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Publications (10 of 97) Show all publications
Svedbo Engström, M., Johansson, U.-B., Linder, E., Leksell, J. & Eeg-Olofsson, K. (2021). Att implementera Diabetesenkäten som kliniskt verktyg i diabetesvården: erfarenheter från patienter, diabetessjuksköterskor och läkare. In: : . Paper presented at Diabetesforum, Svenska Mässan, Göteborg, 1-3 december 2021.
Open this publication in new window or tab >>Att implementera Diabetesenkäten som kliniskt verktyg i diabetesvården: erfarenheter från patienter, diabetessjuksköterskor och läkare
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2021 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:du-39194 (URN)
Conference
Diabetesforum, Svenska Mässan, Göteborg, 1-3 december 2021
Available from: 2021-12-22 Created: 2021-12-22 Last updated: 2023-04-14Bibliographically approved
Husdal, R., Thors Adolfsson, E., Leksell, J. & Nordgren, L. (2021). Diabetes care provided by national standards can improve patients' self-management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care. Health Expectations, 24(3), 1000-1008
Open this publication in new window or tab >>Diabetes care provided by national standards can improve patients' self-management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care
2021 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 24, no 3, p. 1000-1008Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:du-36777 (URN)10.1111/hex.13247 (DOI)000633861500001 ()33774899 (PubMedID)2-s2.0-85103203495 (Scopus ID)
Available from: 2021-05-05 Created: 2021-05-05 Last updated: 2023-04-14Bibliographically approved
Nerpin, E., Toft, E., Fischier, J., Lindholm-Olinder, A. & Leksell, J. (2020). A virtual clinic for the management of diabetes-type 1: study protocol for a randomised wait-list controlled clinical trial. BMC Endocrine Disorders, 20(1)
Open this publication in new window or tab >>A virtual clinic for the management of diabetes-type 1: study protocol for a randomised wait-list controlled clinical trial
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2020 (English)In: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 20, no 1Article in journal (Refereed) Published
National Category
Nursing
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-34996 (URN)10.1186/s12902-020-00615-3 (DOI)000568431800002 ()32891126 (PubMedID)2-s2.0-85090376813 (Scopus ID)
Available from: 2020-09-15 Created: 2020-09-15 Last updated: 2023-09-13Bibliographically approved
Forsman, H., Jansson, I., Leksell, J., Lepp, M., Sundin Andersson, C., Engström, M. & Nilsson, J. (2020). Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students.. Journal of Advanced Nursing, 76, 199-208
Open this publication in new window or tab >>Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students.
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2020 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, p. 199-208Article in journal (Refereed) Published
Abstract [en]

AIMS: To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme and students' general self-efficacy.

DESIGN: A cross-sectional study combining survey data and results from a national examination.

METHODS: Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self-Efficacy scale and results from the National Clinical Final Examination. A Two-Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.

RESULTS: Three clusters were identified illustrating students' different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

CONCLUSION: The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

IMPACT: The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self-efficacy lower than other students. The findings illuminate the need for student-centered strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

Keywords
cluster analysis, nursing education, nursing students, professional competence, questionnaires, self-assessment, survey
National Category
Nursing
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-30964 (URN)10.1111/jan.14222 (DOI)000492752500001 ()31576579 (PubMedID)2-s2.0-85074600928 (Scopus ID)
Available from: 2019-10-16 Created: 2019-10-16 Last updated: 2021-11-12Bibliographically approved
Granstam, E., Rosenblad, A., Modher Raghib, A., Granström, T., Eriksson, J. W., Lindholm Olinder, A. & Leksell, J. (2020). Long-term follow-up of antivascular endothelial growth factor treatment for diabetic macular oedema: a four-year real-world study. Acta Ophthalmologica, 98, 360-367
Open this publication in new window or tab >>Long-term follow-up of antivascular endothelial growth factor treatment for diabetic macular oedema: a four-year real-world study
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2020 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 98, p. 360-367Article in journal (Refereed) Published
Abstract [en]

Purpose

To evaluate visual acuity (VA) and central retinal thickness (CRT) on optical coherence tomography during a 4‐year period in patients treated for sight‐threatening diabetic macular oedema (DMO) at two Swedish county hospitals. Additionally, to compare health‐related quality of life and subjective visual functioning before and after 4 years of treatment.

Methods

Fifty‐eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor (VEGF) treatment. VA, CRT and clinical data were retrospectively reviewed. Health‐related quality of life and subjective visual functioning were evaluated with Short Form Health Survey (SF‐36) and National Eye Institute Vision Functioning Questionnaire 25 (VFQ‐25). Comparisons between independent groups were performed using Pearson's χ2 test, Fisher's exact test or Mann–Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed‐rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years.

Results

Follow‐up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow‐up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti‐VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF‐36 showed no change at 4 years, compared with baseline. VFQ‐25 demonstrated improvement in near vision activities (p = 0.036).

Conclusion

Significant long‐term improvement in visual function was present in patients with anti‐VEGF‐treated DMO.

Keywords
anti-VEGF treatment, diabetic macular oedema, long-term follow-up, longitudinal study, real-world study, visual acuity
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-31172 (URN)10.1111/aos.14290 (DOI)000492664100001 ()2-s2.0-85074598945 (Scopus ID)
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2021-11-12Bibliographically approved
Svedbo Engström, M., Leksell, J., Johansson, U.-B., Borg, S., Palaszewski, B., Franzén, S., . . . Eeg-Olofsson, K. (2020). New diabetes questionnaire to add patients’ perspectives to diabetes care for adults with type 1 and type 2 diabetes – Nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables. BMJ Open, 10(11), Article ID e038966.
Open this publication in new window or tab >>New diabetes questionnaire to add patients’ perspectives to diabetes care for adults with type 1 and type 2 diabetes – Nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables
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2020 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 11, article id e038966Article in journal (Refereed) Published
Abstract [en]

Objectives To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting.

Design Cross-sectional survey.

Setting Swedish diabetes care clinics connected to the National Diabetes Register (NDR).

Participants Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate.

Outcome measures The Diabetes Questionnaire, the generic 36-item Short Form version 2 (SF-36v2) health survey and clinical variables.

Results Related to the prespecified assumptions, supporting evidence for construct validity for the Diabetes Questionnaire was found. Supporting divergent validity, the statistically significant correlations with the clinical variables were few and weak. In relation to the SF-36v2 and in support of convergent validity, the strongest correlations were seen in the Diabetes Questionnaire scales General Well-being and Mood and Energy. In those scales, machine learning analyses showed that about 40%–45% of the variance was explained by the SF-36v2 results and clinical variables. In multiple regression analyses among three groups with differing levels of glycated haemoglobin adjusted for demographics, other risk factors, and diabetes complications, the high-risk group had, in support of sensitivity to clinically relevant groups, statistically significant lower scores than the well-controlled group in most Diabetes Questionnaire scales.

Conclusions This nation-wide study shows that the Diabetes Questionnaire captures some generic health-related quality-of-life dimensions, in addition to adding diabetes-specific information not covered by the SF-36v2 and clinical variables. The Diabetes Questionnaire is also sensitive to differences between clinically relevant groups of glycaemic control.

Keywords
Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Patient-reported outcome; Cross-Sectional Study; Construct validity
National Category
Endocrinology and Diabetes
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-35289 (URN)10.1136/bmjopen-2020-038966 (DOI)000595708300037 ()33203629 (PubMedID)2-s2.0-85096348515 (Scopus ID)
Available from: 2020-10-23 Created: 2020-10-23 Last updated: 2023-08-28Bibliographically approved
Husdal, R., Thors Adolfsson, E., Leksell, J., Eliasson, B., Jansson, S., Jerdén, L., . . . Rosenblad, A. (2020). Organisation of primary diabetes care in people with type 2 diabetes in relation to all-cause mortality: A nationwide register-based cohort study. Diabetes Research and Clinical Practice, 167, Article ID 108352.
Open this publication in new window or tab >>Organisation of primary diabetes care in people with type 2 diabetes in relation to all-cause mortality: A nationwide register-based cohort study
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2020 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 167, article id 108352Article in journal (Refereed) Published
Abstract [en]

AIMS: To examine if personnel resources and organisational features in Swedish primary health-care centres (PHCCs) are associated to all-cause mortality (ACM) in people with type 2 diabetes mellitus (T2DM).

METHODS: A total of 187,570 people with T2DM registered in the Swedish National Diabetes Register (NDR) during 2013 were included in this nationwide cohort study. Individual NDR data were linked to data from a questionnaire addressing personnel resources and organisational features for 787 (68%) PHCCs as well as to individual data on socio-economic status and comorbidities. Furthermore, data on ACM were obtained and followed up until 30 January 2018. Hierarchical Cox regression analyses were applied.

RESULTS: After a median follow-up of 4.2 years, 27,136 (14.5%) participants had died. An association was found between number of whole-time-equivalent (WTE) general practitioner's (GP's) devoted to diabetes care/500 people with T2DM and lower risk of early death (hazard ratio 0.919 [95% confidence interval 0.895-0.945] per additional WTE GP; p = 0.002). No other personnel resources or organisational features were significantly associated with ACM.

CONCLUSIONS: This nationwide register-based cohort study suggests that the number of WTE GPs devoted to diabetes care have an impact on the risk of early death in people with T2DM.

Keywords
All-cause mortality, Organisation, Primary health care, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-34667 (URN)10.1016/j.diabres.2020.108352 (DOI)000580069500014 ()32712123 (PubMedID)2-s2.0-85088838561 (Scopus ID)
Available from: 2020-08-07 Created: 2020-08-07 Last updated: 2023-01-17Bibliographically approved
Eeg-Olofsson, K., Johansson, U.-B., Linder, E. & Leksell, J. (2020). Patients' and Health Care Professionals' Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study.. Journal of Medical Internet Research, 22(8), Article ID e17504.
Open this publication in new window or tab >>Patients' and Health Care Professionals' Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study.
2020 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, no 8, article id e17504Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers.

OBJECTIVE: The objective of the study was to conduct focus group interviews to capture patients' and health care professionals' perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study.

METHODS: A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach.

RESULTS: Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients' and professionals' involvement in diabetes care using digital tools.

CONCLUSIONS: The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.

Keywords
Digital questionnaire, diabetes care, eHealth , focus group interview, health care professionals, qualitative research
National Category
Nursing
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-34865 (URN)10.2196/17504 (DOI)000576700600001 ()32812884 (PubMedID)2-s2.0-85089768683 (Scopus ID)
Available from: 2020-08-25 Created: 2020-08-25 Last updated: 2024-01-17
Katsogiannos, P., Randell, E., Sundbom, M., Rosenblad, A., Eriksson, J. W. & Leksell, J. (2020). Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients’ experiences during 2 years of follow-up. Diabetology and Metabolic Syndrome, 12(1)
Open this publication in new window or tab >>Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients’ experiences during 2 years of follow-up
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2020 (English)In: Diabetology and Metabolic Syndrome, ISSN 1758-5996, E-ISSN 1758-5996, Vol. 12, no 1Article in journal (Refereed) Published
Abstract [en]

Background

To examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods.

Methods

Thirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed.

Results

Significant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme “Finding a balance between the experience of the new body weight and self-confidence”.

Conclusions

The improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness.

Keywords
RYGB, Quality of life, Type 2 diabetes
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-35225 (URN)10.1186/s13098-020-00597-1 (DOI)000576819600001 ()2-s2.0-85092502604 (Scopus ID)
Note

Trial registration ClinicalTrials.gov Identifier NCT02729246. Date of registration 6 April 2016 – Retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02729246?term=bariglykos&draw=2&rank=1

Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2021-11-12
Svedbo Engström, M., Leksell, J., Johansson, U.-B., Borg, S., Palaszewski, B., Franzén, S., . . . Eeg-Olofsson, K. (2019). A new diabetes questionnaire to add patients’ perspectives to diabetes care: A nationwide cross-sectional study among adults with type 1 and type 2 diabetes.. In: : . Paper presented at EASD (The European Association for the Study of Diabetes) Annual meeting 2019, Barcelona, 2019-09-20.
Open this publication in new window or tab >>A new diabetes questionnaire to add patients’ perspectives to diabetes care: A nationwide cross-sectional study among adults with type 1 and type 2 diabetes.
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Endocrinology and Diabetes
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-31087 (URN)
Conference
EASD (The European Association for the Study of Diabetes) Annual meeting 2019, Barcelona, 2019-09-20
Available from: 2019-11-11 Created: 2019-11-11 Last updated: 2021-11-12Bibliographically approved
Projects
Sjuksköterskors självskattade kompetens
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8682-2045

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