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  • 1.
    Carnlöf, Carina
    et al.
    Department of Cardiology Karolinska University Hospital, Stockholm.
    Insulander, Per
    Department of Cardiology Karolinska University Hospital, Stockholm.
    Holmér Pettersson, Pia
    Red Cross University College of Nursing. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm.
    Jensen-Urstad, Mats
    Department of Cardiology Karolinska University Hospital, Stockholm.
    Fossum, Bjöörn
    Sophiahemmet University College, Stockholm.
    Health-related quality of life in patients with atrial fibrillation undergoing pulmonary vein isolation, before and after treatment2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, ISSN 1474-5151, Vol. 9, no 1, p. 45-49Article in journal (Refereed)
    Abstract [en]

    Background: Atrial fibrillation (AF) is the most common arrhythmia and many AF patients experience a significantly impaired health-related quality of life (HRQOL). AF is also associated with a high risk of stroke and death. Many pharmacologic treatments for AF are ineffective and may have adverse effects. New methods, such as pulmonary vein isolation (PVI), have been developed to treat AF.

    Aims: The aim of this study was to investigate the HRQOL issues in severe symptomatic AF patients before and after pulmonary vein isolation.

    Methods: Forty patients treated with PVI were included of which 36 concluded the study with the self-reported HRQOL questionnaires before and once after PVI. A standardized control group was used.

    Results: Compared to the control group the HRQOL before PVI was significantly lower in all domains except for bodily pain. The preoperative scores were compared with the scores obtained at the follow-up. All subscales of the SF-36 significantly improved after the PVI except for bodily pain, which remained unaltered.

    Conclusion: HRQOL is improved in AF patients with severe symptoms after PVI intervention.

  • 2.
    Nahlen Bose, Catarina
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet.
    Elfström, M. L.
    Mälardalen University.
    Persson, H.
    Karolinska Institutet.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine. Karolinska Institutet.
    Implementation of coping effectiveness training in patients with chronic heart failure: participants evaluations indicate psychosocial benefits2015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no S1, p. S10-S10Article in journal (Other academic)
  • 3.
    Nahlen Bose, Catarina
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet, Department of Clinical Sciences Danderyd Hospital AB.
    Persson, Hans
    Karolinska Institutet, Department of Clinical Sciences Danderyd Hospital AB.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet, Department of Clinical Sciences Danderyd Hospital AB.
    Ljunggren, Gunnar
    Public Healthcare Services Committee Administration, Stockholm County Counsil; Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Medical Management Centre.
    Elfström, Magnus L.
    Mälardalen University, Academy of Health, Care and Social Welfare.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine. Karolinska Institutet; Department of Clinical Neuroscience, Division of Insurance Medicine, Administration.
    Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure: a randomized controlled trial2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 537-548Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).AIMS:To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.

    METHODS: Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).

    RESULTS: No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).

    CONCLUSION: CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.

  • 4.
    Nahlén, Catarina
    et al.
    Department of Cardiology Danderyd Hospital AB, S-182 88 Stockholm.
    Saboonchi, Fredrik
    Sophiahemmet University College, Stockholm.
    Coping, Sense of Coherence and the Dimensions of Affect in Patients with Chronic Heart Failure2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, ISSN 1474-5151, Vol. 9, no 2, p. 118-125Article in journal (Refereed)
    Abstract [en]

    Background: Living with chronic heart failure has an impact on several important dimensions of an individual's life. A patient's use of coping strategies may influence his or her health condition and emotional well-being.

    Aim: To investigate factors that may relate to the coping strategies used by individuals with chronic heart failure and how the coping strategies are associated with positive and negative affect.

    Methods: A cross-sectional research design was used. The participants provided demographic data and filled out three questionnaires: Sense of Coherence scale, Brief COPE and Positive Affect Negative Affect Schedule.

    Results: No differences in relation to coping strategies were found with regard to New York Heart Association class. Substance use was associated with gender and age. Sense of coherence was negatively associated with denial, behavioural disengagement, venting and self-blame, and positively associated with acceptance. It was found that avoidant coping positively and sense of coherence negatively, predicted negative affect. Problem focused coping positively predicted positive affect. Socially supported coping predicted both negative and positive affect.

    Conclusion: The present study found that the employment of different coping strategies and sense of coherence had an impact on affect and therefore also the emotional well-being among patients with chronic heart failure.

  • 5.
    Nymark, Carolin
    et al.
    Karolinska Institutet.
    Henriksson, Peter
    Karolinska Institutet.
    Mattiasson, Anne-Cathrine
    Karolinska Institutet.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Kiessling, Anna
    Karolinska Institutet.
    Inability to act was associated with an extended delay prior to care-seeking, in patients with an acute myocardial infarction2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 512-520Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The out-of-hospital mortality in patients with acute myocardial infarction remains unchanged in contrast to a decrease in inhospital mortality. Interventions aiming to shorten patient delay have been largely unsuccessful. A deeper understanding is apparently needed on patients' appraisal prior to care-seeking.

    AIM: To investigate whether appraisal processes influence patient delay, and if the questionnaire 'Patients' appraisal, emotions and action tendencies preceding care seeking in acute myocardial infarction' (PA-AMI) could discriminate between patients with prolonged care-seeking and those with a short delay.

    METHODS: A cross-sectional study including 326 acute myocardial infarction patients filling out the validated questionnaire PA-AMI. The impact of subscales on delay was analysed by projection to latent structures regression. Discrimination opportunities between patients with short and long delays were analysed by projection to latent structures discriminant analysis.

    RESULTS: The subscales 'perceived inability to act' and 'symptom appraisal' had a major impact on patient delay ( P<0.0001). 'Perceived inability to act' had its main influence in patients with a delay exceeding 12 hours, and 'symptom appraisal' had its main influence in patients with a delay shorter than one hour.

    CONCLUSION: Appraisal processes influence patient delay. Acute myocardial infarction patients with a prolonged delay were, besides a low perceived symptom severity and urgency to seek medical care, characterised by a perceived loss of control and ability to act. Therefore, future interventions aimed at decreasing delay should pay attention to appraisal processes, and perceived inability to act may be a sign of a health threat and therefore a signal to seek medical care.

  • 6.
    Nymark, Carolin
    et al.
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine. Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance medicine.
    Mattiasson, A-C
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society.
    Henriksson, P
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Kiessling, A
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Development and validation of an instrument to assess patients' appraisal, emotions and action tendencies preceding care-seeking in acute myocardial infarction: The PA-AMI questionnaire.2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 3, p. 240-248Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Reducing patient delay for patients afflicted by an acute myocardial infarction is a task of great complexity, which might be alleviated if more factors that influence this delay could be identified. Although a number of self-reported instruments associated with patient delay exist, none of these taps the content of the appraisal process related to patients' subjective emotions.

    AIM: The aim of this study was to develop and validate a questionnaire aimed at assessing patients' appraisal, emotions and action tendencies when afflicted by an acute myocardial infarction.

    METHODS: An item pool was generated based on themes conceptualized in a recent qualitative study of acute myocardial infarction patients' thoughts, feelings and actions preceding the decision to seek medical care. The 'Think-Aloud Protocol' and test-retest analysis at item level were performed. The modified item pool was administered to 96 patients when treated for acute myocardial infarction. Explorative factor analysis and principal component analysis with the non-linear iterative partial least squares algorithm were performed to examine the underlying factor structure of the items.

    RESULTS: The findings indicated three core dimensions corresponding to three subscales, namely, 'symptom appraisal'; 'perceived inability to act'; 'autonomy preservation'. The results demonstrated acceptable measures of reliability and validity CONCLUSIONS: The PA-AMI questionnaire demonstrated satisfactory psychometric properties. Assessment of the included core dimensions may contribute to greater understanding of the appraisal processes for patients afflicted by an acute myocardial infarction.

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