Biomedical subjects

Gerry Larsson

Publications and source records attributed to Gerry Larsson.

14 recordsLinked to original sources

PubMed2006

The Developmental Leadership Questionnaire (DLQ): some psychometric properties.

The development leadership model (Larsson et al., 2003), designed to introduce refinements to the transformational leadership model, has been adopted for use in the Swedish Armed Forces. The Developmental Leadership Questionnaire (DLQ) was constructed to measure important parts of the model. The main aim of the study was to evaluate some psychometric properties of the DLQ. Most analyses are based on two subsets of individuals from a sample mostly consisting of male Swedish, military officers, each of whom has rated a given leader (n = 450 and 449 respectively). A second sample consisted of Swedish military cadets (n = 141). The dimensionality was assessed with a confirmatory factor analysis. Most DLQ scales were reasonably well reproduced and showed high or acceptable internal consistency. When related to perceived results of leadership (self-rated by leaders and rated by subordinates), results from multiple regression analyses supported what could be predicted by the theoretical model. It was concluded that the DLQ has acceptable psychometric properties and that the theoretical refinements introduced to the developmental leadership model were empirically supported.

Adult↗

PubMed2005

Psychosocial aspects of health in adolescence: the influence of gender, and general self-concept.

PURPOSE: The aim of this study was to describe age and gender differences in psychosocial aspects of health in adolescents. A further aim was to explore if self-rated behavior problems varied with the adolescents' general self-concept and sense of coherence. METHODS: Questionnaires on self-rated psychosocial aspects of health were answered by 282 (n = 282/390) randomly selected adolescents, aged 13-22 years (M 17.9/18.0). The instruments used were "I think I am (ITIA)," "Youth Self Report (YSR)," "Sense of coherence (SOC)," and "Family APGAR." Differences between males and females (cross-individual grouping) were analyzed using nonparametric tests. A cluster analysis was performed using a three-cluster solution to identify and describe profiles (person-centered grouping). RESULTS: Compared with males, adolescent females scored less favorably on self-esteem (ITIA) (p = .028), reported more behavior problems (YSR) (p = .000), and showed a lower sense of coherence (SOC) (p = .003). The differences were most evident in the age group 15-17 years. The three clusters significantly differed from each other regarding how high proportions of problems the adolescents of each profile reported. CONCLUSIONS: Compared with male adolescents, adolescent females experienced a poorer psychosocial health in somatic, depressive, and internalizing areas. The result indicated that psychological factors had a major impact on the proportions of problems that the adolescents reported.

Adolescent↗

PubMed2005

Personality disorders in a Swedish peacekeeping unit.

There is a lack of knowledge about the incidence of personality disorders and their consequences among peacekeepers. Moreover, most studies are follow-up studies in which, if at all, personality traits are screened for after the soldiers have left their service abroad. The aim of this paper was to study personality disorders in a longitudinal perspective. The method used was to screen the personnel in a Swedish mechanized battalion serving in Bosnia from March until October 1996 on four occasions: before deployment, immediately after deployment, 6 months after deployment and 1 year after deployment. Serving in the battalion were 724 individuals of whom 516 took part in the survey. The screening instrument used was the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The result shows that the rate of personality disorders were on the same level, or a little bit lower, than in the general population. Moreover, personality disorders were related to impaired general mental health and to reported traumatic experiences. Personality disorders also seemed to contribute to poor mental health 1 year after returning home from a mission abroad. The implications of these results for the future selection of peacekeepers are discussed.

Adult↗

PubMed2005

International comparisons of patients' views on quality of care.

PURPOSE: To compare patients' views on quality of care in different countries using a theory-based instrument, while at the same time controlling for the following potential confounders: type of care system (private vs public), type of care (kind of health problem), gender, age, and subjective wellbeing. DESIGN/METHODOLOGY/APPROACH: Patients capable of communicating in wards (medical and surgical departments) and day surgery departments in England, France, Norway, and Sweden were recruited consecutively, to participate in a programme run by the health-care company Capio. Ward patients: England (n=1236), France (n=1051), Norway (n=226), and Sweden (n=428). Day surgery patients: England (n=887), France (n=544), Norway (n=101), and Sweden (n=742). Average response rate across settings: approximately 75 per cent. Patients evaluated the quality of the care they actually received and the subjective importance they ascribed to different aspects of care. The questionnaire "Quality from the patient's perspective" (QPP) was used (modified short version). FINDINGS: Cross-national comparisons were made within each of the two care contexts (wards and day surgery) separately for men and women. Quality of care evaluations were adjusted for age and subjective wellbeing. English and French patients scored significantly higher than Norwegian and Swedish on both kinds of ratings (perceived reality and subjective importance), in both kinds of care contexts, and in both sexes. ORIGINALITY/VALUE: Cross-national comparisons of patients' views on care can give meaningful guidance for practitioners only if they are context-specific and if well-known confounders are controlled for.

Adult↗

PubMed2004

The relationship between illness severity, sociodemographic factors, general self-concept, and illness-specific attitude in Swedish adolescents with epilepsy.

PURPOSE: The aim of this study was to describe the relationship between the epilepsy condition (illness severity), sociodemographic factors, general self-concept, and illness-specific attitude in adolescents with uncomplicated epilepsy. METHODS: Adolescents, aged 13-22, fulfilling criteria registered in four Swedish hospitals, answered questionnaires (n = 149). The instruments "I think I am" and "Sense of coherence" measured the patients' general self-concept. The "Child Attitude Toward Illness Scale" measured illness-specific attitude. A summary score (index) calculated from seizure frequency, seizure type, and antiepileptic drug (AED) with side effects measured "Illness Severity". RESULTS: Illness severity was significantly related to the participants' general self-concept, as well as to their attitude toward their condition; i.e. higher illness severity scores were correlated with lower sense of coherence (SOC), poorer self-esteem, and a more negative attitude towards the epilepsy condition. Females had more severe illness according to the Illness Severity Index, with almost 80% found in the moderate and high severity groups as compared to 63% of males in the moderate/high severity groups. CONCLUSIONS: It was concluded that the severity of the epilepsy condition was related to the adolescents' general self-concept and illness-specific attitude, but further research is needed to understand the causality of the relationship. The brief assessment of illness severity, constructed and used in this study should be addressed and developed further.

Adolescent↗

PubMed2004

Advanced home care: patients' opinions on quality compared with those of family members.

BACKGROUND: Advanced medical care in the patient's home setting is becoming more common. Many of the patients who receive this kind of care have severe illnesses and are unable to respond to questions about the quality of care. The research question was: are the patients' opinions congruent with those of family members? AIM: To explore and compare the relationship between patients' perception of the quality of care and close family members' perception of this care as well as their perception of the patients' perception. METHODS: Sixty-seven patients receiving advanced home care, 82 family members (54 matched patient + family member pairs) participated. Data were collected using a short version of the quality from the patient's perspective questionnaire modified to advanced home care. RESULTS: A high degree of perceptual congruence was found between patients and their family members. The similarity was also high between family members' own opinion and their appraisal of how the patient perceived the care. A subgroup of family members who met the patient once a week or less often deviated from this pattern. CONCLUSION: Patients' views on the quality of care are congruent with the opinions of family members if they meet every day (live together) and share the same everyday and care-related experiences. The results can be understood in the light of empathic accuracy theory. RELEVANCE TO CLINICAL PRACTICE: The findings of this study have important implications for clinical nursing practice. Family members' perception of the quality of care may be a valuable data source for nurses in the case of advanced home care if the patient and family member share the same everyday, care-related experiences, otherwise family members' perception tend to be more critical than those of the patients themselves.

Adolescent↗

PubMed2004

Analysis of the decision-making process leading to appendectomy: a grounded theory study.

The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons' decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors' individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.

Adult↗

PubMed2003

Promising outcome of a hip school for patients with hip dysfunction.

OBJECTIVE: To evaluate, in an exploratory study, a hip school led by physical therapists for patients with hip dysfunction including pain. METHODS: Physicians in primary care and orthopedic units consecutively recruited patients by residential area to a treatment group (T group; n = 77) and a control group (C group; n = 68), mean age 61.8 years, 59 men, 86 women. Ninety-nine of the 145 subjects had radiologic hip osteoarthritis. Outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Nottingham Health Profile (NHP). RESULTS: After hip school (6 months) the T group showed greater reduction on the subscales of pain and activity limitations (WOMAC) than the C group. The subscales sleep disturbances, pain, and physical mobility (NHP) showed improvement for the T group compared with at start. The results for the T group persisted after an additional 6 months. CONCLUSION: A hip school may reduce pain and activity limitations and improve health-related quality of life for patients with hip dysfunction including pain.

Adult↗

PubMed2003

Examination of passive ROM and capsular patterns in the hip.

BACKGROUND AND PURPOSE: The present study was conducted to examine passive hip range of motion (PROM) for patients with hip dysfunction, including pain, with or without hip osteoarthritis, to arrange and describe PROM patterns and to count the number of hips presenting Cyriax's and Kaltenborn's capsular patterns. METHOD: The study is theory-testing, observational, cross-sectional and descriptive. One hundred and sixty-eight patients (mean age 61.7 years, range 36-90 years), 50 with no hip osteoarthritis, 77 with unilateral hip osteoarthritis and 41 with bilateral osteoarthritis, based on radiological reports, were consecutively recruited by physicians in primary health care and orthopaedic settings. One examiner tested PROM bilaterally, by use of a goniometer and a standardized protocol. PROM limitations were calculated by comparing norms from the symptom-free hips (n = 100) in the study, from Kaltenborn and, in patients with unilateral hip osteoarthritis (n = 77), from the non-osteoarthritis hip. The limitations were arranged by size in PROM patterns. The patterns and the numbers of hips with patterns corresponding to Cyriax's and Kaltenborn's capsular patterns were counted. RESULTS: Between 68 and 138 PROM patterns were identified by use of different PROM norms for defining limitations. Few osteoarthritis hips showed Cyriax's capsular pattern and none Kaltenborn's capsular pattern. CONCLUSIONS: The concept of capsular pattern for the hip should be re-examined. No support was found in the present study for its existence. It is impossible to anticipate radiological evidence of hip osteoarthritis from the multitude of PROM patterns. Every patient should be regarded as unique.

Adult↗

PubMed2003

Stress reactions among Swedish peacekeeping soldiers serving in Bosnia: a longitudinal study.

Assessments of mental health (GHQ-28) were performed on a Swedish battalion serving in Bosnia at 4 times: before deployment, immediately after deployment, 6 months after deployment, and 1 year after deployment. Complete responses were obtained from 316 participants (61% response rate). No significant change of mental health over time was noted. Individuals having experienced traumatic events in Bosnia, as well as stressful life events postdeployment, reported the poorest mental health. Logistic regression analysis showed that postdeployment stressors made the strongest contribution to registering a poor mental health score after one year.

Humans↗

PubMed2003

Quality improvement measures based on patient data: some psychometric issues.

Existing methods for handling patients' opinions as a basis for quality improvement measures tend to be too sophisticated for practical nursing and/or weak psychometrically. An Index of Measures was developed by combining patients' perceptions of actual care conditions with the subjective importance they ascribed to these conditions. Data from Swedish somatic inpatients (n = 4002) indicated that this index gave added value compared to patients' ratings of actual care conditions only. Interpretation of the Index of Measures focused on the proportion of patients who receive the value "deficiency." This value is obtained if a given patient has a subjective importance rating on a given item which is higher than the mean subjective importance score for the whole patient group on that item, as well as a perceived reality rating on the item in question which is lower than the mean perceived reality rating for the whole group on that item. Guidelines are suggested on when improvement actions are necessary and when they are not necessary.

Adult↗

PubMed2002

Psychometric testing of the NEECHAM Confusion Scale among patients with hip fracture.

The main aim of this study was to assess the reliability and validity of a Swedish translation of the NEECHAM Confusion Scale among 73 patients having surgery for hip fractures. Cronbach's alpha before and 7 days after surgery were.73 and.82, respectively. Principal-component analyses yielded three factors explaining 69% of the variance of the variables preoperatively and 73.6% of the variance 7 days postoperatively. Four months after discharge vital function, factor II in the NEECHAM scale, significantly predicted the total score on the Ferrans and Powers Quality of Life Index. Items reflecting information processing, behavior, and urinary continence, factor I, also predicted functional capacity, using the Standardized Practical Equipment test, a tool measuring instrumental daily activity. The scale seems to be a reliable and valid instrument for evaluating acute confusional state among patients with hip fracture.

Activities of Daily Living↗

PubMed2002

Development of a short form of the Quality from the Patient's Perspective (QPP) questionnaire.

Patients' views on the quality of care are important and it is desirable that these can be assessed using short, yet valid and reliable instruments. The aim of the work reported here was to develop and test a short version of an established questionnaire: Quality from the Patient's Perspective (QPP). Patients (n=162, 79% response rate) receiving care at medical and surgical departments in two Swedish hospitals responded to the original QPP as well as to a newly developed short version. An ethical research committee approved the study. Pearson correlations were computed between the long and short forms and differences between means were analysed with t-tests. Reliability was estimated by computing Cronbach alpha coefficients. Correlations of acceptable size were found between the short form and the original QPP. The short form also had acceptable reliability coefficients. The strengths of the work are that the items in the short version are derived from a patient perspective and are formulated in words used by patients; the items still have a theoretical foundation, which makes the interpretation of results more meaningful; global formulations such as "What do you think about your care?" have been avoided; the short format should make the questionnaire more attractive for many patients to respond to. Limitations are that results indicate that the short form does not fully measure what the long form does. Therefore, when the short form is used in practice, a two-step procedure is suggested, where a follow-up is done with a selection of items from the original long form. This selection could be restricted to areas where problems may be suspected, based on the results from the short form.

Adolescent↗

PubMed2002

Intermittent versus indwelling catheters for older patients with hip fractures.

Nursing staff identified postoperative urinary tract infection (UTI) in patients with hip fracture as an increasing problem. A quality improvement project was carried out to investigate the problem and to reduce the incidence. The aim of the study was to describe the occurrence of UTI among patients with hip fracture before and after surgery, to assess whether the decision to use intermittent catheters instead of indwelling catheters was adopted and to test the hypothesis that hospital stay is significantly longer for patients with UTI than for those without infection. One hundred and forty-four patients were investigated for bacteriuria before the first catheterization and 1 week after the last catheterization. Positive urine cultures on admission to hospital were found in 38% of patients. Among those free from bacteria on admission, 61% had a positive urine culture after indwelling catheterization compared with 32% in the group treated with intermittent catetherization. A significantly longer hospital stay (P </= 0.05) was found among patients with UTI. The reason for using an indwelling catheter was not found in any medical or nursing documentation for 29% of the patients. The study points to the necessity for systematic assessment to detect and prevent UTI among older patients with hip fracture.

Age Factors↗