Kerstin Blomqvist

Impact of Chronic Heart Failure on Elderly Persons' Daily Life: A Validation Study

Background: Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons. Aim: To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population. Methods: The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used. Results: A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbachs α for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%). Conclusions: The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.

Social support and its association with health-related quality of life among older patients with chronic heart failure

Background: Social support is generally known to influence health-related quality of life (HRQoL), but this association is not well explored among older patients with chronic heart failure. Aims: (1) To describe social support in older patients with chronic heart failure in relation to gender. (2) To investigate if age, gender, cohabitation, perceived financial situation, and disease severity are associated with social support. (3) To investigate if social support is associated with HRQoL after controlling for age, gender, and disease severity. Methods: Data were collected in a sample of 349 patients (≥65 years) with chronic heart failure. Patients’ HRQoL was measured with the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. The Interview Schedule for Social Interaction measured social support. Data were analysed with descriptive statistics, repeated-measure ANOVA, and multiple linear regression analyses with robust standard errors. Results: Social support was generally rated high, although being a man, living alone, perceiving a problematic financial situation, and high disease severity (NYHA) were associated with lower levels of social support. Age was not associated with social support. Social support was generally associated with HRQoL, in particular the emotional dimensions. Conclusion: Taking social support into account when caring for older patients with heart failure can be of importance for improving or maintaining HRQoL.

How to make a workplace health promotion questionnaire process applicable, meaningful and sustainable.

BACKGROUND In workplace health promotion, a questionnaire could be of great use. Unfortunately, fatigue regarding answering questionnaires has recently become greater than before. An action research approach could be a possible way of increasing employee participation. AIM This study reports an attempt to explore key aspects for participation in, and commitment to, a workplace health promotion questionnaire process. METHOD The study was conducted at two wards in a Swedish hospital. Data was collected during an action research process. Data were analysed with regard to a framework of questions. FINDINGS The three key aspects for participation in, and commitment to, a workplace health promotion questionnaire process were: an applicable questionnaire, a meaningful questionnaire process and a continuous and sustainable questionnaire process. A structure is presented as practical advice to managers, describing how such a process could be established to be applicable, meaningful and sustainable. CONCLUSION This study has identified key aspects and prerequisites for questionnaire processes. The prerequisites - share decision-making, involve a core group and follow a structure - are discussed and proposed for managers and workgroups to consider in further workplace health promotion questionnaire processes. IMPLICATIONS FOR NURSING MANAGEMENT The key aspects and prerequisites presented could provide a stimulating standpoint or advice, useful for planning and accomplishing workplace questionnaire processes.

Encountering existential loneliness among older people: perspectives of health care professionals

ABSTRACT Purpose: Existential loneliness is part of being human that is little understood in health care, but, to provide good care to their older patients, professionals need to be able to meet their existential concerns. The aim of this study was to explore health care professionals’ experiences of their encounters with older people they perceive to experience existential loneliness. Method: We conducted 11 focus groups with 61 health professionals working in home care, nursing home care, palliative care, primary care, hospital care, or pre-hospital care. Our deductive–inductive analytical approach used a theoretical framework based on the work of Emmy van Deurzen in the deductive phase and an interpretative approach in the inductive phase. Results: The results show that professionals perceived existential loneliness to appear in various forms associated with barriers in their encounters, such as the older people’s bodily limitations, demands and needs perceived as insatiable, personal shield of privacy, or fear and difficulty in encountering existential issues. Conclusion: Encountering existential loneliness affected the professionals and their feelings in various ways, but they generally found the experience both challenging and meaningful.

Designing an ICT self-management service: suggestions from persons with type 2 diabetes

This paper reports the wishes and needs of people with type 2 diabetes (T2DM) for a future information and communication technology (ICT) self-management service to help manage their condition and their everyday life. Diabetes is a chronic disease affecting more and more people and placing increasing demands on health care. The self-management of diabetes includes instrumental and, decision-making skills and skills in managing daily activities, which may be supported by an ICT service. In this study we used a participatory design including two sessions of Future Workshop (FW) as part of a larger research project on the self-management of diabetes. Adults with type 2 diabetes participated in two FW sessions in which their expressed wishes and needs for an ICT service all fell under the broad category of Acceptance of the diagnosis, with three other suggestions; Trust in partnerships, Communication, and Individualized information. The participants’ experience of the FW as a democratic process and their appreciation of mutual learning contributed to these results, which are consistent with the aims of person-centred care.

Coexisting Needs: Paradoxes in Collegial Reflection—The Development of a Pragmatic Method for Reflection

This paper addresses a feasibility study of a method for recurrent collegial reflection. A qualitative approach, using a participatory research design, was adopted. The collegial reflection was implemented in a school, in a middle-sized municipality in southern Sweden, with 21 teachers participating in the intervention. Data collection included digital recordings of collegial reflection, open questions by mail, and individual interviews. Findings indicated one major theme, paradoxes in the design of the collegial reflection, and three categories: wanting to decide and wanting to be guided; meeting each other as teachers and/or as persons; and looking for the safe and/or looking for the new. Before implementing the method in another context, management needs to appreciate these contradictory experiences, allow for voluntary participation, address participants’ expectations, and allocate time and tasks. This study implicates that collegial reflection may contribute to teachers’ professional development, and it is thereby relevant to teachers’ classroom practice and pupils’ learning. We conclude that, by creating a structure which supports teachers’ collegial reflection, the school may function as a supportive environment, which may contribute to teacher retention.