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Fagerstrom, Cecilia
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Publications (10 of 52) Show all publications
Marcinowicz, L., Jamiołkowski, J., Gugnowski, Z., Strandberg, E. L., Fagerström, C. & Pawlikowska, T. (2017). Evaluation of the trust in physician scale (TIPS) of primary health care patients in north-east poland: A preliminary study. Family Medicine and Primary Care Review, 19(1), 39-43
Open this publication in new window or tab >>Evaluation of the trust in physician scale (TIPS) of primary health care patients in north-east poland: A preliminary study
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2017 (English)In: Family Medicine and Primary Care Review, ISSN 1734-3402, Vol. 19, no 1, p. 39-43Article in journal (Refereed) Published
Abstract [en]

Background. Trust is a complex concept, difficult to study, but very important in a patient-family physician relationship. One of the measures used to assess interpersonal trust is a scale developed by Anderson & Dedrick entitled the Trust in Physician Scale (TI PS). Objectives. The aim of the study was to assess the TI PS properties in relation to the age, gender, and health status of primary health care patients consulting family doctors and trainees in north-east Poland. Material and methods. A cross-sectional study using the TI PS was conducted in primary health care units in north-east Poland. 120 patients (60 who came to see family doctors, and 60 who came to see trainees) were asked to participate in the survey. Results. The Trust in Physician Scale has good reliability in primary care patients in north-east Poland (Cronbach’s alpha coefficient was 0.90). Patients displayed statistically significant greater trust in family doctors than in trainees. A negative correlation was found between age and the trust scale (r = -0.30; p = 0.005); the younger the respondent, the higher trust in the physician, and conversely, a positive correlation between self-assessment of health and the trust scale (r = 0.3; p = 0.003). Conclusions. The Polish translation of the TI PS instrument performed well in terms of acceptability in the family medicine environment. It can be used to differentiate between the level of trust in family doctors and in trainees. A relation between age, sex, education level and self-assessment of health needs to be confirmed using a larger sample. © Wydawnictwo Continuo.

Place, publisher, year, edition, pages
Polish Society of Family Medicine, 2017
Keywords
Doctor–patient relationship, Patient trust, Questionnaire, The trust in physician scale, cross-sectional study, doctor patient relation, family medicine, female, gender, general practitioner, health status, human, major clinical study, male, Poland, reliability, self evaluation, sexual education, student, trust
National Category
Nursing
Identifiers
urn:nbn:se:bth-14094 (URN)10.5114/fmpcr.2017.65089 (DOI)000398934500008 ()2-s2.0-85016439210 (Scopus ID)
Available from: 2017-04-13 Created: 2017-04-13 Last updated: 2018-05-24Bibliographically approved
Wimo, A., Elmstål, S., Fratiglioni, L., Sjölund, B.-M., Sköldunger, A., Fagerström, C., . . . Lagergren, M. (2017). Formal and informal care of community-living older people: A population-based study from the Swedish National study on Aging and Care. The Journal of Nutrition, Health & Aging, 21(§), 17-24
Open this publication in new window or tab >>Formal and informal care of community-living older people: A population-based study from the Swedish National study on Aging and Care
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2017 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no §, p. 17-24Article in journal (Refereed) Published
Abstract [en]

Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC). Design: Cross-sectional, population based cohort. Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County. Participants: 3,338 persons ≥72 years. Measurements: Patterns and amounts of informal and formal care by cognition and area of residence. Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole. Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
DEMENTED ELDERLY PERSONS; NURSING-HOME PLACEMENT; ALZHEIMERS-DISEASE; FAMILY CAREGIVERS; ADVANCED AGE; LINE DATA; COSTS; BURDEN; TIME; DETERMINANTS
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:bth-13123 (URN)10.1007/s12603-016-0747-5 (DOI)000394347000003 ()2-s2.0-84969983766 (Scopus ID)
Available from: 2016-10-04 Created: 2016-10-03 Last updated: 2017-11-30Bibliographically approved
Fagerström, C., Tuvesson, H., Axelsson, L. & Nilsson, L. (2017). The role of ICT in nursing practice: An integrative literature review of the Swedish context. Scandinavian Journal of Caring Sciences, 434-448
Open this publication in new window or tab >>The role of ICT in nursing practice: An integrative literature review of the Swedish context
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, p. 434-448Article in journal (Refereed) Published
Abstract [en]

Background: The Swedish healthcare system employs information and communication technologies (ICT) in nursing practice to meet quality-, security- and efficiency-related demands. Although ICT is integrated with nursing practices, nurses do not always feel that they are convenient to use it. We need to improve our knowledge of the role of ICT in healthcare environments and so we decided to complement existing experience of how ICT influences nursing practice. Aim: This study aimed to review and synthesise the available literature on the role of ICT in nursing practice in Swedish healthcare settings. Method: To consolidate previous studies based on diverse methodologies, an integrative literature review was carried out. Three databases were used to search for literature, 20 articles met the inclusion criteria. Results: The literature review indicates that ICT integration into nursing practice is a complex process that impacts nurses’ communication and relationships in patient care, working conditions, and professional identities and development. Nurses are found to express ambiguous views on ICT as a usable service in their everyday practice since it impacts both positively and negatively. Discussion and conclusion: Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
Keywords
data base; doctor patient relation; human; human experiment; identity; nonverbal communication; nursing practice; patient care; work environment
National Category
Nursing Information Systems
Identifiers
urn:nbn:se:bth-13380 (URN)10.1111/scs.12370 (DOI)000412401200003 ()2-s2.0-84992489225 (Scopus ID)
Available from: 2016-11-11 Created: 2016-11-11 Last updated: 2018-01-13Bibliographically approved
Lagergren, M., Fagerstrom, C., Sjolund, B.-M., Sanmartin Berglund, J., Fratiglioni, L., Nordell, E., . . . Elmstahl, S. (2016). Horizontal and vertical targeting: a population-based comparison of public eldercare services in urban and rural areas of Sweden. Aging Clinical and Experimental Research, 28(1), 147-158
Open this publication in new window or tab >>Horizontal and vertical targeting: a population-based comparison of public eldercare services in urban and rural areas of Sweden
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2016 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, no 1, p. 147-158Article in journal (Refereed) Published
Abstract [en]

The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
Urban/rural differences, Long-term care, Older people, Public care, Eldercare, Target efficiency
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:bth-11777 (URN)10.1007/s40520-015-0369-5 (DOI)000371249700016 ()25990665 (PubMedID)
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2017-11-30Bibliographically approved
Selan, S., Hellström, A. & Fagerström, C. (2016). Impact of nutritional status and sleep quality on hospital utilisation in the oldest old with heart failure. The Journal of Nutrition, Health & Aging, 20(2), 170-177
Open this publication in new window or tab >>Impact of nutritional status and sleep quality on hospital utilisation in the oldest old with heart failure
2016 (English)In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 20, no 2, p. 170-177Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF). Design: Single-centred longitudinal observational study. Setting: South-eastern Sweden. Participants: 90 elderly (80+) with objectively verified HF. Measurements: Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n=90) and at a three-year follow-up (n=41). Data on hospital utilisation during the three years following the HF diagnosis were also collected. Results: Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period. Conclusion: In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present. © 2016, Serdi and Springer-Verlag France.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
80+; heart failure; hospital utilisation; nutritional status; sleep quality
National Category
Nursing
Identifiers
urn:nbn:se:bth-11673 (URN)10.1007/s12603-015-0594-9 (DOI)000374701200011 ()2-s2.0-84957838844 (Scopus ID)
Available from: 2016-03-02 Created: 2016-02-29 Last updated: 2017-11-30Bibliographically approved
Hellström, A., Nilsson, C., Nilsson, A. & Fagerström, C. (2016). Leg ulcers in older people: A national study addressing variation in diagnosis, pain and sleep disturbance. BMC Geriatrics, 16, Article ID 25.
Open this publication in new window or tab >>Leg ulcers in older people: A national study addressing variation in diagnosis, pain and sleep disturbance
2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 25Article in journal (Refereed) Published
Abstract [en]

Background: Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. Methods: The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9 % were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. Results: We found the prevalence of pain intensity ≥ 5 on the NRS to be 34.8 % in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8 % of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venous-arterial ulcers increased the risk of sleep disturbances, as did higher pain scores. Conclusions: The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met. National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed. © 2016 Hellström et al.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Leg ulcers; Older people; Pain; Sleep disturbances
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:bth-11569 (URN)10.1186/s12877-016-0198-1 (DOI)000368459400002 ()2-s2.0-84954525184 (Scopus ID)
Note

Open access

Available from: 2016-02-03 Created: 2016-02-03 Last updated: 2017-11-30Bibliographically approved
M., N., H., F. & Cecilia, F. (2016). Malnutrition, functional ability and mortality among older people aged ⩾60 years: a 7-year longitudinal study. European Journal of Clinical Nutrition, 70(3), 399-404
Open this publication in new window or tab >>Malnutrition, functional ability and mortality among older people aged ⩾60 years: a 7-year longitudinal study
2016 (English)In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 70, no 3, p. 399-404Article in journal (Refereed) Published
Abstract [en]

Background/Objectives:This study aimed to assess the association between risk of malnutrition and 7-year mortality, controlling for functional ability, socio-demographics, lifestyle behavior and diseases, and investigate the interaction between risk of malnutrition and functional ability on the risk of mortality.Subjects/Methods:A longitudinal study on home-living and special-housing residents aged â©Ÿ60 years was conducted. Of 2312 randomly invited participants, 1402 responded and 1203 provided information on both nutritional status and functional ability. The risk of malnutrition was estimated by the occurrence of at least one anthropometric measure (BMI, MAC and CC) below cut-off in addition to the presence of at least one subjective measure (decreased food intake, weight loss and eating difficulty).Results:At baseline, 8.6% of subjects were at risk of malnutrition and during the 7-year follow-up 34.6% subjects died. The risk of malnutrition was independently associated with 7-year mortality (hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.28–2.65). Additional independent predictors were dementia (HR 2.76, 95% CI 1.85–4.10), activity of daily living (ADL) dependence (HR 2.08, 95% CI 1.62–2.67), heart disease (HR 1.44, 95% CI 1.16–1.78), diabetes (HR 1.41, 95% CI 1.03–1.93) and older age (HR 1.09, 95% CI 1.07–1.10). Moreover, the risk of malnutrition and ADL dependence in combination predicted the poorest survival rate (18.7%, P<0.001).Conclusions:The risk of malnutrition significantly increases the risk of mortality in older people. Moreover, risk of malnutrition and ADL dependence together explain a significantly poorer survival rate; however, the importance of this interaction decreased in the multivariable model and risk of malnutrition and ADL dependence independently explained a significant risk of mortality.European Journal of Clinical Nutrition advance online publication, 25 November 2015; doi:10.1038/ejcn.2015.196. © 2015 Macmillan Publishers Limited

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
MINI-NUTRITIONAL ASSESSMENT; 3-YEAR FOLLOW-UP; ELDERLY-PEOPLE; PROSPECTIVE COHORT; 10-YEAR MORTALITY; SCREENING TOOLS; CARE SNAC; POPULATION; ADULTS; RISK
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:bth-11180 (URN)10.1038/ejcn.2015.196 (DOI)000371667700018 ()2-s2.0-84948400170 (Scopus ID)
Available from: 2015-12-11 Created: 2015-12-11 Last updated: 2017-12-01Bibliographically approved
Selan, S., Siennicki-Lantz, A., Berglund, J. & Fagerström, C. (2016). Self-awareness of heart failure in the oldest old-an observational study of participants, ≥ 80 years old, with an objectively verified heart failure. BMC Geriatrics, 16, Article ID 23.
Open this publication in new window or tab >>Self-awareness of heart failure in the oldest old-an observational study of participants, ≥ 80 years old, with an objectively verified heart failure
2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 23Article in journal (Refereed) Published
Abstract [en]

Background: One of the primary reasons for hospitalisation among elderly individuals with heart failure (HF) is poor self-care. Self-awareness of having HF may be a key-element in successful self-care. The prevalence of self-awareness of HF, and how it is affected by age-and HF-related factors, remains poorly understood. The aims of the present study were to determine the prevalence of self-awareness of HF in participants, ≥ 80 years of age, and to investigate the association between this self-awareness and age-related and HF-related factors. Methods: A single-centre observational study was conducted in which non-hospitalised participants (80+) with objectively verified HF were identified (n = 90). The statement of having HF or not having HF was used to divide the participants into two groups for comparisons: aware or unaware of one’s own HF. Logistic regression models were completed to determine the impact of age-and HF-related factors on self-awareness. Results: Twenty-six percent (23/90) were aware of their own HF diagnosis. No significant differences were found between the participants who were aware of their own HF diagnosis and the participants who were not. Neither age-nor HF-related factors had influence on the prevalence of self-awareness. Conclusions: Prevalence of self-awareness of own HF in the oldest old is insufficient, and this self-awareness may be influenced by external factors. One such factor is likely the manner in which the HF diagnosis is relayed to the patient by health care professionals. © 2016 Selan et al.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
80+; Heart failure; Oldest old; Prevalence; Self-awareness
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:bth-11570 (URN)10.1186/s12877-016-0195-4 (DOI)000368459200001 ()2-s2.0-84954465917 (Scopus ID)
Available from: 2016-02-03 Created: 2016-02-03 Last updated: 2017-11-30Bibliographically approved
Lindberg, T., Andersson, O., Palm, M. & Fagerstrom, C. (2015). A systematic review and meta-analysis of dressings used for wound healing: the efficiency of honey compared to silver on burns. Contemporary Nurse: health care across the lifespan, 51(2-3), 121-134
Open this publication in new window or tab >>A systematic review and meta-analysis of dressings used for wound healing: the efficiency of honey compared to silver on burns
2015 (English)In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 51, no 2-3, p. 121-134Article in journal (Refereed) Published
Abstract [en]

Background: Honey has the antibacterial effect of silver without the toxic effect of silver on the skin. Even so, silver is the dominant antibacterial dressing used in wound healing. Objectives: To evaluate the healing effects of honey dressings compared to silver dressings for acute or chronic wounds. Design: A systematic review with meta-analysis. Method: The search, conducted in seven databases, resulted in six randomised controlled trial studies from South Asia focusing on antibacterial properties and healing times of honey and silver. Result: Honey was more efficacious for wound healing than silver, as measured in the number of days needed for wounds to heal (pooled risk difference -20, 95% CI -0.29 to -0.11, p < .001). Honey turned out to have more antibacterial qualities than silver. Conclusion: All the included studies based on burns showed the unequivocal result that honey had an even more positive effect than silver on wound healing.

Place, publisher, year, edition, pages
Routledge, 2015
Keywords
antibacterial dressing; burns; honey; silver; wound healing
National Category
Nursing
Identifiers
urn:nbn:se:bth-12535 (URN)10.1080/10376178.2016.1171727 (DOI)000375908400002 ()27027667 (PubMedID)
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2017-11-28Bibliographically approved
Lindberg, C., Sivberg, B., Willman, A. & Fagerström, C. (2015). A trajectory towards partnership in care - Patient experiences of autonomy in intensive care: A qualitative study. Intensive & Critical Care Nursing, 31(5), 294-302
Open this publication in new window or tab >>A trajectory towards partnership in care - Patient experiences of autonomy in intensive care: A qualitative study
2015 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 5, p. 294-302Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to describe and elucidate patient experiences of autonomy in an intensive care context from a caring perspective. Background: Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients’ vital functions but also of their decision-making. Methods: A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. The data were analysed using Inductive Content Analysis. Findings: Patient autonomy in intensive care was shown to be ’A trajectory towards partnership in care depending on state of health and mutual understanding’. It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care. Conclusion: Patients in need of intensive care wanted to be involved in making decisions about their care as this creates a trusting and healthy care environment. Greater awareness is required about the ICU patient not only being a passive care recipient but also an active agent and where involvement in decision-making and participation in care are crucial. © 2015 Elsevier Ltd.

Keywords
Caring; Content analysis; Intensive care; Interviews; Patient Autonomy; Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:bth-10886 (URN)10.1016/j.iccn.2015.04.003 (DOI)000362147700005 ()2-s2.0-84941738418 (Scopus ID)
Available from: 2015-10-26 Created: 2015-10-26 Last updated: 2017-12-01Bibliographically approved
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