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1.  Central venous oxygen saturation during cardiopulmonary bypass predicts 3-year survival 
OBJECTIVES
Long-term survival after cardiac surgery is determined by a number of different risk factors. Central venous oxygen saturation (SvO2) measures the balance between oxygen delivery and demand. SvO2 levels in the intensive care situation are reported to be associated with patient outcome. The present report explores the connection between SvO2 during cardiopulmonary bypass (CPB) and survival after cardiac surgery.
METHODS
Retrospective analysis of one thousand consecutive cardiac surgical patients was undertaken. SvO2 during CPB was monitored online. Registry data combining specific risk factors with SvO2 were selected for Kaplan–Meier and Cox regression analysis to examine the influence on 30-day and 3-year survivals.
RESULTS
Nine-hundred and thirty-two patient records were eligible for analysis. SvO2 below 75% during CPB was associated with significantly shorter 30-day and 3-year survivals. Based on Kaplan–Meier statistics, the survival rate decreased by 3.1% (98.1–95.0), P = 0.011 and 6.1% (92.7–86.6), P = 0.003, respectively. The influence of SvO2 on 3-year survival remained statistically significant after controlling for a series of risk factors in the Cox regression analysis. Patients with SvO2 <75% carried a 2-fold (odds ratio 2.1) increased relative risk of shortened 3-year survival (P = 0.003). Other risk factors statistically significantly associated with 3-year survival were age, gender, duration of CPB, blood temperature, hypertension, haematocrit and type of surgical procedure.
CONCLUSIONS
We report decreased 30-day and 3-year survival expectancy for patients experiencing SvO2 lower than 75% during CPB.
doi:10.1093/icvts/ivs363
PMCID: PMC3523619  PMID: 23065747
Survival; Cardiopulmonary bypass; Venous oxygen saturation; Systemic blood flow
2.  Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden 
BMC Family Practice  2013;14:143.
Background
Overweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care.
Method
A qualitative study, based on open-ended interviews, involving 18 CHC-nurses strategically selected from 17 CHC Centres in the southern part of Sweden using a phenomenographic approach.
Results
Two categories of description emerged from the data: (i) Internal obstacles to the CHC- nurses’ work with overweight in children and (ii) External obstacles to the management of overweight in children. The CHC-nurses conceived their work with overweight in Child Health Care to be complicated and constrained by several obstacles depending on the nurses’ personal priorities, knowledge, responsibility and the absence of resources and cooperation, as well as the lack of uniform guidelines for preventing and managing childhood overweight and further a deficient management organisation.
Conclusion
Nurses’ attention to monitoring overweight in children, and their initiative for prevention, is based on their conceptions of the obstacles that hinder them in their efforts. An increased awareness of the CHC-nurses conceptions of the priorities, their sense of responsibility and prevention practices is warranted. If measures in this direction are not taken there is a growing risk that overweight children will pass through the CHC without any formal recognition of their situation. There is an indication that the present level of the CHC-nurses’ preventive work with childhood overweight has room for improvement in several areas. It is suggested that the specialist education of these health care professionals should be supplemented and that organisation of the management of childhood overweight should be also revised at the primary health care level.
doi:10.1186/1471-2296-14-143
PMCID: PMC3852529  PMID: 24079391
Child; Nurses; Obesity; Overweight; Perceptions; Preventive work; Primary care; Qualitative research
3.  Swedish Child Health Care nurses conceptions of overweight in children: a qualitative study 
BMC Family Practice  2012;13:57.
Background
Registered Sick Children’s Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care.
Method
A qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden.
Results
Four categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent’s lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight.
Conclusion
CHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse’s conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse’s, as well as the parent’s efforts to influence the children’s weight. It is suggested that CHC- nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight.
doi:10.1186/1471-2296-13-57
PMCID: PMC3426496  PMID: 22697580
Child; Conceptions; Nurses; Overweight; Perceptions; Primary health care; Qualitative research
4.  An occupational therapy approach to the support of a young immigrant female's mental health: A story of bicultural personal growth 
Young immigrants who suffer from psychosis perceive their illness from the outlook of at least two cultures, which is often a source of confusion and misunderstanding for clients, their families, and clinicians. This article presents a case study with a narrative approach, aiming to illustrate how an occupational therapy intervention can highlight the role of culture and address bicultural identification in a young adult immigrant woman with mental health problems. The results show how a culturally adapted intervention model can be used to help the client go through a transition from an interdependent to a more independent self. During the course of occupational therapy, the client gained greater insight into her problems and could view herself as integrating numerous facets related to two different social and cultural contexts. Moreover, the client achieved better skills in dealing with discrepancies and cultural contradictions and became capable of relying on either or both of the cultures in different situations.
doi:10.3402/qhw.v6i3.7084
PMCID: PMC3171197  PMID: 21912570
Young immigrant; psychosis; interdependent self; occupational therapy
5.  The impact of personality factors on delay in seeking treatment of acute myocardial infarction 
Background
Early hospital arrival and rapid intervention for acute myocardial infarction is essential for a successful outcome. Several studies have been unable to identify explanatory factors that slowed decision time. The present study examines whether personality, psychosocial factors, and coping strategies might explain differences in time delay from onset of symptoms of acute myocardial infarction to arrival at a hospital emergency room.
Methods
Questionnaires on coping strategies, personality dimensions, and depression were completed by 323 patients ages 26 to 70 who had suffered an acute myocardial infarction. Tests measuring stress adaptation were completed by 180 of them. The patients were then categorised into three groups, based on time from onset of symptoms until arrival at hospital, and compared using logistic regression analysis and general linear models.
Results
No correlation could be established between personality factors (i.e., extraversion, neuroticism, openness, agreeableness, conscientiousness) or depressive symptoms and time between onset of symptoms and arrival at hospital. Nor was there any significant relationship between self-reported patient coping strategies and time delay.
Conclusions
We found no significant relationship between personality factors, coping strategies, or depression and time delays in seeking hospital after an acute myocardial infraction.
doi:10.1186/1471-2261-11-21
PMCID: PMC3123302  PMID: 21595967
6.  Test - retest reliability of two instruments for measuring public attitudes towards persons with mental illness 
BMC Psychiatry  2011;11:11.
Background
Research has identified stigmatization as a major threat to successful treatment of individuals with mental illness. As a consequence several anti-stigma campaigns have been carried out. The results have been discouraging and the field suffers from lack of evidence about interventions that work. There are few reports on psychometric data for instruments used to assess stigma, which thus complicates research efforts. The aim of the present study was to investigate test-retest reliability of the Swedish versions of the questionnaires: FABI and "Changing Minds" and to examine the internal consistency of the two instruments.
Method
Two instruments, fear and behavioural intentions (FABI) and "Changing Minds", used in earlier studies on public attitudes towards persons with mental illness were translated into Swedish and completed by 51 nursing students on two occasions, with an interval of three weeks. Test-retest reliability was calculated by using weighted kappa coefficient and internal consistency using the Cronbach's alpha coefficient.
Results
Both instruments attain at best moderate test-retest reliability. For the Changing Minds questionnaire almost one fifth (17.9%) of the items present poor test-retest reliability and the alpha coefficient for the subscales ranges between 0.19 - 0.46. All of the items in the FABI reach a fair or a moderate agreement between the test and retest, and the questionnaire displays a high internal consistency, alpha 0.80.
Conclusions
There is a need for development of psychometrically tested instruments within this field of research.
doi:10.1186/1471-244X-11-11
PMCID: PMC3025948  PMID: 21235749

Results 1-6 (6)