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Svedbo Engström, MariaORCID iD iconorcid.org/0000-0002-8267-592X
Publications (4 of 4) Show all publications
Svedbo Engström, M., Leksell, J., Johansson, U.-B., Borg, S., Palaszewski, B., Franzén, S., . . . Eeg-Olofsson, K. (2019). Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study. Health and Quality of Life Outcomes, 17(1), Article ID 141.
Open this publication in new window or tab >>Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study
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2019 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, no 1, article id 141Article in journal (Refereed) Published
Abstract [en]

Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.

Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36- item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.

Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.

Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

Keywords
Diabetes mellitus, type 1, Diabetes mellitus, type 2, Health-related quality of life, SF-36, Cross-sectional study
National Category
Endocrinology and Diabetes
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30618 (URN)10.1186/s12955-019-1212-z (DOI)000480805700002 ()31412881 (PubMedID)2-s2.0-85071014854 (Scopus ID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-10-22Bibliographically approved
Borg, S., Eeg-Olofsson, K., Palaszewski, B., Svedbo Engström, M., Gerdtham, U.-G. & Gudbjörnsdottir, S. (2018). Patient-reported outcome and experience measures for diabetes: development of scale models, differences between patient groups and relationships with cardiovascular and diabetes complication risk factors, in a combined registry and survey study in Sweden. BMJ Open, 9(1), Article ID e025033.
Open this publication in new window or tab >>Patient-reported outcome and experience measures for diabetes: development of scale models, differences between patient groups and relationships with cardiovascular and diabetes complication risk factors, in a combined registry and survey study in Sweden
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 1, article id e025033Article in journal (Refereed) Published
Abstract [en]

Purpose The Swedish National Diabetes Register (NDR) has developed a diabetes-specific questionnaire to collect information on individuals' management of their diabetes, collaboration with healthcare providers and the disease’s impact on daily life. Our main objective was to develop measures of well-being, abilities to manage diabetes and judgements of diabetes care, and to detect and quantify differences using the NDR questionnaire.

Design, setting and participants The questionnaire was analysed with using responses from 3689 participants with type 1 and 2 diabetes, randomly sampled from the NDR population, combined with register data on patient characteristics and cardiovascular and diabetes complication risk factors.

Methods We used item response theory to develop scales for measuring well-being, abilities to manage diabetes and judgements of diabetes care (scores). Test–retest reliability on the scale level was analysed with intraclass correlation. Associations between scores and risk factor levels were investigated with subgroup analyses and correlations.

Results We obtained scales with satisfactory measurement properties, covering patient reported outcome measures such as general well-being and being free of worries, and patient reported experience measure, for example, access and continuity in diabetes care. All scales had acceptable test–retest reliability and could detect differences between diabetes types, age, gender and treatment subgroups. In several aspects, for example, freedom of worries, type 1 patients report lower than type 2, and younger patients lower than older. Associations were found between some scores and glycated haemoglobin, but none with systolic blood pressure or low-density lipoprotein cholesterol. Clinicians report positive experience of using scores, visually presented, in the patient dialogue.

Conclusions The questionnaire measures and detects differences in patient well-being, abilities and judgements of diabetes care, and identifies areas for improvement. To further improve diabetes care, we conclude that patient-reported measures are important supplements to cardiovascular and diabetes complication risk factors, reflecting patient experiences of living with diabetes and diabetes care.

Keywords
Diabetes, Item Response Theory (IRT), Patient Reported Outcomes Measures (PROM), Patient Reported Experience Measures (PREM)
National Category
Endocrinology and Diabetes
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29178 (URN)10.1136/bmjopen-2018-025033 (DOI)000471116800222 ()30612113 (PubMedID)2-s2.0-85059500159 (Scopus ID)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-07-22Bibliographically approved
Svedbo Engström, M., Leksell, J., Johansson, U.-B., Eeg-Olofsson, K., Borg, S., Palaszewski, B. & Gudbjörnsdottir, S. (2017). A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability.. Patient Education and Counseling, 101(1), 139-146
Open this publication in new window or tab >>A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability.
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2017 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 1, p. 139-146Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes.

METHODS: In this methodological study, a questionnaire was developed over four phases using an iterative process. Expert reviews and cognitive interviews were conducted to evaluate content and face validity, and a postal survey was administered to evaluate test-retest reliability.

RESULTS: The expert reviews and cognitive interviews found the disease-specific questionnaire to be understandable, with relevant content and value for diabetes care. An item-level content validity index ranged from 0.6-1.0 and a scale content validity/average ranged from 0.7-1.0. The fourth version, with 33 items, two main parts and seven dimensions, was answered by 972 adults with type 1 and type 2 diabetes (response rate 61%). Weighted Kappa values ranged from 0.31-0.78 for type 1 diabetes and 0.27-0.74 for type 2 diabetes.

CONCLUSIONS: This study describes the initial development of a disease-specific questionnaire in conjunction with the NDR. Content and face validity were confirmed and test-retest reliability was satisfactory.

PRACTICE IMPLICATIONS: With the development of this questionnaire, the NDR becomes a clinical tool that contributes to further understanding the perspectives of adult individuals with diabetes.

Keywords
Development, Patient-reported outcome, Type 1 diabetes, Type 2 diabetes, Validity
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-25651 (URN)10.1016/j.pec.2017.07.016 (DOI)28736071 (PubMedID)
Available from: 2017-07-31 Created: 2017-07-31 Last updated: 2018-02-09Bibliographically approved
Elf, M., Svedbo Engström, M. & Wijk, H. (2012). An assessment of briefs used for designing healthcare environments: a survey in Sweden. Construction Management and Economics, 30(10), 835-844
Open this publication in new window or tab >>An assessment of briefs used for designing healthcare environments: a survey in Sweden
2012 (English)In: Construction Management and Economics, ISSN 0144-6193, E-ISSN 1466-433X, Vol. 30, no 10, p. 835-844Article in journal (Refereed) Published
Abstract [en]

The brief is a central document in decision making during the early stages of the planning and construction (briefing/programming) of healthcare environments. Thus, the demand on the content and quality of these documents is high. This study aimed to assess the content and quality of initial briefs developed in Sweden to obtain an up-to-date picture of current practices of writing project statements in the early stages of designing healthcare environments. A study of 29 initial briefs was performed with a new instrument called the Content and Quality of Brief Instrument (CQB-I). The results showed that, in many cases, the documentation in the briefs was incomplete and that the information did not adequately address users’ needs. In addition, the briefs often did not include any measurable outcomes or explicitly evidence-based information. This study’s findings have implications for identifying areas for improvement in design teams’ documentation practices. Assessment can have a real impact on the quality of briefs and can raise awareness of the need to improve the briefing process itself. The present study is one of the first to assess the content and quality of briefs and provides a starting point for both practitioners and future researchers to explore the role of briefs in briefing process quality improvement.  

Place, publisher, year, edition, pages
Taylor & Francis, 2012
Keywords
Briefing, building design, healthcare, assessment, quality improvement
National Category
Medical and Health Sciences Engineering and Technology
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-10629 (URN)10.1080/01446193.2012.702917 (DOI)
Available from: 2012-08-28 Created: 2012-08-28 Last updated: 2017-07-31Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-8267-592X

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