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Papers by Bodil Wilde-larsson

Research paper thumbnail of COPD patientsperspectives at the time of diagnosis: a qualitative study

Aims: To gain an understanding of patientsperspectives and perceptions of chronic obstructive pul... more Aims: To gain an understanding of patientsperspectives and perceptions of chronic obstructive pulmonary disease (COPD) at the time of diagnosis. Methods: A qualitative study using grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or with suspected COPD, were interviewed. Results: The analysis created a process model with a core category "Consequences of smoking" and main

Research paper thumbnail of Patients' perceptions of quality of care, self-rated functional ability, and health one year after total knee arthroplasty: a follow-up of forty-one patients

Journal of Orthopaedic Nursing, 1999

Research paper thumbnail of COPD patients perspectives at the time of diagnosis: a qualitative study

Primary care respiratory journal : journal of the General Practice Airways Group, 2007

To gain an understanding of patients perspectives and perceptions of chronic obstructive pulmonar... more To gain an understanding of patients perspectives and perceptions of chronic obstructive pulmonary disease (COPD) at the time of diagnosis. A qualitative study using grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or with suspected COPD, were interviewed. The analysis created a process model with a core category "Consequences of smoking" and main categories "Shame", "Appearance of symptoms", "Adaptation", "Reflection", and "Action". "Restrictions in physical capacity" was a key indicator of evolving disease and "Getting a diagnosis" was crucial for the patient. The COPD patient needs a clear diagnosis at an early stage. It is important to seize the opportunity when the presumptive COPD patient is receptive towards support and further action. To detect and support the patient, health professionals must be aware of minor symptoms and underlying mechanisms of possible shame.

Research paper thumbnail of Registered nurses and enrolled nurses assessments of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture

International Journal of Orthopaedic and Trauma Nursing, 2010

The aim of the study was to describe and compare registered (RNs') and enrolled nurses' (ENs') as... more The aim of the study was to describe and compare registered (RNs') and enrolled nurses' (ENs') assessments of postoperative pain, risk for malnutrition and pressure ulcers in patients with hip fracture. Furthermore, the aim was to describe and compare their perceptions of using assessment tools. Thirty-four (34) RNs and forty-three (43) ENs, working on orthopaedic wards in Sweden, took part in the study. The assessments were carried out on 82 patients with hip fracture. The assessment tools included the numerical rating scale (NRS), short-form nutritional assessment tool (MNA-SF), modified Norton scale (MNS) and pressure ulcer card. Many patients were assessed to be in postoperative pain and at possible risk for malnutrition. Around 50% were assessed as being at risk for pressure ulcer formation (PU). There is a difference between RNs and ENs assessments of patients' postoperative pain, risk for malnutrition and PU. ENs assessed to a greater degree that patients were in intense pain currently. RNs assessed to a greater degree that patients had been in intense pain in the past 24 h. Single items on the tools showed differences. However, there was no statistically difference for MNA-SF screening score and MNS total score. ENs found it easier to assess postoperative pain with the NRS compared to RNs.

Research paper thumbnail of Assessments of patients’ pain, nutrition and skin in clinical practice: Registered and enrolled nurses’ perceptions

International Journal of Orthopaedic and Trauma Nursing, 2012

... Qualitative content analysis is a method that deals with manifest as well as latent content i... more ... Qualitative content analysis is a method that deals with manifest as well as latent content in the text (Graneheim and Lundman, 2004). ... The qualitative content analysis method by Graneheim and Lundman (2004) was found to be relevant and useful for the aim of the study. ...

Research paper thumbnail of Seizures and therapy in adolescents with uncomplicated epilepsy

Seizure, 2003

Purpose: This study aimed to describe seizures and their therapy among Swedish adolescents, aged ... more Purpose: This study aimed to describe seizures and their therapy among Swedish adolescents, aged 13-22, with active but uncomplicated epilepsy. Method: The adolescents answered questionnaires (158/193). Data were also obtained from medical records. Results: Epileptic seizure types could be specified in 92.1% of the cases. Predominant types were Primary Generalised Tonic-Clonic Seizures and Partial Complex Seizures with Secondary Generalisation. Clinical diagnoses by physicians were unspecified in 25.8%. Ninety percent were on antiepileptic drugs (AEDs), most commonly valproate and carbamazepine. New AEDs were used in 9.3% of the cases and polytherapy in 13.9%. More than 40% of the respondents had seizures despite AED treatment. Side effects of AEDs were experienced by 61%, most commonly tiredness, concentration difficulties and headache. Patients on polytherapy experienced significantly more side effects. The choice of a new AED over a traditional one was not related to seizure type or seizure control. Conclusions: Many adolescents had persistent seizures despite treatment at a specialist regional epilepsy centre. This, plus the high reported rate of side effects of AED treatment, suggests that treatment is not optimal for the group studied. As traditional AEDs strongly dominated treatment possibly newly marketed AEDs are underused in this group.

Research paper thumbnail of Refinement of the Questionnaire 'Quality of Care from the Patient's Perspective' using Structural Equation Modelling

Scandinavian Journal of Caring Sciences, 1998

In 1994, the questionnaire 'Quality of Care from the Patient's Perspective&#3... more In 1994, the questionnaire 'Quality of Care from the Patient's Perspective' (QPP) was developed using a conventional factor analytical approach (Wilde et al. 1994). The items and conceptual framework of this questionnaire were derived from a theoretical model, which, in turn, was developed from qualitative patient interviews, using a grounded theory method of analysis (Wilde et al. 1993). The aims of this study were to develop further the dimensionality of the QPP using structural equation modelling combined with advances in factor analysis modelling, and to refine the instrument. This comparatively new methodology extracts more information out of questionnaire data and is considered to be superior to traditional scaling methods. The sample consisted of 611 somatic inpatients from four departments at a Swedish hospital. Data collected with the QPP were explored with the new tool tracing the dimensions postulated in the theoretical model underlying the QPP. A nested factor model was developed fulfilling statistical criteria for adjustment between model and data. The model consists of a general factor and 16 subordinate factors. Most of the original QPP scales were reproduced with the new statistical technique. However, some content changes were made which appear to bring the QPP scales closer to patients' meaning representations of the area. Some changes were also made to the response format, changes which appear to strengthen the psychometric properties of the instrument. The refined QPP will hopefully contribute to a more differentiated picture of quality of care when applied in the field. All scales, items, and response formats of the revised QPP are presented in an appendix.

Research paper thumbnail of Advanced home care: patients' opinions on quality compared with those of family members

Journal of Clinical Nursing, 2004

Advanced medical care in the patient's home setting is be... more 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? 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. 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. 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. 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. 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.

Research paper thumbnail of Womens’ opinions on intrapartal care: development of a theory-based questionnaire

Journal of Clinical Nursing, 2009

Aim. To develop a patient questionnaire specific to intrapartal care, based on the theoretical fo... more Aim. To develop a patient questionnaire specific to intrapartal care, based on the theoretical foundation of the general instrument Quality from the Patient's Perspective (QPP). Background. Existing general patient questionnaires do not take intrapartal care aspects fully into account, and available intrapartal-specific patient questionnaires tend to have a weak theoretical foundation. Design. A cross-sectional, nationwide study carried out during a two-week period in 2007 at Swedish maternity units.

Research paper thumbnail of Patient Participation in Health Care Consultations: Qualitative Perspectives

Journal of Clinical Nursing, 2008

Research paper thumbnail of Patients' views on quality of care: do they merely reflect their sense of coherence?

Journal of Advanced Nursing, 1999

  1. Journal of Advanced Nursing 30(1), 33±39

Research paper thumbnail of International comparisons of patients’ views on quality of care

International Journal of Health Care Quality Assurance, 2005

Research paper thumbnail of Nursing theory based changes of work organisation in an ICU: effects on quality of care

Intensive and Critical Care Nursing, 1992

Research paper thumbnail of Push or pull? Relationships between lung cancer patients’ perceptions of quality of care and use of complementary and alternative medicine

European Journal of Oncology Nursing, 2011

Research paper thumbnail of Adolescents' experiences of being food-hypersensitive: a qualitative study

BMC Nursing, 2007

Background: Experiencing or being at risk of adverse reactions to certain food items is a common ... more Background: Experiencing or being at risk of adverse reactions to certain food items is a common health issue, especially among children and adolescents. Research has shown that living with the risk of food reactions and always having to take measures to avoid certain food in one's diet has a negative impact on quality of life. The aim of this study was to illuminate adolescents' experiences of being food hypersensitive.

Research paper thumbnail of Psychometric properties of the Quality in Psychiatric Care–Outpatient (QPC–OP) instrument

… Journal of Mental …, Jan 1, 2011

The purpose of the present study was to test the psychometric properties and dimensionality of th... more The purpose of the present study was to test the psychometric properties and dimensionality of the Quality in Psychiatric Care -Outpatient (QPC-OP) instrument, in order to determine whether the model of QPC that is applicable to the inpatient clinic is also applicable to the outpatient clinic, and to briefly describe the patients' perceptions of quality of psychiatric outpatient care. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden participated in the study. A confirmatory factor analysis revealed that the QPC-OP consists of eight dimensions, and has a factor structure largely corresponding to that of the QCP -Inpatient instrument. The internal consistency of the factors was generally acceptable, except in the case of two, where there were not enough items. Thus, the QPC-OP shows adequate psychometric properties. The patients' ratings of quality of care were generally high; the highest rating was for 'encounter' and the lowest for 'discharge'. The quality of discharge was rated as the lowest among the eight dimensions in 14 of the participating outpatient clinics. Thus, this dimension would seem to indicate an important area for improvement. The QPC-OP includes important aspects of patients' assessments of quality of care, and offers a simple and inexpensive way to evaluate psychiatric outpatient care.

Research paper thumbnail of COPD patientsperspectives at the time of diagnosis: a qualitative study

Aims: To gain an understanding of patientsperspectives and perceptions of chronic obstructive pul... more Aims: To gain an understanding of patientsperspectives and perceptions of chronic obstructive pulmonary disease (COPD) at the time of diagnosis. Methods: A qualitative study using grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or with suspected COPD, were interviewed. Results: The analysis created a process model with a core category "Consequences of smoking" and main

Research paper thumbnail of Patients' perceptions of quality of care, self-rated functional ability, and health one year after total knee arthroplasty: a follow-up of forty-one patients

Journal of Orthopaedic Nursing, 1999

Research paper thumbnail of COPD patients perspectives at the time of diagnosis: a qualitative study

Primary care respiratory journal : journal of the General Practice Airways Group, 2007

To gain an understanding of patients perspectives and perceptions of chronic obstructive pulmonar... more To gain an understanding of patients perspectives and perceptions of chronic obstructive pulmonary disease (COPD) at the time of diagnosis. A qualitative study using grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or with suspected COPD, were interviewed. The analysis created a process model with a core category "Consequences of smoking" and main categories "Shame", "Appearance of symptoms", "Adaptation", "Reflection", and "Action". "Restrictions in physical capacity" was a key indicator of evolving disease and "Getting a diagnosis" was crucial for the patient. The COPD patient needs a clear diagnosis at an early stage. It is important to seize the opportunity when the presumptive COPD patient is receptive towards support and further action. To detect and support the patient, health professionals must be aware of minor symptoms and underlying mechanisms of possible shame.

Research paper thumbnail of Registered nurses and enrolled nurses assessments of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture

International Journal of Orthopaedic and Trauma Nursing, 2010

The aim of the study was to describe and compare registered (RNs') and enrolled nurses' (ENs') as... more The aim of the study was to describe and compare registered (RNs') and enrolled nurses' (ENs') assessments of postoperative pain, risk for malnutrition and pressure ulcers in patients with hip fracture. Furthermore, the aim was to describe and compare their perceptions of using assessment tools. Thirty-four (34) RNs and forty-three (43) ENs, working on orthopaedic wards in Sweden, took part in the study. The assessments were carried out on 82 patients with hip fracture. The assessment tools included the numerical rating scale (NRS), short-form nutritional assessment tool (MNA-SF), modified Norton scale (MNS) and pressure ulcer card. Many patients were assessed to be in postoperative pain and at possible risk for malnutrition. Around 50% were assessed as being at risk for pressure ulcer formation (PU). There is a difference between RNs and ENs assessments of patients' postoperative pain, risk for malnutrition and PU. ENs assessed to a greater degree that patients were in intense pain currently. RNs assessed to a greater degree that patients had been in intense pain in the past 24 h. Single items on the tools showed differences. However, there was no statistically difference for MNA-SF screening score and MNS total score. ENs found it easier to assess postoperative pain with the NRS compared to RNs.

Research paper thumbnail of Assessments of patients’ pain, nutrition and skin in clinical practice: Registered and enrolled nurses’ perceptions

International Journal of Orthopaedic and Trauma Nursing, 2012

... Qualitative content analysis is a method that deals with manifest as well as latent content i... more ... Qualitative content analysis is a method that deals with manifest as well as latent content in the text (Graneheim and Lundman, 2004). ... The qualitative content analysis method by Graneheim and Lundman (2004) was found to be relevant and useful for the aim of the study. ...

Research paper thumbnail of Seizures and therapy in adolescents with uncomplicated epilepsy

Seizure, 2003

Purpose: This study aimed to describe seizures and their therapy among Swedish adolescents, aged ... more Purpose: This study aimed to describe seizures and their therapy among Swedish adolescents, aged 13-22, with active but uncomplicated epilepsy. Method: The adolescents answered questionnaires (158/193). Data were also obtained from medical records. Results: Epileptic seizure types could be specified in 92.1% of the cases. Predominant types were Primary Generalised Tonic-Clonic Seizures and Partial Complex Seizures with Secondary Generalisation. Clinical diagnoses by physicians were unspecified in 25.8%. Ninety percent were on antiepileptic drugs (AEDs), most commonly valproate and carbamazepine. New AEDs were used in 9.3% of the cases and polytherapy in 13.9%. More than 40% of the respondents had seizures despite AED treatment. Side effects of AEDs were experienced by 61%, most commonly tiredness, concentration difficulties and headache. Patients on polytherapy experienced significantly more side effects. The choice of a new AED over a traditional one was not related to seizure type or seizure control. Conclusions: Many adolescents had persistent seizures despite treatment at a specialist regional epilepsy centre. This, plus the high reported rate of side effects of AED treatment, suggests that treatment is not optimal for the group studied. As traditional AEDs strongly dominated treatment possibly newly marketed AEDs are underused in this group.

Research paper thumbnail of Refinement of the Questionnaire 'Quality of Care from the Patient's Perspective' using Structural Equation Modelling

Scandinavian Journal of Caring Sciences, 1998

In 1994, the questionnaire 'Quality of Care from the Patient's Perspective&#3... more In 1994, the questionnaire 'Quality of Care from the Patient's Perspective' (QPP) was developed using a conventional factor analytical approach (Wilde et al. 1994). The items and conceptual framework of this questionnaire were derived from a theoretical model, which, in turn, was developed from qualitative patient interviews, using a grounded theory method of analysis (Wilde et al. 1993). The aims of this study were to develop further the dimensionality of the QPP using structural equation modelling combined with advances in factor analysis modelling, and to refine the instrument. This comparatively new methodology extracts more information out of questionnaire data and is considered to be superior to traditional scaling methods. The sample consisted of 611 somatic inpatients from four departments at a Swedish hospital. Data collected with the QPP were explored with the new tool tracing the dimensions postulated in the theoretical model underlying the QPP. A nested factor model was developed fulfilling statistical criteria for adjustment between model and data. The model consists of a general factor and 16 subordinate factors. Most of the original QPP scales were reproduced with the new statistical technique. However, some content changes were made which appear to bring the QPP scales closer to patients' meaning representations of the area. Some changes were also made to the response format, changes which appear to strengthen the psychometric properties of the instrument. The refined QPP will hopefully contribute to a more differentiated picture of quality of care when applied in the field. All scales, items, and response formats of the revised QPP are presented in an appendix.

Research paper thumbnail of Advanced home care: patients' opinions on quality compared with those of family members

Journal of Clinical Nursing, 2004

Advanced medical care in the patient's home setting is be... more 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? 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. 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. 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. 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. 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.

Research paper thumbnail of Womens’ opinions on intrapartal care: development of a theory-based questionnaire

Journal of Clinical Nursing, 2009

Aim. To develop a patient questionnaire specific to intrapartal care, based on the theoretical fo... more Aim. To develop a patient questionnaire specific to intrapartal care, based on the theoretical foundation of the general instrument Quality from the Patient's Perspective (QPP). Background. Existing general patient questionnaires do not take intrapartal care aspects fully into account, and available intrapartal-specific patient questionnaires tend to have a weak theoretical foundation. Design. A cross-sectional, nationwide study carried out during a two-week period in 2007 at Swedish maternity units.

Research paper thumbnail of Patient Participation in Health Care Consultations: Qualitative Perspectives

Journal of Clinical Nursing, 2008

Research paper thumbnail of Patients' views on quality of care: do they merely reflect their sense of coherence?

Journal of Advanced Nursing, 1999

  1. Journal of Advanced Nursing 30(1), 33±39

Research paper thumbnail of International comparisons of patients’ views on quality of care

International Journal of Health Care Quality Assurance, 2005

Research paper thumbnail of Nursing theory based changes of work organisation in an ICU: effects on quality of care

Intensive and Critical Care Nursing, 1992

Research paper thumbnail of Push or pull? Relationships between lung cancer patients’ perceptions of quality of care and use of complementary and alternative medicine

European Journal of Oncology Nursing, 2011

Research paper thumbnail of Adolescents' experiences of being food-hypersensitive: a qualitative study

BMC Nursing, 2007

Background: Experiencing or being at risk of adverse reactions to certain food items is a common ... more Background: Experiencing or being at risk of adverse reactions to certain food items is a common health issue, especially among children and adolescents. Research has shown that living with the risk of food reactions and always having to take measures to avoid certain food in one's diet has a negative impact on quality of life. The aim of this study was to illuminate adolescents' experiences of being food hypersensitive.

Research paper thumbnail of Psychometric properties of the Quality in Psychiatric Care–Outpatient (QPC–OP) instrument

… Journal of Mental …, Jan 1, 2011

The purpose of the present study was to test the psychometric properties and dimensionality of th... more The purpose of the present study was to test the psychometric properties and dimensionality of the Quality in Psychiatric Care -Outpatient (QPC-OP) instrument, in order to determine whether the model of QPC that is applicable to the inpatient clinic is also applicable to the outpatient clinic, and to briefly describe the patients' perceptions of quality of psychiatric outpatient care. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden participated in the study. A confirmatory factor analysis revealed that the QPC-OP consists of eight dimensions, and has a factor structure largely corresponding to that of the QCP -Inpatient instrument. The internal consistency of the factors was generally acceptable, except in the case of two, where there were not enough items. Thus, the QPC-OP shows adequate psychometric properties. The patients' ratings of quality of care were generally high; the highest rating was for 'encounter' and the lowest for 'discharge'. The quality of discharge was rated as the lowest among the eight dimensions in 14 of the participating outpatient clinics. Thus, this dimension would seem to indicate an important area for improvement. The QPC-OP includes important aspects of patients' assessments of quality of care, and offers a simple and inexpensive way to evaluate psychiatric outpatient care.