissura Palatina/psicologia , Adaptação Psicológica , Pesquisa Qualitativa
4.
Support Care Cancer ; 31(12): 699, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37966497

RESUMO

PURPOSE: Pain is a frequent symptom of head and neck cancer (HNC) but longitudinal studies investigating facial pain are scarce. We aimed to investigate prevalence of facial pain, its effect on health-related quality of life (HRQL) and trismus-related symptoms in a HNC cohort. METHODS: Patients (n = 194) were prospectively followed post completion of radiotherapy (RT). Outcome measures included facial pain, HRQL, trismus-specific symptoms, and maximal interincisal opening (MIO). RESULTS: Facial pain was reported by 50% at baseline. Corresponding figures for 3-, 12-, and 60 months post-RT were 70%, 54% and 41%. Moderate to severe pain was reported in 29-44% of patients reporting pain during the study period. Patients reporting pain scored significantly worse on more HRQL variables and trismus symptoms, as well as had significantly smaller MIO at all follow-up time points. CONCLUSIONS: Facial pain was common in HNC patients pre- and post-RT and remained prevalent up to 5 years after completion of RT. Reductions in MIO were associated with more facial pain. Pain was also associated with worse HRQL.


Assuntos
Neoplasias de Cabeça e Pescoço , Radioterapia (Especialidade) , Humanos , Qualidade de Vida , Trismo/epidemiologia , Trismo/etiologia , Dor Facial/epidemiologia , Dor Facial/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia
5.
Support Care Cancer ; 31(3): 166, 2023 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-36781552

RESUMO

PURPOSE: Radiotherapy-induced trismus is present in up to 40% of patients treated radiotherapeutically for head and neck cancer (HNC) and impacts health-related quality of life (HRQL) negatively. This prospective study aimed to investigate the development of trismus and its influence on HRQL and trismus-related symptoms in HNC patients for up to 5 years post-radiotherapy completion as no such follow-up studies exist. METHODS: Patients (n = 211) were followed prospectively from pre-radiotherapy to 12 and 60 months post-radiotherapy. At each follow-up, maximum interincisal opening (MIO) was measured, and patients filled in the European Organization for Treatment of Cancer Quality-of-Life Questionnaire Core-30 (EORTC QLQ-C30), Head and Neck-35 (EORTC QLQ-HN35), and Gothenburg Trismus Questionnaire (GTQ). Trismus was defined as an MIO ≤ 35 mm. RESULTS: At 1 year post-radiotherapy, a total of 27% met the trismus criterion, and at 5 years post-radiotherapy, the corresponding figure was 28%. Patients in the trismus group scored significantly worse compared to the patients without trismus on 8/15 domains at 1 year post-radiotherapy on EORTC QLQ-C30, further worsening in 11/15 domains at 5 years post-radiotherapy. Similar results were found for EORTC QLQ-HN35. Patients with trismus reported more trismus-related symptoms according to the GTQ at both timepoints compared to those without trismus. CONCLUSION: This study highlights that HNC patients suffering from radiotherapy-induced trismus report poorer HRQL and more trismus-specific symptoms compared to patients without trismus. These differences persist and increase up to at least 5 years following treatment completion. Hence, our results highlight that radiotherapy-induced trismus affects long-term HRQL, jaw symptoms, and pain, further stressing the need for early and structured intervention.


Assuntos
Neoplasias de Cabeça e Pescoço , Trismo , Humanos , Trismo/epidemiologia , Trismo/etiologia , Trismo/diagnóstico , Qualidade de Vida , Estudos Prospectivos , Seguimentos , Neoplasias de Cabeça e Pescoço/radioterapia , Inquéritos e Questionários
6.
Nutr Metab Cardiovasc Dis ; 33(5): 998-1006, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36890072

RESUMO

BACKGROUND AND AIMS: After bariatric surgery, micronutrient deficiencies may lead to anaemia. To prevent post-operative deficiencies, patients are recommended lifelong micronutrient supplementation. Studies investigating the effectiveness of supplementation to prevent anaemia after bariatric surgery are scarce. This study aimed to investigate the relationship between nutritional deficiencies and anaemia in patients who report use of supplementation two years after bariatric surgery versus patients who do not. METHODS AND RESULTS: Obese (BMI≥35 kg/m2) individuals (n = 971) were recruited at Sahlgrenska University Hospital in Gothenburg, Sweden between 2015 and 2017. The interventions were Roux-en-Y gastric bypass (RYGB), n = 382, sleeve gastrectomy (SG), n = 201, or medical treatment (MT), n = 388. Blood samples and self-reported data on supplements were collected at baseline and two years post treatment. Anaemia was defined as haemoglobin <120 g/L for females and <130 g/L for males. Standard statistical methods, including a logistic regression model and a machine learning algorithm, were used to analyse data. The frequency of anaemia increased from baseline in patients treated with RYGB (3·0% vs 10·5%; p < 0·05). Neither iron-dependent biochemistry nor frequency of anaemia differed between participants who reported use of iron supplements and those who did not at the two-year follow-up. Low preoperative level of haemoglobin and high postoperative percent excessive BMI loss increased the predicted probability of anaemia two years after surgery. CONCLUSION: The results from this study indicate that iron deficiency or anaemia may not be prevented by substitutional treatment per current guidelines after bariatric surgery and highlights there is reason to ensure adequate preoperative micronutrient levels. TRIAL REGISTRATION: March 03, 2015; NCT03152617.


Assuntos
Anemia , Cirurgia Bariátrica , Derivação Gástrica , Desnutrição , Obesidade Mórbida , Masculino , Feminino , Humanos , Ferro/efeitos adversos , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/cirurgia , Estudos Prospectivos , Autorrelato , Cirurgia Bariátrica/efeitos adversos , Derivação Gástrica/efeitos adversos , Anemia/diagnóstico , Anemia/epidemiologia , Anemia/prevenção & controle , Suplementos Nutricionais/efeitos adversos , Hemoglobinas , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Micronutrientes
7.
J Adv Nurs ; 79(7): 2610-2621, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36843299

RESUMO

AIM: The aim of the study was to explore the work conditions that influence the opportunities for professional development of specialist nurses in surgical care. DESIGN: A qualitative descriptive design was used. METHODS: With a purposeful sampling procedure, 14 specialist nurses in surgical care were included. Four focus-group interviews were conducted during November to December 2021 and deductively analysed using the Job Demand-Resource theory as a guiding framework. Reporting adheres to COREQ guidelines. FINDINGS: Work conditions that were identified as job demands and that inhibited nurses' opportunities for professional development were mainly found at an organizational and leadership level. Primarily, those conditions included role ambiguity and time constraints caused by uncompensated nursing shortages that restricted the nurses from exercising their role. Such conditions could also discourage other nurses from further education. Job demands were seen as largely compensated for by work conditions identified as job resources and located mainly at an individual level, for example finding the work interesting and multifaceted. Most prominent was the participants' inner motivation to work with surgical patients and to continue to develop themselves and other nurses professionally. CONCLUSIONS: A prerequisite for professional development is that the specialist role is clearly defined in collaboration with representatives from the nursing profession and universities. Hence, hospital organizations need to reflect on how to utilize the competence. Also, it is important that nurse leaders promote the specialist nurses' motivation by supporting them in the exercise of their role. IMPACT: Findings from this study revealed work conditions that need to be acknowledged during hospital organizations' endeavours to maintain and enhance nursing competence. PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution was not applicable since the study focused on specialist nurses' working conditions.


Assuntos
Motivação , Enfermeiras e Enfermeiros , Humanos , Pesquisa Qualitativa , Grupos Focais , Local de Trabalho , Satisfação no Emprego
8.
BMC Nurs ; 22(1): 79, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36949475

RESUMO

BACKGROUND: A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development. METHOD: This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%. RESULTS: Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021). CONCLUSIONS: Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

9.
BMC Endocr Disord ; 21(1): 183, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507573

RESUMO

BACKGROUND: The development of obesity is most likely due to a combination of biological and environmental factors some of which might still be unidentified. We used a machine learning technique to examine the relative importance of more than 100 clinical variables as predictors for BMI. METHODS: BASUN is a prospective non-randomized cohort study of 971 individuals that received medical or surgical treatment (treatment choice was based on patient's preferences and clinical criteria, not randomization) for obesity in the Västra Götaland county in Sweden between 2015 and 2017 with planned follow-up for 10 years. This study includes demographic data, BMI, blood tests, and questionnaires before obesity treatment that cover three main areas: gastrointestinal symptoms and eating habits, physical activity and quality of life, and psychological health. We used random forest, with conditional variable importance, to study the relative importance of roughly 100 predictors of BMI, covering 15 domains. We quantified the predictive value of each individual predictor, as well as each domain. RESULTS: The participants received medical (n = 382) or surgical treatment for obesity (Roux-en-Y gastric bypass, n = 388; sleeve gastrectomy, n = 201). There were minor differences between these groups before treatment with regard to anthropometrics, laboratory measures and results from questionnaires. The 10 individual variables with the strongest predictive value, in order of decreasing strength, were country of birth, marital status, sex, calcium levels, age, levels of TSH and HbA1c, AUDIT score, BE tendencies according to QEWPR, and TG levels. The strongest domains predicting BMI were: Socioeconomic status, Demographics, Biomarkers (notably TSH), Lifestyle/habits, Biomarkers for cardiovascular disease and diabetes, and Potential anxiety and depression. CONCLUSIONS: Lifestyle, habits, age, sex and socioeconomic status are some of the strongest predictors for BMI levels. Potential anxiety and / or depression and other characteristics captured using questionnaires have strong predictive value. These results confirm previously suggested associations and advocate prospective studies to examine the value of better characterization of patients eligible for obesity treatment, and consequently to evaluate the treatment effects in groups of patients. TRIAL REGISTRATION: March 03, 2015; NCT03152617 .


Assuntos
Cirurgia Bariátrica/métodos , Biomarcadores/análise , Índice de Massa Corporal , Exercício Físico , Estilo de Vida , Obesidade/diagnóstico , Qualidade de Vida , Adulto , Feminino , Seguimentos , Gastrectomia/métodos , Derivação Gástrica/métodos , Hemoglobinas Glicadas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Estado Nutricional , Obesidade/epidemiologia , Obesidade/cirurgia , Prognóstico , Estudos Prospectivos , Suécia/epidemiologia
10.
Acta Paediatr ; 110(5): 1534-1540, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33325092

RESUMO

AIM: To assess the prevalence of neurodevelopmental problems in adolescents with severe obesity and their associations with binge eating and depression. METHODS: Data were collected at inclusion in a randomised study of bariatric surgery in 48 adolescents (73% girls; mean age 15.7 ± 1.0 years; mean body mass index 42.6 ± 5.2 kg/m2 ). Parents completed questionnaires assessing their adolescents' symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder and reported earlier diagnoses. Patients answered self-report questionnaires on binge eating and depressive symptoms. RESULTS: The parents of 26/48 adolescents (54%) reported scores above cut-off for symptoms of the targeted disorders in their adolescents, but only 15% reported a diagnosis, 32% of adolescents reported binge eating, and 20% reported symptoms of clinical depression. No significant associations were found between neurodevelopmental problems and binge eating or depressive symptoms. Only a third of the adolescents reported no problems in either area. CONCLUSION: Two thirds of adolescents seeking surgical weight loss presented with substantial mental health problems (reported by themselves or their parents). This illustrates the importance of a multi-professional approach and the need to screen for and treat mental health disorders in adolescents with obesity.


Assuntos
Transtorno do Espectro Autista , Cirurgia Bariátrica , Transtorno da Compulsão Alimentar , Obesidade Mórbida , Adolescente , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/epidemiologia , Feminino , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Prevalência
11.
J Trauma Nurs ; 27(6): 327-334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33156248

RESUMO

BACKGROUND: Injuries were the most common cause of hospitalization in Sweden in 2017. There is a lack of knowledge about trauma recovery and its relation to health-related quality of life (HRQoL) after hospitalization due to minor trauma. This study aimed to prospectively evaluate recovery and HRQoL at discharge from hospital and 3 and 6 months after the trauma. METHODS: This is a secondary analysis of data from a prospective follow-up study. Fifty-seven patients who sustained physical trauma were included. Recovery was measured with postoperative recovery profile and HRQoL 3 and 6 months after discharge. The association between the outcomes was analyzed, as well as the impact of gender, age, Injury Severity Score (ISS), and trauma mechanism using nonparametric statistics. RESULTS: There was a significant improvement in recovery and HRQoL between discharge and 3 months after the trauma (p < .001) as well as between 3 and 6 months after the trauma (p < .001) except for EQ-5D VAS scale (p = .222). However, only 14 (25%) patients viewed themselves as fully recovered 6 months after the incident. Correlation between recovery and HRQoL increased after discharge and was at its strongest 6 months after the trauma (rs > .071). CONCLUSION: Trauma mechanism has an impact on recovery but not gender, age, or ISS score. Most patients did not consider themselves fully recovered even at 6 months postinjury, indicating that they require additional support to manage their recovery.


Assuntos
Qualidade de Vida , Ferimentos e Lesões , Seguimentos , Humanos , Escala de Gravidade do Ferimento , Estudos Prospectivos , Suécia , Enfermagem em Ortopedia e Traumatologia , Ferimentos e Lesões/enfermagem
13.
Gastroenterol Nurs ; 42(3): 233-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31145247

RESUMO

The incidence of registered admissions in inpatient care with a diagnosis of acute pancreatitis was 58 per 100,000 capita in Sweden during the year 2013. Although acute pancreatitis is a well-explored area, there is a demand for research from the patients' perceptions. The aim of this study was to describe patients' perceptions of recovering from acute pancreatitis. Data collection for this phenomenographical study included 16 individual semistructured interviews. Analysis was done according to the 7 steps suggested by . Recovery after acute pancreatitis was perceived within 5 categories; a time of physical suffering, an emotional journey, challenges to the usual life and its good qualities, barriers and need for social support, and healthcare as an important factor. Physical and emotional symptoms influence recovery after acute pancreatitis by challenging the good things and things that are taken for granted in everyday life. Promoting factors toward good recovery was a proper support from the social network as well as healthcare providers.


Assuntos
Pancreatite/complicações , Pancreatite/psicologia , Recuperação de Função Fisiológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Emoções , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Pancreatite/terapia , Avaliação de Resultados da Assistência ao Paciente , Pesquisa Qualitativa , Qualidade de Vida , Apoio Social , Suécia
14.
J Trauma Nurs ; 25(4): 233-241, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29985857

RESUMO

Injuries due to trauma are the leading cause of death in Sweden among people younger than 45 years, and more than 120,000 patients were admitted to hospitals in 2014 as a result of trauma. Patients suffering from less serious physical trauma are often discharged directly from the trauma unit, commonly without any follow-up plans. There is a lack of knowledge about how these patients experience their recovery process.Eight women and 6 men were interviewed 3 months after being directly discharged from a trauma unit. Data were analyzed using the constructive grounded theory approach.The main finding was the core category of social support, the key to recovery. Patients' roads to recapturing their health and to recovery had several barriers, which can be clustered together to either physical or psychological symptoms that enhanced their feelings of ill health and delayed their recovery. Participants described different strategies that they used to deal with these barriers. Most important was the support of others, that is, family, social life, work, and health care (primary health care).The participants in this study described managing the recovery process by themselves as troublesome. This is partly because they do not view themselves as healthy, as the health care providers do, and many are in need of further health care after discharge. Health care providers should give better information on the expected process of recovery and the importance of social support, as it might enable patients to better overcome physical and psychological barriers in their recovery.


Assuntos
Adaptação Psicológica , Qualidade de Vida , Recuperação de Função Fisiológica/fisiologia , Centros de Traumatologia , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/psicologia , Adaptação Fisiológica , Adulto , Idoso , Estudos de Coortes , Continuidade da Assistência ao Paciente , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Prospectivos , Pesquisa Qualitativa , Retorno ao Trabalho , Suécia , Ferimentos e Lesões/terapia , Adulto Jovem
15.
J Surg Res ; 209: 199-205, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28032560

RESUMO

BACKGROUND: Undergoing surgery always involves various risks of complications, often depending on the type of surgery. Because of complications, a second surgical intervention, a reoperation, must occasionally be done, which in turn often causes an extended hospital stay, a longer recovery phase, greater suffering for the patient, and higher health care costs. Even though complications after general surgery are relatively common, little is known regarding patient experience of a reoperation. Knowledge of this could impact on care models in the future. The aim of this study was to describe patients' experience of acute, unplanned reoperation during a planned hospital stay. MATERIALS AND METHODS: A purposive sampling strategy was used, and 16 patients were included, all who had undergone acute unplanned reoperation during a planned hospital stay. Semi-structured interviews were used to collect data, and a content analysis with an inductive approach was used for data analysis. RESULTS: The analysis resulted in two main themes: (1) health professionals' importance, having its foundation in categories trust and information, and (2) reaction, based on the categories anxiety and sadness. CONCLUSIONS: Unplanned reoperation caused psychological, social, and existential reactions. Health care professionals were perceived as important because good communication, accurate information, their presence, and creating feelings of confident and safe care were meaningful factors for the patients as they managed the situation.


Assuntos
Reoperação/psicologia , Adulto , Idoso , Comunicação , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Confiança
16.
J Trauma Nurs ; 23(2): 51-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26953531

RESUMO

Violence in health care is increasing globally and Sweden is no exception. Still, this topic is sparsely studied in the Swedish trauma care setting. This focus group study examined nurses' experience of violence and threats, and their consequences. The content analysis revealed two main categories, threatening situations and consequences, which led to a change in priorities in nursing care in order to avoid a potential violent situation. Furthermore, negative stress among the staff and greater vigilance and unwillingness to be near the patient resulted in altered communication and, in the end, a decreased quality of nursing care.


Assuntos
Recursos Humanos de Enfermagem Hospitalar/psicologia , Saúde Ocupacional , Centros de Traumatologia , Violência no Trabalho/estatística & dados numéricos , Adulto , Feminino , Grupos Focais , Hospitais Universitários , Humanos , Incidência , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Medição de Risco , Suécia , Violência no Trabalho/prevenção & controle
17.
Clin Obes ; 14(3): e12657, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38549516

RESUMO

Improved self-esteem and body image, as well as reduced experiences of weight stigma are important patient-reported obesity treatment outcomes. However, more knowledge is needed about how individuals who have undergone metabolic and bariatric surgery (MBS) perceive themselves and their bodies and use different coping strategies in relation to body image and self-esteem long-term after MBS. In this qualitative study body image, self-esteem, weight stigma and coping strategies were explored among 18 individuals who underwent MBS more than 10 years ago when interviewed. Using reflexive thematic analysis, two primary themes were identified: 'Experiences of living with a stigmatised body' and 'Coping with weight stigma, body image and self-esteem', and eight sub-themes. Findings capture frequent experiences of weight stigma before bariatric surgery, the need for coping with stigma and body dissatisfaction before and after MBS, and how different coping strategies are related to participants' perceptions of their bodies and self-concepts. More adaptive coping strategies, such as confrontation and cognitive restructuring may facilitate more positive body image outcomes, than more ruminative and avoidant strategies. Understanding adaptive coping strategies can be useful to develop interventions to reduce negative consequences of weight stigma on body image and self-esteem.


Assuntos
Adaptação Psicológica , Cirurgia Bariátrica , Imagem Corporal , Pesquisa Qualitativa , Autoimagem , Estigma Social , Humanos , Imagem Corporal/psicologia , Cirurgia Bariátrica/psicologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Obesidade/psicologia , Obesidade/cirurgia
18.
JAMA Netw Open ; 7(6): e2414340, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38829616

RESUMO

Importance: Results from long-term follow-up after biliopancreatic diversion with duodenal switch (DS) are scarce. Objective: To compare weight loss, health outcomes, and quality of life 10 years or more after Roux-en-Y-gastric bypass (RYGB) and DS surgery in patients with severe obesity-that is, a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 50 to 60. Design, Setting, and Participants: This open-label randomized clinical trial was conducted at 2 academic bariatric centers in Sweden and Norway. Sixty patients with a BMI of 50 to 60 were included from March 1, 2006, to August 31, 2007. Data were analyzed from August 12, 2022, to January 25, 2023. Interventions: Laparoscopic RYGB or laparoscopic DS. Main Outcomes and Measures: The main outcome was change in BMI after 10 or more years. Secondary outcomes included anthropometric measures, lipid and glycemic profiles, bone mass density, adverse events, gastrointestinal tract symptoms, and health-related quality of life. Results: Forty-eight of the original 60 patients (80%) were assessed after a median of 12 (range, 9-13) years (mean [SD] age, 48.0 [6.0] years; 35 women [73%]). At follow-up, the mean BMI reductions were 11.0 (95% CI, 8.3-13.7) for RYGB and 20.3 (95% CI, 17.6-23.0) for DS, with a mean between-group difference of 9.3 (95% CI, 5.4-13.1; P < .001). Total weight loss was 20.0% (95% CI, 15.3%-24.7%) for RYGB and 33.9% (95% CI, 27.8%-40.0%) for DS (P = .001). Mean serum lipid levels, except high-density lipoprotein cholesterol and hemoglobin A1c, improved more in the DS group during follow-up. Bone mass was reduced for both groups from 5 to 10 years, with lower bone mass after DS at 10 years. Quality-of-life scores (Obesity-Related Problem Scale and the 36-Item Short Form Health Survey) were comparable across groups at 10 years. The total number of adverse events was higher after DS (135 vs 97 for RYGB; P = .02). More patients in the DS group developed vitamin deficiencies (21 vs 11 for RYGB; P = .008) including 25-hydroxyvitamin D deficiency (19 for DS vs 9 for RYGB; P = .005). Four of 29 patients in the DS group (14%) developed severe protein-caloric malnutrition, of whom 3 (10%) underwent revisional surgery. Conclusions and Relevance: In this randomized clinical trial, BMI reduction was greater after DS, but RYGB had a better risk profile over 10 years. Biliopancreatic diversion with DS may not be a better surgical strategy than RYGB for patients with a BMI of 50 to 60. Trial Registration: ClinicalTrials.gov Identifier: NCT00327912.


Assuntos
Índice de Massa Corporal , Derivação Gástrica , Obesidade Mórbida , Qualidade de Vida , Redução de Peso , Humanos , Derivação Gástrica/métodos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Obesidade Mórbida/cirurgia , Resultado do Tratamento , Suécia , Noruega , Duodeno/cirurgia , Laparoscopia/métodos , Desvio Biliopancreático/métodos
19.
Nurs Open ; 10(3): 1684-1692, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36315031

RESUMO

AIM: Having a culture of safety is crucial when providing high-quality health care, yet preventable adverse events are common in the Swedish healthcare system, especially in the field of surgical care. Research shows that patient participation can improve patient safety. This study aimed to explore patients' experience of the safety leaflet, "Your safety in hospital," including participation in care and feelings of safe care. DESIGN: This study uses a descriptive qualitative study design. METHODS: Twenty patients from surgical wards received patient safety leaflets and participated in semi-structured interviews during their hospital stay. Data were analysed using qualitative content analysis. RESULTS: Three categories emerged from the analysis: Positive and negative experiences of provided information, Experiences of participation in own care, and Feelings of being safe arising from a perception of good quality care. Most participants were satisfied with their participation in their care and felt safe during their hospital stay. Oral information about the safety leaflet from healthcare personnel was lacking.


Assuntos
Hospitais , Segurança do Paciente , Humanos , Tempo de Internação , Pacientes , Pessoal de Saúde
20.
J Patient Saf ; 19(2): 137-142, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36729426

RESUMO

OBJECTIVE: One way to decrease adverse events is to increase patient participation in their own care. Sahlgrenska University Hospital has introduced a patient safety advisory, consisting of an animated video and structured oral information. This article investigates how the animated video and structured oral information regarding was perceived by the patients and determines which communication method the patients preferred. METHOD: In this study, we compared patients' attitudes toward patient safety information delivered in video or oral format. Data were collected after intervention through a survey consisting of 5 questions. RESULTS: One hundred thirty-four patients were recruited to the study. Ninety-two patients either watched the video or received oral information. Forty-two patients were given both oral information and viewed the video. Information received by the patients was rated as good or very good by 90% of those viewing the video and by 100% who received the oral presentation ( P = 0.007). Of the 42 participants who received both formats, 74% preferred the oral presentation ( P < 0.001). CONCLUSIONS: The patients thought the patient safety information to be good and beneficial. An informative video can complement the oral information, but not replace, when informing patients about patient safety. Providing patients with information in a manner they prefer may increase patient's involvement in their care and possibly reduce the risk of adverse events.


Assuntos
Participação do Paciente , Segurança do Paciente , Humanos , Atitude , Inquéritos e Questionários
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