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  • 1.
    Brorsson, Anna Lena
    et al.
    Karolinska institutet.
    Lindholm Olinder, Anna
    Viklund, Gunnel
    Granström, Therese
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method: a qualitative study2017In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 5, no 1, article id e000432Article in journal (Refereed)
    Abstract [en]

    Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.

    Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.

    Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.

    Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.

  • 2.
    Granström, Therese
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Anti-VEGF treatment of patients with diabetic macular edema: Studies of visual acuity, macular edema and patient-reported outcomes2016Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to describe and evaluate visual acuity, macular edema and patientreported outcomes (PRO) following anti-VEGF treatment of diabetic macular edema (DME) patients in a real-world setting. Using a longitudinal study design, a cohort of DME patients was followed from baseline to 1 year after treatment start. Data were collected from two eye clinics at two county hospitals. Social background characteristics, medical data and PRO were measured before treatment initiation, at four month and after 1 year. A total of 57 patients completed the study. Mean age was 69 years and the sample was equally distributed regarding sex. At baseline, the patients described their general health as low. One year after treatment initiation, 30 patients had improved visual acuity and 27 patients had no improvement in visual acuity. The patients whose visual acuity improved reported an improvement in several subscales in patient-reported outcome measures (PROM), which was in contrast to the group that experienced a decline in visual acuity, where there was no improvement in PROM. Outcomes from the study can be useful for developing and providing relevant information and support to patients undergoing this treatment.

  • 3.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Brorsson, Anna Lena
    Uppsala University; Karolinska Institute and Hospital.
    Granstam, Elisabet
    Uppsala University/County Council of Västmanland; Västmanland County Hospital.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

  • 4.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient reported outcomes and visual function among patients with diabetes related macular edema2016Conference paper (Refereed)
  • 5.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jani, Siba
    Modher Raghib, Aseel
    Granstam, Elisabet
    Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema2015In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 29, no 8, p. 1183-1190Article in journal (Refereed)
    Abstract [en]

    Purpose

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).

    Material and methods

    In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36).

    Results

    The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision.

    Conclusions

    Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

  • 6.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting2016In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, p. 157-165Article in journal (Refereed)
    Abstract [en]

    Aims

    To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

    Methods

    In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

    Results

    The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

    Conclusions

    Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

  • 7.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient-reported outcomes: in patients with diabetic macular oedema treated with anti-VEGF2016In: The 16th European Doctoral Conference in Nursing Science, 2016Conference paper (Refereed)
  • 8.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundberg, Pranee
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientrelaterade utfallsmått vid införande av ny behandlingsform vid retinopati.2012In: SFSD (Svensk Förening för Sjuksköterskor i Diabetesvård) Symposium, Stockholm, 2012Conference paper (Refereed)
  • 9.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Quality of life among patients with diabetes macular edema2015Conference paper (Refereed)
    Abstract [en]

    Vision loss have a significant negative impact on quality of life. One of the most common causes of vision loss in patients with diabetes is diabetic macular edema - DME. Among DME patients, visual impairment is regarded as the most feared late diabetic complication. In January 2011 a new treatment for DME was approved, called anti-Vascular Endothelial Growth Factor, anti-VEGF- treatment. The treatment involves 3 injections every 4 weeks into the eye. The new treatment places increasing demands on the patient because of more visits and a stressful treatment. Beside that it is of great importance to learn more about the patient's experiences about the visual impairment and the new treatment.

    The aim of the study is to measure the effects of anti-VEGF treatment on vision related functioning, quality of life and sight-related variables.

    Fifty-nine patients are included in this longitudinal study at the eye clinics of two Swedish county hospitals. All patients who started anti-VEGF treatment were asked to participate.

    We have measured visual functioning with the eye-specific questionnaire - National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with the general questionnaire Short Form- 36 (SF-36). Medical variables were collected at baseline, after 4 months and one year respectively.

    A large number of patients are affected by diabetes each year and may suffer from visual impairment. These patients may be treated with this new form of treatment. Therefore it is of great importance to examine the patient's experiences of treatment and self-percieved quality of life to be able to provide the best possible information and procedures at the eye clinics.

  • 10.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Visual functioning and quality of life among patients with diabetic macular edema2015Conference paper (Refereed)
    Abstract [en]

    Background

    One of the most common causes of vision impairment in patients with diabetes is diabetic macular edema (DME) and is regarded as the most feared late diabetic complication. In January 2011 a treatment for DME was approved, called anti-Vascular Endothelial Growth Factor treatment. The treatment involves an injection into the vitreous of the eye and places increasing demands on the patient because of more visits and a stressful treatment. Therefore it is of most importance to capturing patients’ thoughts and feelings, so called Patient reported Outcome (PRO).

    Aim

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients with diabetes-related macula edema about to receive anti-vascular endothelial growth factor treatment for diabetic macular edema.

    Method

    Visual functioning was measured with National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with Short Form- 36 (SF-36). The initial eye examination included measurement of visual acuity with the ETDRS, and retinal thickness by OCT. In addition, medical variables were collected. The data collection was performed at baseline, after 4 months and one year. In this abstract we reported the result from the baseline.

    Result

    The participants were 30 men and 29 women (mean age, 68.5 years) and 92% of them had type 2 diabetes. With NEI VFQ-25, the participants showed the lowest score for the subscale of general health (mean 35.65 ± 22.04) and the highest for dependency (mean 93.48 ± 18.12). For SF-36, the participants gave the lowest score in the subscale of general health (mean 56.55 ± 22.14) and the highest for the subscale of role emotional (mean 88.73 ± 22.32). The mean ETDRS score in the eye planned for treatment was 63.9 (± 13.2) and the mean central retinal thickness was 396 (± 129).

    Conclusions: Patients diagnosed with diabetes macula edema about to receive anti-VEGF treatment reported low general health. Hence, it is of most importance to follow up patients’ thoughts and feelings (PRO) after the treatment is performed in order to promote improvements in the quality of patient care.

  • 11.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Department of Ophthalmology, Västerås, Sweden.
    Anti-VEGF treatment for diabetic macular edema: a qualitative evaluation of patients experiences2013Conference paper (Refereed)
  • 12.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Uppsala universitet.
    Visual functioning and quality of life among patients with macular edema: a quantitative study2015Conference paper (Refereed)
  • 13.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Olsen, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mentoring model in municipal health care in Dalarna, Sweden: A model for supporting new employeed nurses' professional role in municipal health care2012In: Ageing connects: book of abstracts, International Federation on Ageing. Global Conference on Ageing , 2012Conference paper (Refereed)
    Abstract [en]

    Background

    The society and health care units are increasing the demands on nurses.  Newly employed nurses   are expected to be able to work from the first day of employment independently.

    Aim

    That the newly employed nurses in communities within the County of Dalarna, receive support enabling them to feel safe in their professional role and ensure patient safety.

    The scope of the project

    The Mentor Model (MM) is based on the fact that the municipalities in Dalarna County (n = 15) appoints a Headmentor (HM).  The HM is responsible for appointing a mentor (M) for all newly employed nurses and has a supportive function for all mentors. The mentors (M) should have professional experience and are responsible for the newly employed nurses under a period of one year. In order for the M to provide support i.e. time for reflection with the HM and newly employed nurse sufficient, time must be allocated, i.e. two weeks.

    The (M) should be available to answer necessary, and networking with other mentors in Dalarna.

    Interviews with HM, M and newly employed in the municipalities showed positive gains with appointing an MM. The positive effects were: patient safety, the nurses felt more confident and the HM and M had opportunity to develop professionally.

1 - 13 of 13
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