Scandinavian journal of caring sciences
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Our knowledge of the immigrant patient's experiences and reflections regarding consultations in primary health care where interpreters are used is limited. Thus, the primary aim was to explore these experiences and reflections. The second aim was to study whether demographic and migration-related factors are associated with the patient's satisfaction with the consultation and feeling of consolation given by the general practitioner (GP). ⋯ The use of authorized interpreters during the consultation is essential. The consultation must be based on a patient-centred strategy and adjusted to the patient's educational level. Cultural competence is needed when meeting immigrant patients.
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The brief screening version of the Multidimensional Pain inventory (MPI) is a shorter version of the West Haven-Yale Multidimensional Pain Inventory that measures pain in a multidimensional way and is theoretically linked to a cognitive-behavioural perspective on chronic pain. ⋯ The result showed that the instrument had acceptable validity and reliability in all age groups except for those aged >or=90 years. Thus, the instrument can be seen as a useful (multidimensional) form of screening for chronic pain.
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Advancing age is associated with high prevalence of dementia, often combined with under-diagnosed and under-treated pain. A nurse-administered assessment tool has been developed to unmask pain during standardised, guided movements, called Mobilisation-Observation-Behaviour-Intensity-Dementia (MOBID) Pain Scale. The aim was to examine intra- and inter-rater reliability of pain behaviour indicators, inferred pain intensity, and the overall MOBID Pain Score. ⋯ Intra- and inter-rater reliability of overall pain were very good [intraclass correlation coefficient (1,1) ranging 0.92-0.97 and 0.94-0.96 respectively, at day 8]. Reliability of pain intensity scores tended to increase by repeated assessment. Using video uptake, MOBID Pain Scale was shown to be sufficiently reliable to assess pain in older persons with severe dementia.
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Randomized Controlled Trial
Effects of COPD self-care management education at a nurse-led primary health care clinic.
Chronic obstructive pulmonary disease (COPD) is disabling, with symptoms such as chronic cough, phlegm, wheezing, shortness of breath and increased infections of the respiratory passage. The aim was to examine the effects of a structured educational intervention programme at a nurse-led primary health care clinic (PHCC) on quality of life (QoL), knowledge about COPD and smoking cessation in patients with COPD. This study had an experimental design in which 52 patients with COPD from a Swedish primary care setting were randomized into two groups (intervention or control). ⋯ This implies that patients were in a dependent relationship which may have affected the responses in a favourable direction. Our findings show that conventional care alone did not have an effect on patients' QoL and smoking habits. Instead, the evidence suggests that a structured programme with self-care education is needed to motivate patients for life-style changes.
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Chronic heart failure (CHF) is a common condition among Europe's aging population. Findings indicate that CHF patients must make significant changes in many aspects of daily life. Previous studies of older primary health-care participants and their activities of daily living (ADL)-ability are rare. ⋯ Participants in NYHA III/IV (adjusted for age), had significantly increased effort (under motor cut-off) when performing ADL-tasks (OR: 15.5, CI 2.40-100.1, p = 0.004) compared to those in NYHA I/II. Older persons in primary health care with CHF exhibit a high amount of dependence, perceived strain and increased effort during performance of ADL. There is an association between NYHA class III/IV and a decreased ADL-ability (AMPS motor ability) even when adjusted for age.