The Research Group for Frail, Seriously Ill Patients
About the research
Our research group is cross-professional and consists of nurses, doctors, and other professions in health care and community medicine.
The group's research focuses on facilitating care for elderly frail patients to prevent a deteriorating health-related quality of life with the help of Health conversations provide support for the fragile cardiovascular patients to be able to manage their symptoms and improve their function during the first year after surgery. We also work to improve the life situation after a cardiac arrest for affected people and next of kin. A sudden cardiac arrest is common and one of the most common causes of death in the Western world. Survivors report serious health problems, with symptoms of anxiety, depression, memory and sleep-related problems. Family members of survivors report prolonged grief and problems with self-reported health, and then associated with anxiety. With this research, we want to increase knowledge about people who have survived a cardiac arrest and the family's health, in order to give them adequate support.
From the point of view of health care, it is also important to reduce the need for intensive care through earlier detection, reduce antibiotic resistance and, in the long run, reduce costs for society related to sepsis. For the individual, HAI, especially sepsis, means increased suffering, lasting harm or mortality. The project can strengthen and confirm signs and symptoms that early indicate ongoing HAI. These signs and symptoms are formulated in a decision support system that is then clinically tested to confirm the detection of HAIs and how it is best used.
Working person-centered benefits for the patient and their next of kin during the ongoing period of illness and treatment. Person-centered care provides better adherence and, in the long run, improved medical results. A conversation where the person meets a listening nurse is described as the basis for then making a joint plan for the upcoming treatment period. The key is understanding the situation that the person is in and that the plan it is drawn up based on the.
The group works with different approaches for fragile patients and research-based with preventing and improving the person-centered through, among other things, Health support and decision support where both qualitative and quantitative research is conducted with both retrospective and prospective design used.
FrailHeart
Health for heart patients can help them identify a problem, increase patient engagement, and manage their health, which also improves patients' quality of life.
It is also an important asset for patients' next of kin. The follow-up is advisory and supportive and aims to avoid and detect possible complications in the patient and to strengthen the patient's self-care ability.
The results are expected to increase knowledge about patients' physical and mental well-being before and after heart surgery. All in all, the questionnaires can reflect what the health looks like for the fragile heart surgery patients and how we can provide extra support to these patients.
The projects are well established at the thoracic vascular clinic in Linköping, where the clinic management has set requirements for the well-being of fragile patients in connection with heart surgery.
The originality of the projects is that the study will increase the basic understanding of how the degree of frailty can contribute to preoperative assessments and later better adapt individuals' expectations of the surgical outcome.
The project is expected to lead to an increased knowledge of which preoperative factors to a greater extent than others provide a better quality of life after surgery.
Knowledge of how fragile patients experience health in connection with heart surgery contributes to the possibility of adapting care. This can be achieved by listening to the patient's need for adapted information and thus the continued rehabilitation can be optimized.
We also want to increase knowledge about the family and look further at their health, satisfaction with life, anxiety, depression and sleep linked to family function and social support among next of kin of survivors of a cardiac arrest.
FrailBrain
Cognitive impairment is a relatively common phenomenon after cardiovascular surgery.
It is of the utmost importance that healthcare professionals are aware of risk factors for suffering from cognitive impairment and to prevent and take early action as far as possible.
We can improve and improve and develop care in connection with heart surgery, both in terms of the reception of the patient at admission, during the hospital stay and what the follow-up should look like. This is to improve support from the health care system when the patient has a deteriorating health, is fragile and has insufficient support. It is of great importance for improving the physical and mental well-being of the frail patients after cardiovascular surgery.
A sudden cardiac arrest immediately results in a circulatory pause, a life-threatening condition that leads to death unless circulation is restored immediately. The condition leads directly to a lack of oxygen in the brain and cognitive impairment is therefore common in survivors, even after shorter circulatory pauses. Studies that specifically examined the prevalence of cognitive impairment in cardiac arrest survivors show that between 6% and 100% have an affected cognitive function. A likely explanation for this strong variation is that the studies used different assessment methods, probably due to the lack of consensus on which assessment instruments should be used to screen for cognitive impairment after a cardiac arrest. Another importance is to detect mild cognitive impairment early, this is emphasized in the Diagnostic and Statistical Manual of Mental Disorders -5 criteria. In today's health care, follow up in cardiac arrest does not include systematic screening for cognitive impairments. As cognitive problems increase with age, this group of survivors is likely to be more vulnerable than younger cardiac arrest survivors and therefore needs to be identified to an even greater extent. In summary, there is a great need for valid self-assessment instruments that can increase the possibility of detecting and treating mild cognitive impairment in elderly cardiac arrest survivors.
FrailHealth
From the point of view of health care, it is important to reduce the need for intensive care through earlier detection, reduce antibiotic resistance and, in the long run, reduce costs for society related to sepsis.
Overall, it is crucial to find the patients with HAIs before it has time to develop into serious HAI, this can reduce suffering for the patient, reduce the length of stay and thus the costs for healthcare. It is important to study what signs and symptoms these patients with severe HAIs exhibit and what characteristics and diagnoses these patients have. The nurse's vigilant nursing is of great importance in earlier identification of signs and symptoms of ongoing severe HAIs and, above all, sepsis.
Studies from countries with a low incidence of tuberculosis report shortcomings in the treatment of healthcare professionals. The treatment is completed but it happens many times under frustration and discomfort and with a sense of humiliation. There is a lack of knowledge about how Swedish tuberculosis care works in this regard. There are no studies on how people undergoing treatment for tuberculosis in Sweden and their next of kin experience care and treatment time, which gives reason to investigate this further.
Studies from countries with a low incidence of tuberculosis report shortcomings in the treatment of healthcare professionals. The treatment is completed but it happens many times under frustration and discomfort and with a sense of humiliation. There is a lack of knowledge about how Swedish tuberculosis care works in this regard. There are no studies on how people undergoing treatment for tuberculosis in Sweden and their next of kin experience care and treatment time, which gives reason to investigate this further.
FrailSleep
Insomnia has a major impact on both physical and mental health and is therefore important to detect and treat.
Insomnia increases the risk of suffering from cardiovascular diseases. Poor sleep efficiency (problems with sleep onset and waking up after sleep onset) is associated with mortality, metabolic syndrome and cardiovascular disease.
About one-fifth of survivors of a cardiac arrest have insomnia problems shortly after the event. A long-term study has described that sleep problems are common in people who survived a cardiac arrest and who did not improve after two years of follow-up. It is therefore important to screen for insomnia problems so that they can be identified and treated. One problem is that the question of sleep is not asked, and then due to lack of knowledge about sleep and that sleep is not a priority area during recovery and follow-up in cardiac follow-up care.
Cooperation
The research project Frail has close collaboration with the infection clinic, ThoraxVascular Clinic at Linköping University Hospital, and Linnaeus University Kalmar.
Research Group
Facts
Detecting early stage infections in critically ill patients (Vigilance health-associated infections)
In Sweden, approximately 65,000 patients are affected by healthcare-associated infections (HAIs) every year, which more than doubles the length of care for these and contributes to the death of 1500, most commonly from healthcare-associated sepsis on the basis of healthcare-associated pneumonia or healthcare-associated urinary tract infection.
Vigilance is based on the nurse having the ability to understand the meaning of an observation, anticipate what may happen and also understand the risks of an action. It is also important to be ready to act and know when it is appropriate to act. Finally, vigilance also implies the responsibility to monitor the results of one's own and others' actions. The aim of this project is to identify signs and symptoms to detect severe HAIs in hospitalized surgical patients at an early stage.
Identify fragile heart surgery patients
In Sweden, around 5800 open heart surgeries are performed annually. The patient group consists of elderly people who often carry a multimorbidity, which can mean greater vulnerability. In connection with cardiac surgery, the patient faces challenges that affect both physically and mentally. Increased knowledge about how fragile patients undergoing heart surgery experience their health can contribute with an opportunity for healthcare to better understand how nursing can be improved. The nurse's understanding of the patient's life situation becomes an important prerequisite for providing person-centred nursing.
The aim was to explore how fragile patients experience health, anxiety and anxiety in connection with heart surgery.
The aim was to explore how fragile patients experience health, anxiety and anxiety in connection with heart surgery.
Health solutions for increased patient engagement and better quality of life for frail elderly heart surgery patients
In Sweden, approximately 5800 open heart surgeries are performed annually. The patient group consists of older people who often carry a multimorbidity, which can
mean greater vulnerability. There is a need for a better understanding of this and follow-up and support with an Health intervention to help the heart surgery patients manage their symptoms and improve their function in the first year after heart surgery. Increased knowledge of how fragile patients undergoing heart surgery experience their health can contribute with an opportunity for healthcare to better understand how nursing can be improved. The nurse's knowledge of the patient's life situation becomes an important prerequisite for be able to provide person-centred care. Our main goal is to improve the care of heart surgery on fragile patients.
mean greater vulnerability. There is a need for a better understanding of this and follow-up and support with an Health intervention to help the heart surgery patients manage their symptoms and improve their function in the first year after heart surgery. Increased knowledge of how fragile patients undergoing heart surgery experience their health can contribute with an opportunity for healthcare to better understand how nursing can be improved. The nurse's knowledge of the patient's life situation becomes an important prerequisite for be able to provide person-centred care. Our main goal is to improve the care of heart surgery on fragile patients.
Cognitive self-assessment, function, assessment in cardiac arrest survivors
Cardiac Arrest (CA) is an important global health problem. Survival rates vary between countries, but according to a more recent overview guide, the survival rate for cardiac arrest is 20% in hospital and 10% if people are affected outside hospital. Despite poor prognosis, survival rates have increased in recent decades. The survivors have reported good health after their cardiac arrest, but despite this, CA survivors report health problems with cognitive impairments that can negatively affect their lives. Not all people affected by CA are routinely screened for cognitive impairments. Healthcare professionals have an important role in detecting cognitive impairment in the follow up of CA care. There is little research and knowledge about how healthcare professionals perceive and understand cognitive impairment in people who have survived a cardiac arrest. Most assessments of cognitive function are made by health care professionals and sometimes by next of kin, but there are no self-reported instruments for detecting cognitive impairments that are developed for those who have survived a cardiac arrest. We want to expand the knowledge of cognitive function and cognitive self-assessment in these people.
The impact of sleep on health and quality of life after cardiac arrest
Sleep is an important element in all aspects of health-related quality of life. Sleep problems today are strongly associated with various health problems. Today, there is research that shows that both too short and too long sleep increase the risk of premature death. Sleep problems also increase the risk of cardiovascular disease. A study in the Netherlands, which followed over 18,000 healthy people for 10-14 years, shows that people with sleep for 6 hours or over 9 hours had an increased risk of heart disease by 23% and by 15% for vascular diseases. For people who also had a reduced sleep quality, the risk of vascular disease increased up to 63% and for heart disease up to 79% compared to people with normal sleep. With this project, we want to increase knowledge about cardiac arrest survivors' health-related quality of life with a focus on symptoms of insomnia.
Next of kins' health and life situation after cardiac arrest
Sudden cardiac arrest is common and is one of the most common causes of death in the Western world. The sudden loss after cardiac arrest can have a significant impact on the health of grieving family members. Family members report prolonged grief and problems with self-reported health, and then associated with anxiety. Spouses report more problems with long-term grief and self-reported health compared to non-spouses.
Next of kin experience contradictory feelings and concerns. The feeling of unexpectedly being alone and being given responsibility for the common life is particularly burdensome. The fear of losing one's family member increased the burden and after discharge an adapted everyday life emerged, influenced by the needs of the survivor, such as emotional, social, socio-economic and practical changes within the family. Increased knowledge of how next of kin experience their life situation can help to improve contact after discharge. There is a risk that these family members will also develop serious health problems and professional support should be offered. The goal is to describe and explore next of kins' health, satisfaction with life, sleep, family function and develop increased social support after a cardiac arrest.
Experiences of tuberculosis treatment in Sweden, perspectives from patients, next of kin and healthcare professionals
In Sweden, 365 cases of turbercolosis (TB) were reported in 2021. Of these, 90% were infected abroad and this reflects that the incidence of TB in Sweden correlates well with migration flows from countries where the disease is still common. It can be stated that in Sweden there are no major problems with interrupted TB treatments, but there is no knowledge of how people with TB and next of kin and healthcare professionals in Sweden experience the treatment period. The aim is to describe, explore and evaluate how patients, next of kin and healthcare professionals experience the treatment period of TB and support based on a person-centered approach.