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  • 51.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Dalarna University, School of Health and Welfare, Care Sciences.
    Alam, Moudud
    Dalarna University, School of Information and Engineering, Statistics.
    Swall, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Boström, Anne-Marie
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Factors associated with older persons’ perceptions of dignity and well-being over a three-year period: A retrospective national study in residential care facilities2022In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, no 1, article id 515Article in journal (Refereed)
    Abstract [en]

    Background: Dignity and well-being are central concepts in the care of older people, 65 years and older, world‑wide. The person-centred practice framework identifes dignity and well-being as person-centred outcomes. Older persons living in residential care facilities, residents, have described that they sometimes lack a sense of dignity and well-being, and there is a need to understand which modifable factors to target to improve this. The aim of this study was to examine the associations between perceptions of dignity and wellbeing and the independent variables of the attitudes of staf, the indoor-outdoor-mealtime environments, and individual factors for residents over a three-year period.

    Methods: A national retrospective longitudinal mixed cohort study was conducted in all residential care facilities within 290 municipalities in Sweden. All residents aged 65 years and older in 2016, 2017 and 2018 were invited to responded to a survey; including questions regarding self-rated health and mobility, the attitudes of staf, the indooroutdoor-mealtime environments, safety, and social activities. Data regarding age, sex and diagnosed dementia/pre‑scribed medication for dementia were collected from two national databases. Descriptive statistics and ordinal logistic regression models were used to analyse the data.

    Results: A total of 13 763 (2016), 13 251 (2017) and 12 620 (2018) residents answered the survey. Most of them (69%) were women and the median age was 88 years. The odds for satisfaction with dignity did not difer over the three-year period, but the odds for satisfaction with well-being decreased over time. Residents who rated their health as good, who were not diagnosed with dementia/had no prescribed medication for dementia, who had not experienced disrespectful attitudes of staf and who found the indoor-outdoor-mealtime environments to be pleasant had higher odds of being satisfed with aspects of dignity and well-being over the three-year period.

    Conclusions: The person-centred practice framework, which targets the attitudes of staf and the care environment, can be used as a theoretical framework when designing improvement strategies to promote dignity and well-being. Registered nurses, due to their core competencies, focusing on person-centred care and quality improvement work, should be given an active role as facilitators in such improvement strategies.

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  • 52.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Alam, Moudud
    Dalarna University, School of Information and Engineering, Statistics.
    Swall, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Boström, Anne‐Marie
    Division of Nursing Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden;Theme Inflammation and Ageing, Unit Nursing Ageing Karolinska University Hospital Huddinge Sweden;Research and Development UnitStockholms Sjukhem Stockholm Sweden.
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Factors associated with perceptions of dignity and well‐being among older people living in residential care facilities in Sweden. A national cross‐sectional study2022In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 5, p. e2350-e2364Article in journal (Refereed)
    Abstract [en]

    The care of older people living in residential care facilities (RCFs) should promote dignity and well-being, but research shows that these aspects are lacking in such facilities. To promote dignity and well-being, it is important to understand which associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to the attitudes of staff, the care environment and individual issues among older people living in RCFs. A national retrospective cross-sectional study was conducted in all RCFs for older people within 290 municipalities in Sweden. All older people 65 years and older (n = 71,696) living in RCFs in 2018 were invited to respond to the survey. The response rate was 49%. The survey included the following areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, attitudes of staff, safety, social activities, availability of staff and care in its entirety. Data were supplemented with additional data from two national databases regarding age, sex and diagnosed dementia. Descriptive statistics and ordinal logistic regression models were used to analyse the data. Respondents who had experienced disrespectful treatment, those who did not thrive in the indoor-outdoor-mealtime environment, those who rated their health as poor and those with dementia had higher odds of being dissatisfied with dignity and well-being. To promote dignity and well-being, there is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The person-centred practice framework can be used as a theoretical framework for improvements, as it targets the prerequisites of staff and the care environment. As dignity and well-being are central values in the care of older people worldwide, the results of this study can be generalised to other care settings for older people in countries outside of Sweden.

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  • 53.
    Rosberg Petersson, Johanna
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Berglund, Lars
    Dalarna University, School of Health and Welfare, Medical Science.
    Giedraitis, Vilmantas
    Dalarna University, School of Health and Welfare.
    Halvorsen, Kjartan
    Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Rosendahl, Erik
    Umeå University.
    McKee, Kevin
    Dalarna University, School of Health and Welfare, Social Work.
    Åberg, Anna Cristina
    Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Step length during Timed Up and Go performance: preliminary results of a cross-sectional cohort study2023Conference paper (Refereed)
  • 54.
    Rudman, Ann
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Melander, Sara
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Lindström, Veronica
    Falk, Lotta
    Hörberg, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Wallin, Lars
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Rasoal, Dara
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Dahlgren, Anna
    Boström, Anne-Marie
    Gustavsson, Petter
    Dahl, Oili
    Sjuksköterskor i frontlinjen av COVID-19 pandemin: Vilka blev konsekvenserna? Teknisk rapport om enkät och datainsamling2022Report (Other academic)
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  • 55.
    Rutberg, Stina
    et al.
    Luleå University of Technology, Luleå.
    Henriksson, Malin
    The Swedish National Road and Transport Research Institute, Linköping.
    Andersson, Mathias
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Sport and Health Science.
    Palstam, Annie
    Dalarna University, School of Health and Welfare, Medical Science. Sahlgrenska University Hospital, Gothenburg; University of Gothenburg, Gothenburg.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Luleå.
    My Way to School Through a Camera Lens: Involving Children to Inform a Policy Recommendation on Active School Travel2024In: Health Promotion Practice, ISSN 1524-8399, E-ISSN 1552-6372Article in journal (Refereed)
    Abstract [en]

    Active school travel (AST) is an effective approach for increasing children's physical activity and independent mobility, but policy supporting AST is lacking. This study aims to explore children's experiences of AST to inform a policy recommendation. Photovoice methodology with a qualitative approach was applied, with children taking pictures on their way to school. This was followed by focus groups where the children explored their experiences of AST based on their photos. The data were analyzed using qualitative content analysis. The results show that the children valued independent mobility and wanted to be involved in decisions about their travels; they also expressed feelings of increased responsibility and personal growth as a consequence. Although the children recognized areas of improvement regarding infrastructure, especially regarding heavy traffic that jeopardized travel safety, they continued using AST. Finally, the children talked about the value of the health and environmental benefits of AST. Opportunities for friendship, play, and making decisions about their own time were highlighted as important incentives. The benefits from AST are many for children, as well as for society. The result has informed policy recommendations for AST, and the children's input will be used to communicate the recommendations. Listening to the voices of children could be a steppingstone toward forming future healthy mobility initiatives. In that process, it is key to include children's perspectives when formulating the AST policy for successful adoption and implementation.

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  • 56.
    Rönnegård, Ann-Sofie
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.
    Nowak, Christoph
    Department of Neurobiology, Care Sciences and Society (NVS), Family Medicine and Primary Care Unit, Karolinska Institutet, Huddinge, Sweden.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Ärnlöv, Johan
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Family Medicine and Primary Care Unit, Karolinska Institutet, Huddinge, Sweden.
    The association between short-term, chronic localized and chronic widespread pain and risk for cardiovascular disease in the UK Biobank2022In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 29, no 15, p. 1994-2002, article id zwac127Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The interplay between pain of different chronicity and cardiovascular disease (CVD) is incompletely understood.

    AIM: We aimed to investigate the association between different levels of chronic or non-chronic pain and risk of CVD.

    METHODS: Participants in the UK Biobank who reported pain at baseline were divided into three groups according to pain duration and widespreadness. Participants reporting no pain were controls. Multivariable Cox regression was used to investigate the association between pain and incidence of myocardial infarction, heart failure, stroke, cardiovascular mortality and composite CVD (defined as any of the before-mentioned cardiovascular events).

    RESULTS: Of 475,171 participants, 189,289 reported no pain, 87,830 reported short-term pain, 191,716 chronic localized pain, and 6,336 chronic widespread pain (CWP). During a median of 7.0 years' follow-up, participants with CWP and chronic localized pain had, after adjustment for age, sex, established cardiovascular risk factors, physical activity, anxiety, depression, cancer, chronic inflammatory/painful disease, pain/anti-inflammatory medication, socioeconomic status, a significantly increased risk for composite CVD (hazard ratio, HR 1.14, CI 1.08-1.21, p-value < 0.001; and HR 1.48, CI 1.28-1.73, p-value < 0.001, respectively) compared to controls, with similar results when using the different specific CVDs as outcomes. Population attributable risk proportion for chronic pain as a risk factor for composite CVD was comparable to that of diabetes (8.6% vs. 7.3%, respectively).

    CONCLUSIONS: Chronic pain is associated with an increased risk for myocardial infarction, stroke, heart failure and cardiovascular death independent of established cardiovascular risk factors, socioeconomic factors, co-morbidities and medication. Our study, the largest to date, confirms and extends our understanding of chronic pain as an underestimated cardiovascular risk factor with important public health implications.

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  • 57.
    Schmöker, Annika
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Uppsala University.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University; Department of Paediatrics, County of Dalarna, Falun.
    Flacking, Renée
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Health and Welfare, Social Work. Center for Clinical Research Dalarna, Uppsala University; Palliative Research Centre, Ersta Sköndal University College, Stockholm.
    Needs and Perceptions Relative to Emotional Support in Parents With Preterm Infants.2021In: Journal of Perinatal & Neonatal Nursing, ISSN 0893-2190, E-ISSN 1550-5073Article in journal (Refereed)
    Abstract [en]

    Objectives of this study were to explore parents' needs for emotional support and how such support could be best delivered during admittance to a neonatal unit. This study took place at 6 neonatal units in Sweden. Forty-two semistructured interviews were analyzed using qualitative content analysis: 26 individual telephone interviews with mothers of preterm infants 6 to 10 months after discharge and 16 face-to-face interviews with parents of preterm infants admitted to neonatal units. The main category to emerge was needs and preferences for emotional support, which consisted of 2 generic categories: emotional needs and preferences for potential support interventions. Emotional needs define the importance of comprehending the new situation, finding meaning, and managing the situation through resources. Preferences for potential support interventions identify possible ways to deliver emotional support in the form of parental PhD group, diary writing, professional counseling, and Internet support. The results highlight the importance of supporting parents' sense of coherence in their situation and parenthood by offering different interventions according to parent preferences. Parental groups could serve as a keystone for emotional support with the possibility to combine with other support mechanisms.

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  • 58.
    Sedelius, Helene
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Centre for Clinical Research Dalarna-Uppsala University, Falun, Sweden; .
    Tistad, Malin
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Bergsten, Ulrika
    R&D Department at Region Halland, Halmstad, Sweden.
    Dehlin, Mats
    Department of Rheumatology and Inflammation Research, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg SE, Gothenburg, Sweden.
    Iggman, David
    Centre for Clinical Research Dalarna-Uppsala University, Falun, Sweden.
    Wallin, Lars
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Svärd, Anna
    Centre for Clinical Research Dalarna-Uppsala University, Falun, Sweden.
    Professionals' perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare2022In: BMC Primary Care, E-ISSN 2731-4553, Vol. 23, no 1, article id 71Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gout affects nearly 2 % of the population and is associated with repeated painful flares of arthritis. Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary healthcare are implicated as partial explanations for this undertreatment. Nurse-led care has proved to be an effective model when treating patients with gout, but there is a need for more knowledge about factors that can be expected to influence the future implementation of such care. The aim of this study was to describe factors influencing existing gout care in primary healthcare and the conditions for a future implementation of nurse-led gout care based on national treatment recommendations.

    METHODS: In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.

    RESULTS: Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).

    CONCLUSION: In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy.

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  • 59. Sharma, Bharati
    et al.
    Christensson, Kyllike
    Bäck, Lena
    Karlström, Annika
    Lindgren, Helena
    Mudokwenyu-Rawdon, Christina
    Maimbolwa, Margaret C
    Laisser, Rose Mjawa
    Kiruja, Jonah
    Dalarna University, School of Health and Welfare, Care Sciences. Hargeisa University, Somaliland, Africa.
    Hildingsson, Ingegerd
    African midwifery students' self-assessed confidence in postnatal and newborn care: A multi-country survey.2021In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 101, article id 103051Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Majority of maternal and new-born deaths occur within 28 hours and one week after birth. These can be prevented by well-educated midwives. Confidence in postnatal and newborn care skills depend on the quality of midwifery education.

    OBJECTIVE: To assess confidence and its associated factors for basic postnatal and new-born care skills of final year midwifery students , from seven African countries.

    METHODS: A multi-country cross-sectional study where final year midwifery students answered a questionnaire consisting of basic skills of postnatal and newborn care listed by the International Confederation of Midwives. The postnatal care area had 16 and newborn care area had 19 skill statements. The 16 skills of postnatal care were grouped into three domains through principle component analysis (PCA); Basic postnatal care; postnatal complications and educating parents and documentation. The 19 skills under the newborn care area were grouped into three domains; Basic care and care for newborn complications; Support parents for newborn care; and Care for newborns of HIV positive mothers and documentation.

    RESULTS: In total 1408 midwifery students from seven Sub-Saharan countries participated in the study namely; Kenya, Malawi, Tanzania, Uganda, Zambia, Zimbabwe, and Somaliland Overall high confidence for all domains under Post Natal Care ranged from 30%-50% and for Newborn care from 39-55%. High confidence for postnatal skills was not found to be associated with any background variables (Age, sex, type and level of educational programme). High confidence for newborn care was associated with being female students, those aged 26-35 years, students from the direct entry programmes and those enrolled in diploma programmes.

    CONCLUSIONS: Almost half of the study participants expressed lack of confidence for skills under postnatal and newborn care. No association was found between high confidence for domains of postnatal care and background variables. High confidence was associated with being a female, between 26-35 years of age, from direct entry or diploma programmes for newborn care area. The results of the study indicate gaps in midwifery education. Countries could use the ICM list of competencies to develop country specific standards for midwifery education. However, actual competence remains to be measured.

  • 60.
    Silverplats, Jennie
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    In-hospital cardiac arrest and cardiopulmonary resuscitation in Sweden: Healthcare professionals’ competence and compliance with guidelines2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Competence in cardiopulmonary resuscitation (CPR) is the foundation for performing CPR in accordance with guidelines during in-hospital cardiac arrest (IHCA) events, which is crucial to patient survival. All IHCA events are to be reported to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR), but compliance is unclear. This may affect the interpretation of patient characteristics, IHCA care and outcomes.

    The aim of this thesis was to evaluate CPR competence and compliance with guidelines among in-hospital healthcare professionals (HCP), including evaluation of possible associated factors, patient characteristics, situational factors, and patient outcomes in the in-hospital setting.

    Methods: Data were collected through surveys among in-hospital HCPs during 2009 and 2013–2016. Further, data from the SRCR, the Swedish PeriOperative Register, and medical records were used to find all treated IHCA events at selected hospitals during 2018–2019. All witnessed IHCA events involving adult patients were evaluated regarding compliance with initial CPR guidelines.

    Results: The theoretical knowledge of CPR was poor and self-assessed abilities of performing CPR were low. Recent CPR training, working on a monitored ward, and being a nurse or physician were factors associated with higher knowledge and ratings of abilities. A majority of HCPs showed positive attitudes towards being required to perform CPR. However, attitudes in real-life IHCA situations signaled a possible perceived lack of resources. The case completeness of IHCA events in the SRCR was lacking. Most non-reported events occurred on monitored wards, with differences from reported events observed. Compliance with initial CPR guidelines was higher among HCPs on monitored wards versus non-monitored wards, but the place of arrest was not associated with patient outcome.

    Conclusion: The results underline the importance of frequent CPR training, especially on non-monitored wards, and of compliance with initial CPR guidelines. Non-reporting of IHCA events on monitored wards affects the interpretation of patient characteristics, IHCA care and outcomes. The procedures for reporting IHCA to the SRCR need to be well established. Reviews of patient medical records from monitored wards may improve case completeness in the SRCR.

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  • 61.
    Silverplats, Jennie
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Region Dalarna, Mora Hospital, Mora.
    Strömsöe, Anneli
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Falun / Region Dalarna, Falun.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Falun / Karolinska Institutet.
    Södersved Källestedt, Marie-Louise
    Centre for Clinical Research Västmanland, Uppsala University, Västerås.
    Attitudes towards cardiopulmonary resuscitation situations and associations with potential influencing factors: A survey among in-hospital healthcare professionals2022In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 7, article id e0271686Article in journal (Refereed)
    Abstract [en]

    Introduction Attitudes towards cardiopulmonary resuscitation (CPR) among in-hospital healthcare professionals (HCPs) are poorly understood. The aim of this study was to evaluate attitudes towards CPR situations among in-hospital HCPs and assess associations with potential influencing factors. Materials and methods A questionnaire was distributed to 3,085 HCPs in 2009 and 2,970 HCPs in 2015–2016. The associations of influencing factors were analyzed using binary logistic regression. Results In the event of a possible cardiac arrest situation, 61% of the HCPs would feel confident in their CPR knowledge, 86% would know what to do, and 60% would be able to take command if necessary. In the latest real-life CPR situation, 30% had been worried about making mistakes or causing complications, 57% had been stressed, and 27% had been anxious. A short time since the latest real-life CPR performance and a high number of previous real-life CPR performances were associated with lower odds of worrying about making mistakes/causing complications, lower odds of feeling stressed or anxious, and higher odds of feeling calm. Regardless of previous real-life CPR experience, there were differences in attitudes between groups of professions, where physicians showed increased odds of worrying about making mistakes/causing complications and nurses showed increased odds of stress. Working on a non-monitored ward meant increased odds of stress and worrying about making mistakes/causing complications. Twelve months or more having passed since the latest CPR training course was associated with increased odds of anxiety. Conclusions Despite HCPs’ generally positive attitudes towards performing CPR in the event of a possible cardiac arrest situation, feelings of stress and anxiety were common in real-life CPR situations. Regular CPR training among all HCPs is a key factor to maintain competence and reduce anxiety. The possible effects of attitudes on performing CPR need to be studied further.

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  • 62.
    Silverplats, Jennie
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Södersved Källestedt, Marie-Louise
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge; Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun.
    Strömsöe, Anneli
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun; Department of Prehospital Care, Region Dalarna, Falun.
    Compliance with cardiopulmonary resuscitation guidelines in witnessed in-hospital cardiac arrest events and patient outcome on monitored versus non-monitored wards2024In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 196, article id 110125Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Adherence to cardiopulmonary resuscitation (CPR) guidelines in treatment of in-hospital cardiac arrest (IHCA) have been associated with favourable patient outcome. The aim of this study was to evaluate if compliance with initial CPR guidelines and patient outcome of witnessed IHCA events were associated with the place of arrest defined as monitored versus non-monitored ward.

    METHODS: A total of 956 witnessed IHCA events in adult patients at six hospitals during 2018 to 2019, were extracted from the Swedish Registry of Cardiopulmonary Resuscitation. Initial CPR guidelines were: ≤ 1 min from collapse to alert of the rapid response team, ≤ 1 min from collapse to start of CPR, ≤ 3 min from collapse to defibrillation of shockable rhythm.

    RESULTS: The odds of compliance with guidelines was higher on monitored wards vs non-monitored wards, even after adjustment for factors that could affect staffing and resources. The place of arrest was not a significant factor for sustained return of spontaneous circulation, survival at 30 days, or neurological status at discharge, when adjusting for clinically relevant confounders. Compliance with initial CPR guidelines remained a significant factor for survival to 30 days and favourable neurological outcome at discharge regardless of other confounders.

    CONCLUSION: Compliance with initial CPR guidelines was higher in witnessed IHCA events on monitored wards than on non-monitored wards, which indicates that healthcare professionals in monitored wards are quicker to recognize a cardiac arrest and initiate treatment. When initial CPR guidelines are followed, the place of arrest does not influence patient outcome.

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  • 63.
    Silverplats, Jennie
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Department of Anaesthesiology and Intensive Care, Region Dalarna, Mora.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Center for Clinical Research Dalarna, Uppsala University, Falun.
    Södersved Källestedt, Marie-Louise
    Centre for Clinical Research Västmanland, Uppsala University, Västerås; Mälardalen University.
    Strömsöe, Anneli
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Falun; Department of Prehospital Care, Region Dalarna, Falun.
    Incidence and case ascertainment of treated in-hospital cardiac arrest events in a national quality registry – a comparison of reported and non-reported events2024In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 195, article id 110119Article in journal (Refereed)
    Abstract [en]

    Background: Approximately 2,500 in-hospital cardiac arrest (IHCA) events are reported annually to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) with an estimated incidence of 1.7/1,000 hospital admissions. The aim of this study was to evaluate the compliance in reporting IHCA events to the SRCR and to compare reported IHCA events with possible non-reported events, and to estimate IHCA incidence.

    Methods: Fifteen diagnose codes, eight Classification of Care Measure codes, and two perioperative complication codes were used to find all treated IHCAs in 2018-2019 at six hospitals of varying sizes and resources. All identified IHCA events were cross-checked against the SRCR using personal identity numbers. All non-reported IHCA events were retrospectively reported and compared with the prospectively reported events.

    Results: A total of 3,638 hospital medical records were reviewed and 1,109 IHCA events in 999 patients were identified, with 254 of the events not found in the SRCR. The case completeness was 77% (range 55-94%). IHCA incidence was 2.9/1,000 hospital admissions and 12.4/1,000 admissions to intensive care units. The retrospectively reported events were more often found on monitored wards, involved patients who were younger, had less comorbidity, were often found in shockable rhythm and more often achieved sustained spontaneous circulation, compared with in prospectively reported events.

    Conclusion: IHCA case completeness in the SRCR was 77% and IHCA incidence was 2.9/1,000 hospital admissions. The retrospectively reported IHCA events were found in monitored areas where the rapid response team was not alerted, which might have affected regular reporting procedures.

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  • 64.
    Sjöberg, Veronica
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    eVIS – A digital support for physical activity in patients with chronic pain2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Chronic pain is a significant contemporary health challenge, exerting enormous impact on both individuals and societies. Although physical activity is the primary treatment, many patients struggle with incorporating it into their lives. In order to facilitate individualised physical activity within Interdisciplinary Pain Rehabilitation Programs (IPRP), the eVISualisation of physical activity and pain intervention was developed. This intervention consists of device-based measured physical activity, jointly visualised with patient-reported pain intensity, pain interference, and pharmaceutical consumption. 

    Overall aim: To i) develop the eVIS intervention as a digital support for physical activity in IPRP, ii) to evaluate eVIS’s validity, feasibility, and acceptability as a supplementary treatment for patients taking part of IPRP, and iii) to evaluate the feasibility and acceptability of the trial design and conduct of an ongoing Registry-based Randomised Clinical Trial (R-RCT), where the effectiveness of eVIS as an addition to IPRP is evaluated.

    Methods: The Medical Research Council’s updated framework for development and evaluation of complex interventions guided study designs and methodologies. This thesis contains four papers: I. Evaluation of the criterion validity of a wrist-worn activity tracker, II. Evaluation of pre-clinical content validity of eVIS, III. A study protocol outlining trial design and trial conduct of an ongoing R-RCT, and IV. Evaluation of the aforementioned trial design and trial conduct. 

    Results: The wrist-worn activity tracker provided fair to acceptable measurements of SR. In collaboration with relevant stakeholders, eVIS was continuously developed and found to be relevant, simple, and safe for use by patients, clinicians, and researchers. The first real-world test of the clinical feasibility of the intervention motivated further development in the web application and procedures relating to recruitment and data collection. The evaluation of the acceptability and feasibility of the trial design and conduct provided promising results, with mainly satisfactory feasibility. However, minor revisions are required to safeguard the external validity of the ongoing R-RCT. 

    Conclusions: Through continuous refinement in collaboration with stakeholders and careful consideration of the intervention’s complexity, key uncertainties, and context, indicate that the intervention is relevant, valid, feasible, and well prepared for effectiveness testing.

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  • 65.
    Sjöberg, Veronica
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Forsner, Maria
    Umeå University.
    Shifting roles: physiotherapists’ perception of person-centered care during a pre-implementation phase in the acute hospital setting - A phenomenographic study2022In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 38, no 7, p. 879-889Article in journal (Refereed)
    Abstract [en]

    Background

    Person-centered care (PCC) is an acknowledged health care practice involving increased patient influence regarding decisions and deliberation. Research indicates that physiotherapists (PTs) embrace patient participation, but that PCC is difficult to grasp and fully implement.

    Objective

    To contribute to knowledge about how PCC influences physiotherapy by eliciting PTs? experiences from the acute care setting, this study aims to describe and illuminate variations in perceptions of PCC during a pre-implementation phase, among PTs in acute hospital care.

    Methods

    Phenomenological approach: individual interviews with PTs in acute care (n = 7) combined with focus group interviews (n = 3).

    Findings

    The analysis yielded two main categories: 1) Physiotherapists perceived a transformed patient role involved in the transition from patient to person; and 2) Physiotherapists perceived a challenged professional role when departing from the expert role, and entailed restrictions to prescribing the best treatment and, instead, meant aiming for a collaborative and equal relationship with the patient.

    Conclusion

    Although the interviewed PTs embraced PCC in principle, PCC does seem to challenge the professional roles of patient and PT. The findings indicate that theories of power relations need to be considered, and further reflection may facilitate implementation. More research is needed to deepen the knowledge of how PTs perceive PCC during all implementation phases.

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  • 66.
    Sjöberg, Veronica
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Tseli, Elena
    Dalarna University, School of Health and Welfare, Medical Science.
    Björk, Mathilda
    Department for Prevention, Rehabilitation, and Community Medicine, Linköping University.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet; Department for Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science.
    Content Validity and Feasibility of the eVISualisation of physical activity and pain (eVIS) intervention in Interdisciplinary Pain Rehabilitation Programs: Valuable steps in a systematical development and evaluation process2022Conference paper (Refereed)
    Abstract [en]

    Background and aims: *Low physical health is one consequence that chronic pain encompasses. To improveeffectiveness of Interdisciplinary pain rehabilitation programs (IPRP) theeVISualisation of physical activity and pain (eVIS) intervention was developed. Thepurpose of this study was to evaluate eVIS validity by the aspects of content validityand clinical feasibility in IPRP-context.Methods: *This observational study was performed in 3 phases. Twenty-two field experts (patients,caregivers, researchers) participated, and provided quantitative scores and qualitativecomments on eVIS and its included elements (data collection, visualization,communication). In phase 1, ratings on a four-point Likert scale of each element´scontent validity (relevance, simplicity, safety) were collected through digitalquestionnaires. Three iterative assessment loops were completed, each followed byconsensus panel protocol revisions. Item-level content validity index (I-CVI), averageand overall CVI were calculated, and free-text comments were analyzed. In phase 2,ratings of content validity and elements’ clinical feasibility categorized in 5 focus areas(acceptability, demand, implementation, limited efficacy, practicality), were collectedfrom patients and caregivers after 2-3 weeks test trial. Phase 3 involved follow-up focusgroup interview with caregivers on specific ratings, as well as interviews with expertsin clinical pain management pharmacology.Results: *CVI for relevance, simplicity and safety improved over time and were all rated abovecut-off (0.78). Revisions were mainly made in the visualization element. In phase 2,participants rated eVIS as relevant and feasible to use in clinical IPRP-context.Conclusions: *Patients, caregivers, and researchers found eVIS valid in IPRP-context. Methodicalvalidation was essential to ascertain eVIS’ substantiality before clinical trial.

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  • 67.
    Sjöberg, Veronica
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Tseli, Elena
    Dalarna University, School of Health and Welfare, Medical Science.
    Monnier, Andreas
    Dalarna University, School of Health and Welfare, Medical Science. Military Academy Karlberg, Swedish Armed Forces.
    Westergren, Jens
    Dalarna University, School of Health and Welfare, Sport and Health Science.
    LoMartire, Riccardo
    Department of Research and Higher Education, Region Dalarna.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Research and Higher Education, Region Dalarna.
    Hagströmer, Maria
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm.
    Björk, Mathilda
    Department for Prevention, Rehabilitation and Community Medicine, Linköping University.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science.
    Effectiveness of the eVISualisation of physical activity and pain (eVIS) intervention in Interdisciplinary Pain Rehabilitation Programs: Study Protocol for a Registry-based Randomised Controlled Clinical Trial2022Conference paper (Refereed)
    Abstract [en]

    Background and aims: * Interdisciplinary Pain Rehabilitation Programs (IPRPs) are considered to be superior to single-treatment measures in chronic pain treatment. However, the effects of IPRPs are moderate and as many as 30% of patients deteriorate in some outcomes. Although physical activity and exercise are central components in IPRPs, many patients struggle to achieve and maintain the recommended levels. An intervention, entitled eVISualisation of physical activity and pain (eVIS), has now been systematically developed and designed to facilitate patients with chronic pain in achieving and maintaining recommended physical activity levels. The aim of the present study protocol is to transparently report on the methodology, outcomes, and processes for an initiated registry-based randomized controlled trial (R-RCT), which will evaluate the effectiveness of eVIS on the primary outcome physical health and defined secondary outcomes. Methods: * Participants (approximately 400) will be recruited from IPRP units and randomly allocated to either IPRP with an addition of eVIS or to treatment as usual by IPRP. eVIS entails objectively measured physical activity and patient-reported outcomes of pain intensity, effect on daily activities and pharmaceutical consumption. Data is collected and visualized in a web application, PATRON. Pilot analyses evaluating the feasibility of the R-RCT will be performed on data from initial 30 participants. Outcomes will be extracted from PATRON and from six national registries. Multivariate statistics and repeated measures analyses will be performed. Results: * Recruitment will be initiated in late 2021. ClinicalTrials.gov identifier: NCT05009459. Conclusions: * This study protocol describes a R-RCT that is designed to provide robust data on the feasibility and effectiveness of eVIS as an addition to IPRPs.

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  • 68.
    Sjöberg, Veronica
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Tseli, Elena
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Monnier, Andreas
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Military Academy Karlberg, Swedish Armed Forces, Solna, Sweden.
    Westergren, Jens
    Dalarna University, School of Health and Welfare, Sport and Health Science.
    LoMartire, Riccardo
    Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.
    Hagströmer, Maria
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.
    Björk, Mathilda
    Department for Prevention, Rehabilitation, and Community Medicine, Division of Occupational Therapy, Institution of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science.
    Effectiveness of the eVISualisation of physical activity and pain intervention (eVIS) in Swedish Interdisciplinary Pain Rehabilitation Programmes: study protocol for a registry-based randomised controlled clinical trial2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e055071Article in journal (Refereed)
    Abstract [en]

    Introduction Living with chronic pain often involves negative consequences. Interdisciplinary Pain Rehabilitation Programmes (IPRP) is considered superior to single-treatment measures in patients with chronic pain. Despite this, effects emerge suboptimal and more than 20% of patients deteriorate in patientreported physical health outcomes after IPRP. A novel e-Health intervention, eVISualisation (eVIS) of physical activity and pain, was systematically developed to facilitate individualisation of physical activity levels. By adding elements of data collection, visualisation and communication of objectively measured physical activity and patient-reported outcomes (pain intensity, interference of pain, pharmaceutical consumption) to existing treatment modalities in IPRP, the IPRP team acquires prerequisites to adapt advice and physical activity prescriptions and to evaluate set activity goals. The overall aim is two fold. First, the aim is to evaluate the feasibility of the subsequent registry-based randomised controlled clinical trial (R-RCT). Second, the aim is to prospectively evaluate the effectiveness of the eVISintervention as a supplement to IPRP on our defined primary (physical health) and secondary outcomes.

    Methods and analysis In the R-RCT, recruitment of 400 patients with chronic pain will be performed at 15 IPRP units. A random allocation to either IPRP + eVIS or to control group that will receive IPRP only will be performed. Data from the initial 30 participants completing the study period (6 months) will be included in a pilot study, where key feasibility outcomes (recruitment, randomisation, implementation, treatment integrity, data collection procedure, preliminary outcome measures) will be evaluated. Outcome variables will be extracted from the web application Pain And TRaining ON-line (PATRON) and from six national registries. Multivariate statistics and repeated measure analyses will be performed. Quality-adjusted life years and incremental cost-effectiveness ratio will be calculated for cost-effectiveness evaluation.

    Ethics/dissemination The Swedish Ethics Review Board granted approval (Dnr 2021/02109). Results will be disseminated through peer-reviewed journals.

    Trial registration number NCT05009459. Protocol V.1

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  • 69.
    Sjöberg, Veronica
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences.
    Westergren, Jens
    Dalarna University, School of Health and Welfare, Sport and Health Science.
    Monnier, Andreas
    Dalarna University, School of Health and Welfare, Medical Science. Military Academy Karlberg, Swedish Armed Forces; Karolinska Institutet.
    Lo Martire, Riccardo
    Karolinska Institutet.
    Hagströmer, Maria
    Karolinska Institutet; Academic Primary Health Care Centre, Region Stockholm.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Division of Physiotherapy, Karolinska Institutet; Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science.
    Wrist-Worn Activity Trackers in Laboratory and Free-Living Settings for Patients With Chronic Pain: Criterion Validity Study2021In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 9, no 1, article id e24806Article in journal (Refereed)
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  • 70.
    Tseli, Elena
    et al.
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Sjöberg, Veronica
    Dalarna University, School of Health and Welfare, Medical Science. Dalarna University, School of Health and Welfare, Care Sciences.
    Björk, Mathilda
    Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linko¨ping University.
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet; Center for Clinical Research Dalarna—Uppsala University, Falun; The Administration of Regional Board, Department of Research and Higher Education, Region Dalarna, Falun.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science. The Administration of Regional Board, Department of Research and Higher Education, Region Dalarna, Falun.
    Evaluation of content validity and feasibility of the eVISualisation of physical activity and pain (eVIS) intervention for patients with chronic pain participating in interdisciplinary pain rehabilitation programs2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 3, p. e0282780-e0282780Article in journal (Refereed)
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    fulltext
  • 71.
    Westergren, Jens
    et al.
    Dalarna University, School of Health and Welfare, Sport and Health Science. Dalarna University, School of Health and Welfare, Care Sciences.
    Sjöberg, Veronica
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Vixner, Linda
    Dalarna University, School of Health and Welfare, Medical Science.
    Nyberg, Roger G.
    Dalarna University, School of Information and Engineering, Informatics.
    Moulaee Conradsson, David
    Monnier, Andreas
    Dalarna University, School of Health and Welfare, Medical Science. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge.
    LoMartire, Riccardo
    Enthoven, Paul
    Äng, Björn
    Dalarna University, School of Health and Welfare, Medical Science. Karolinska Institutet; Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun; Regional Board Administration, Region Dalarna, Falun.
    Acute exercise as active inference in chronic musculoskeletal pain, effects on gait kinematics and muscular activity in patients and healthy participants: a study protocol for a randomised controlled laboratory trial2023In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 5, article id e069747Article in journal (Refereed)
    Abstract [en]

    Introduction

    Chronic musculoskeletal pain is a highly prevalent, complex and distressing condition that may negatively affect all domains of life. In view of an active inference framework, and resting on the concept of allostasis, human movement per se becomes a prerequisite for health and well-being while chronic pain becomes a sign of a system unable to attenuate an allostatic load. Previous studies on different subgroups of chronic pain conditions have demonstrated alterations in gait kinematics and muscle activity, indicating shared disturbances in the motor system from long-term allostatic load. We hypothesise that such alterations exist in heterogenous populations with chronic musculoskeletal pain, and that exposure to acute and controlled exercise may attenuate these alterations. Therefore, the main aim of this study is to investigate the acute effects of exercise on gait kinematics and activity of the back and neck muscles during diverse walking conditions in patients with chronic musculoskeletal pain compared with a reference sample consisting of healthy participants.

    Methods and analysis

    This two-sample two-armed parallel randomised controlled laboratory trial will include 40 participants with chronic musculoskeletal pain (>3 months) and 40 healthy participants. Participants will be randomly allocated to either 30 min of aerobic exercise or rest. Primary outcomes are gait kinematics (walking speed, step frequency, stride length, lumbar rotation, gait stability) and muscular activity (spatial and temporal) of the back and neck during diverse walking conditions. Secondary outcomes are variability of gait kinematics and muscle activity and subjective pain ratings assessed regularly during the trial.

    Ethics and dissemination

    The study has been approved by the Regional Ethics Review Board in Uppsala, Sweden (#2018/307). Findings will be disseminated via conference presentations, publications in peer-reviewed journals and engagement with patient support groups and clinicians.

    Trial registration number

    NCT03882333.

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    Acute exercise as active inference in chronic musculoskeletal pain, effects on gait kinematics and muscular activity in patients and healthy participants: a study protocol for a randomised controlled laboratory trial
  • 72.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Rosberg Petersson, Johanna
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Giedraitis, Vilmantas
    Dalarna University, School of Health and Welfare. Uppsala University.
    McKee, Kevin J
    Dalarna University, School of Health and Welfare, Social Work.
    Rosendahl, Erik
    Umeå University.
    Halvorsen, Kjartan
    Dalarna University, School of Health and Welfare, Medical Science. Tecnologico de Monterrey, Campus Estado de Mexico, Mexico.
    Berglund, Lars
    Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Prediction of conversion to dementia disorders based on timed up and go dual-task test verbal and motor outcomes: a five-year prospective memory-clinic-based study2023In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, no 1, article id 535Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: While assessment tools can increase the detection of cognitive impairment, there is currently insufficient evidence regarding clinical outcomes based on screening for cognitive impairment in older adults.

    METHODS: The study purpose was to investigate whether Timed Up and Go dual-task test (TUGdt) results, based on TUG combined with two different verbal tasks (name different animals, TUGdt-NA, and recite months in reverse order, TUGdt-MB), predicted dementia incidence over a period of five years among patients (N = 186, mean = 70.7 years; 45.7% female) diagnosed with Subjective Cognitive Impairment (SCI) and Mild Cognitive Impairment (MCI) following assessment at two memory clinics. Associations between TUG parameters and dementia incidence were examined in Cox regression models.

    RESULTS: During follow-up time (median (range) 3.7 (0.1-6.1) years) 98 participants converted to dementia. Novel findings indicated that the TUGdt parameter words/time, after adjustment for age, gender, and education, can be used for the prediction of conversion to dementia in participants with SCI or MCI over a period of five years. Among the TUG-related parameters investigated, words/time showed the best predictive capacity, while time scores of TUG and TUGdt as well as TUGdt cost did not produce significant predictive results. Results further showed that the step parameter step length during TUGdt predicts conversion to dementia before adjustment for age, gender, and education. Optimal TUGdt cutoffs for predicting dementia at 2- and 4-year follow-up based on words/time were calculated. The sensitivity of the TUGdt cutoffs was high at 2-year follow-up: TUGdt-NA words/time, 0.79; TUGdt-MB words/time, 0.71; reducing respectively to 0.64 and 0.65 at 4-year follow-up.

    CONCLUSIONS: TUGdt words/time parameters have potential as cost-efficient tools for conversion-to-dementia risk assessment, useful for research and clinical purposes. These parameters may be able to bridge the gap of insufficient evidence for such clinical outcomes.

    TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05893524: https://www.

    CLINICALTRIALS: gov/study/NCT05893524?id=NCT05893524&rank=1 .

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  • 73.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Health and Welfare, Medical Science. Uppsala University.
    Rosberg Petersson, Johanna
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Medical Science.
    Giedraitis, Vilmantas
    Dalarna University, School of Health and Welfare.
    McKee, Kevin
    Dalarna University, School of Health and Welfare, Social Work.
    Rosendahl, Erik
    Umeå University.
    Berglund, Lars
    Dalarna University, School of Health and Welfare, Medical Science.
    Prediction of conversion to dementia disorders based on Timed Up and Go dual-task test verbal outcomes: A longitudinal prospective memory-clinic-based study2023Conference paper (Refereed)
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