Sigridur Gunnarsdottir - Academia.edu (original) (raw)
Papers by Sigridur Gunnarsdottir
Pain Management Nursing, 2017
Pain Management Nursing, 2016
Pain is a personal experience and patient-provider communication therefore an essential part of d... more Pain is a personal experience and patient-provider communication therefore an essential part of diagnosis and treatment where the patient's perspective needs to be central. The aim of this descriptive cross-sectional study was to investigate chronic-pain-related patientprovider communication in the context of sociodemographic variables, pain variables, perceived outcome of care, and satisfaction with health care providers. A postal questionnaire measuring sociodemographic variables, pain characteristics, pain-related health care utilization and patient-provider communication was sent to a sample of 4,500 individuals randomly drawn from the national population of Iceland. A subsample reporting chronic pain and having visited a health care provider for pain the previous six months (n ¼ 401) was analyzed. Relationships between patient-provider communication and other measured variables were tested using bivariate and multivariate statistics. The more chronic pain impaired health-related quality of life, the more provider control the patients perceived in the patient-provider communication. There was also a strong negative relationship between patients' perception of providers' support and openness to discussing symptoms, and satisfaction with health care provider. Patients' perception of their own control in patient
Scandinavian Journal of Pain, 2016
Aims To investigate the use of Complimentary/Alternative therapy for chronic pain in nationwide s... more Aims To investigate the use of Complimentary/Alternative therapy for chronic pain in nationwide sample. Methods In this cross-sectional study a postal questionnaire measuring socio-demographic variables (e.g. gender, education, income and residence), pain characteristics (severity and interference with daily life), health related quality of life and use of Complimentary/Alternative therapy for chronic pain, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. The relationships between sociodemographic and pain related variables and pain related use Complimentary/Alternative therapy among participants reporting chronic pain (≥3 months) were tested. Results The prevalence of chronic pain (≥3 months) among respondents was 47.5%. Among participants reporting chronic pain, 45.5% (n = 343) reported having consulted some kind of Complimentary or Alternative therapy for their pain the previous six months and this was more prevalent among women tha...
![Research paper thumbnail of Symptoms and quality of life : a cross-sectional, descriptive, correlation study, evaluating the relationship between symptoms and quality of life in patients on opioids with advanced cancer [M.S. Thesis]](https://attachments.academia-assets.com/90873373/thumbnails/1.jpg)
](Neðst á síðunni er hægt að nálgast ritgerðina í heild sinni með því að smella á hlekkinn Skoða/Op... more Neðst á síðunni er hægt að nálgast ritgerðina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open) B A C K G R O U ND : Cancer patients experience multiple symptoms that affect their quality of life (QOL). Cancer related symptoms may be caused by the disease itself or its treatment, but factors like age, gender, and concurrent diseases may also influence the symptomatology. The symptoms-quality of life model shows the relationship between symptoms and QOL in cancer patients. G O A L OF P R O J E C T: To review the literature on quality of life and symptomatology among cancer patients, to pull together a model that explains the relationship between symptoms and quality of life and to test selected aspects of the model. P A R T I C I P A N T S: 150 cancer patients on opioids, 62 (41%) men and 88 (59%) women, all Caucasians. The patients ranged in age from 20-92 years with a mean (SD) age of 64,7 (12,7) years. R E S E A R C H D E S I G N: Descriptive, cross-sectional, and c...
Pain Management Nursing, 2014
To establish the scope of the problem of chronic pain in the population, we need to extend the fo... more To establish the scope of the problem of chronic pain in the population, we need to extend the focus on prevalence, the most frequently studied factor. Among other important factors is the complex relationship between the temporal characteristics of pain and their impact on peoples' lives. The purpose of the present study was to describe the characteristics of chronic pain, including pattern, severity, location, spread, and duration, in a population-based sample and to investigate the relationships between pain pattern and impact on the individual's life measured by interference with life and health-related quality of life (HRQoL). In this cross-sectional study, a postal questionnaire measuring pain characteristics, life interference (Brief Pain Inventory), and HRQoL (Short Form 36 Health Survey), was sent to a sample of 4,500 individuals, randomly drawn from the Icelandic National Register. The total response rate was 36.9% and was significantly higher among native Icelanders (40.6%) than individuals of non-Icelandic origin (8.6%).The prevalence of chronic pain ($3 months) was 47.5% with mean duration of 9.3 years, and 31.9% reported constant pain. Participants with constant pain reported higher life interference scores and less HRQoL than participants with intermittent or periodic pain. Hierarchical stepwise regression analyses showed that pain pattern and severity accounted for 44.4% variance for life interference. The range of the variances for these variables for the five domains of HRQoL was from 7.3% (mental health) to 53.3% (bodily pain). Pain pattern and severity are the most significant predictors of the
Scandinavian Journal of Caring Sciences, 2012
The aim of this study was to evaluate the psychometric properties of the Icelandic version of the... more The aim of this study was to evaluate the psychometric properties of the Icelandic version of the Modified Patients' Perceived Involvement in Care Scale (M-PICS), I-PICS, an instrument measuring patients' perceptions of pain-related communication with health care providers (HCP). The M-PICS was translated into Icelandic according to standard procedures for forward and backward translation. The questionnaire consisted of 20 items measuring four constructs: (i) the degree to which the HCP was perceived as controlling the information-exchange process; (ii) to what extent patients sought or shared information with their HCP; (iii) patients' perceived encouragement to raise questions and discuss their symptoms with their health care provider and (iv) patients' perceived participation in decision-making during the health care visit. The response options for each item ranged from one to five on a 5-point Likert scale, where higher scores indicated higher endorsement. One hundred and forty-nine participants with pain lasting longer than three months (77.2% women; mean age, 49.9 years) completed the questionnaire. To examine the construct validity of the I-PICS, a confirmatory factor analysis was performed, specifying four factors in congruence with the theoretical underpinnings of the original modified scale (M-PICS). Of the 20 items, 19 were retained, and the I-PICS factor structure was for the most part identical to the M-PICS, with the exception of three items that moved between factors and one item that did not fall decisively on one specific factor. Internal consistency (alpha) for the four factors ranged from 0.74 to 0.86 and was 0.86 for the total scale. The mean score on the total I-PICS was 2.67 on a one to five scale, ranging from 1.21 to 4.28 (possible range, 1-5). This study supports the four-factor structure of the M-PICS and that the I-PICS is a valid and reliable instrument for assessing patient-HCP communication.
Journal of Nursing Scholarship, 2007
Purpose-To provide an update on the Representational Approach to patient education. Organizing Co... more Purpose-To provide an update on the Representational Approach to patient education. Organizing Construct-The development and testing of theoretically sound interventions are essential for advancing the science of patient education. The Representational Approach to patient education was introduced in 2001 as an intervention theory that could guide the content and process of a wide-range of educational interventions. Since that time several specific interventions based on the approach have been developed and tested, resulting in modifications to the Representational Approach. Methods-Four intervention trials based on the Representational Approach are discussed: the Representational Intervention to Decrease cancer Pain (RIDcancerPain), Patient-Centered Advance Care Planning (PC-ACP), an Individualized Representational Intervention to Improve Symptom management (IRIS), and the Written Representational Intervention to Ease Symptoms (WRITE symptoms). Results-Findings from these trials support that interventions based on the Representational Approach are efficacious. In addition, these trials provided critical information to strengthen the approach and to extend it to novel clinical problems and delivery modes. Conclusion-The Representational Approach to patient education appears to be adequately flexible to guide interventions in different patient care situations, while also sufficiently structured to be replicable and testable.
Oncology Nursing Forum, 2003
➤ The vast majority of participants calling the Cancer Information Service (CIS) responded that t... more ➤ The vast majority of participants calling the Cancer Information Service (CIS) responded that they would be willing to participate in a telephone-delivered educational intervention for either pain management or family quality of life. ➤ The numbers of willing participants and the short time to collect data support the feasibility of conducting telephone-based interventions through CIS. ➤ The number and types of concerns regarding pain management and family quality of life reported by patients and significant others calling CIS suggest a need for nursing interventions. ➤ These results provide researchers with data needed to demonstrate to funding sources that conducting a study of a telephone-delivered intervention using CIS would be feasible.
Supportive Care in Cancer
The purpose of this study was to examine attitudinal barriers to cancer pain management and their... more The purpose of this study was to examine attitudinal barriers to cancer pain management and their relationship to pain, analgesic use, clinical, and demographic variables, as well as QOL, in a large sample of patients receiving strong opioids for pain in three European countries. Participants in the present study were 555 patients with cancer, 18 years and older recruited from six centers in Germany, Iceland, and Norway. All had received strong opioids for at least 72 h. Data was collected with the Barriers Questionnaire-II, the Brief Pain Inventory, and the European Organization for Research and Treatment of Cancer QLQ-C30. The mean (SD) age of patients was 61.68 (12.35) years and 53% were men. Most common diagnoses were gastrointestinal, lung, prostate, and breast cancer. The mean (SD) time from diagnosis was 32.24 (44.55) and 4.97 (9.64) months from start of opioid therapy. Mean (SD) pain severity was 3.19 (1.93) on a 0 to 10 scale, and 46.5% reported worst pain of 7 or higher. Attitudinal barriers had a mean (SD) of 1.95 (0.82) on a 0-5 scale, with fear of addiction as the strongest barrier across countries 2.85 (1.49). Barrier scores increased with age, and were higher among men than women. Higher barrier scores were associated with higher pain severity and interference, and lower performance status, but not with global health-QOL. Patients who had been on opioids for a shorter time reported higher barriers. Attitudinal barriers are frequent in cancer pain patients on opioids and are associated with less effective pain control.
International journal of nursing studies, Jan 16, 2017
The Pain Resource Nurse program is a widely disseminated, evidence-based, nursing staff developme... more The Pain Resource Nurse program is a widely disseminated, evidence-based, nursing staff development program, designed to improve pain management in hospitals. The program has shown promising results, but has never been tested with a rigorous research design. Our objective was to test the effectiveness of the Pain Resource Nurse program. Hypothesized outcomes included improvements in nurses' knowledge, attitudes, and assessment practices, and in patients' participation in decision-making, adequacy of pain management, pain severity, time spent in severe pain, pain interference, and satisfaction. Cluster randomized controlled trial. A 650-bed university hospital in Iceland Participants: The sample consisted of a) patients ≥18 years of age, native speaking, hospitalized for at least 24h, alert and able to participate; and b) registered nurses who worked on the participating units. Twenty three surgical and medical inpatient units were randomly assigned to the Pain Resource Nurse...
European Journal of Oncology Nursing, 2016
To examine the attitudes, practices and perceived barriers in relation to a sexual health care ed... more To examine the attitudes, practices and perceived barriers in relation to a sexual health care educational intervention among oncology health care professionals at the Landspítali-National University Hospital of Iceland. The design was quasi experimental, pre - post test time series. A comprehensive educational intervention project, including two workshops, was implemented over a two year time period. A questionnaire was mailed electronically to all nurses and physicians within oncology at baseline (T1, N = 206), after 10 months (T2, N = 216) and 16 months (T3, N = 210). The response rate was 66% at T1, 45% at T2 and 38% at T3. At all time points, the majority of participants (90%) regarded communication about sexuality part of their responsibilities. Mean scores on having enough knowledge and training, and in six of eight practice issues increased significantly over time. Overall, 10-16% reported discussing sexuality-related issues with more than 50% of patients and the frequency was significantly higher among workshop attendants (31%) than non-attendants (11%). Overall, the most common barriers for discussing sexuality were "lack of training" (38%) and "difficult issue to discuss" (27%), but the former barrier decreased significantly by 22% over time. The intervention was successful in improving perception of having enough knowledge and training in providing sexual health care. Still, the issue remains sensitive and difficult to address for the majority of oncology health care professionals. Specific training in sexual health care, including workshops, should be available to health care professionals within oncology.
Scandinavian Journal of Pain, 2012
Supportive Care in Cancer, 2013
Spirituality is one of the main aspects of palliative care. The concept is multidimensional and e... more Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being. Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology. Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith. Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.
Nursing Forum, 2014
To explore the concept of quality pain management (QPM) in adult hospitalized patients. Pain is c... more To explore the concept of quality pain management (QPM) in adult hospitalized patients. Pain is common in hospitalized patients, and pain management remains suboptimal in some settings. A concept evaluation based on Morse et al.'s method. Of more than 5,000 articles found, data were restricted to 37 selected key articles published in peer-reviewed journals. Data were extracted from the selected articles and then synthesized according to the following: definition, characteristics, boundaries, preconditions, and outcomes. QPM relates to the Structure: organizationally supported evidence-based policies, competent staff, interprofessional and specialized care, and staff accountability; Process: screening, assessment/reassessment and communication of pain and its treatment, patient/family education, individualized evidence-based treatment, embedded in safe, effective, patient-centered, timely, efficient, and equitable services; and Outcomes: reduced pain severity and functional interference, decreased prevalence/severity of adverse consequences from pain or pain treatment, and increase in patient satisfaction. QPM is a multifaceted concept that remains poorly defined in the literature. Studies should aim to develop valid, reliable, and operational measures of the pillars of QPM and to look at the relationship among these factors. Authors need to state how they define and what aspects of QPM they are measuring.
Cancer Nursing, 2010
The overall survival gain of cancer chemotherapy is estimated to be small, and some claim that it... more The overall survival gain of cancer chemotherapy is estimated to be small, and some claim that it rarely improves quality of life (QOL). The purpose of this population-based study was to describe QOL and symptoms of anxiety and depression, over time, in a group of Icelandic cancer patients receiving chemotherapy. Quality of life was measured with the Icelandic version of Cancer Rehabilitation Evaluation System, Short Form (CARES-SF), and symptoms of anxiety and depression, with the Icelandic version of Hospital Anxiety and Depression Scale (HADS). Enrolled into the study were 144 patients, 90 women and 54 men; mean (SD) age was 55 (12.1) years. Although QOL was found relatively good during the period of chemotherapy, it was significantly worse after 3 and 6 months compared to baseline. Quality of life was found worst in the sexual and physical domains. At all time points, a significant association was found between symptoms of anxiety and depression and QOL with those reporting symptoms of either anxiety or depression experiencing worse QOL. The good QOL found during the period of chemotherapy is a positive finding. The results, however, call for an intense assessment, over time, of physical symptoms, anxiety, and depression, as well as sexuality issues.
Health Expectations, 2014
Background Individuals with chronic pain are among the most frequent users of health care. Still,... more Background Individuals with chronic pain are among the most frequent users of health care. Still, a significant percentage does not utilize health care for pain. A range of factors predict chronic pain-related health care utilization.
Scandinavian Journal of Pain, 2013
Pain Management Nursing, 2017
Pain Management Nursing, 2016
Pain is a personal experience and patient-provider communication therefore an essential part of d... more Pain is a personal experience and patient-provider communication therefore an essential part of diagnosis and treatment where the patient's perspective needs to be central. The aim of this descriptive cross-sectional study was to investigate chronic-pain-related patientprovider communication in the context of sociodemographic variables, pain variables, perceived outcome of care, and satisfaction with health care providers. A postal questionnaire measuring sociodemographic variables, pain characteristics, pain-related health care utilization and patient-provider communication was sent to a sample of 4,500 individuals randomly drawn from the national population of Iceland. A subsample reporting chronic pain and having visited a health care provider for pain the previous six months (n ¼ 401) was analyzed. Relationships between patient-provider communication and other measured variables were tested using bivariate and multivariate statistics. The more chronic pain impaired health-related quality of life, the more provider control the patients perceived in the patient-provider communication. There was also a strong negative relationship between patients' perception of providers' support and openness to discussing symptoms, and satisfaction with health care provider. Patients' perception of their own control in patient
Scandinavian Journal of Pain, 2016
Aims To investigate the use of Complimentary/Alternative therapy for chronic pain in nationwide s... more Aims To investigate the use of Complimentary/Alternative therapy for chronic pain in nationwide sample. Methods In this cross-sectional study a postal questionnaire measuring socio-demographic variables (e.g. gender, education, income and residence), pain characteristics (severity and interference with daily life), health related quality of life and use of Complimentary/Alternative therapy for chronic pain, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. The relationships between sociodemographic and pain related variables and pain related use Complimentary/Alternative therapy among participants reporting chronic pain (≥3 months) were tested. Results The prevalence of chronic pain (≥3 months) among respondents was 47.5%. Among participants reporting chronic pain, 45.5% (n = 343) reported having consulted some kind of Complimentary or Alternative therapy for their pain the previous six months and this was more prevalent among women tha...
Neðst á síðunni er hægt að nálgast ritgerðina í heild sinni með því að smella á hlekkinn Skoða/Op... more Neðst á síðunni er hægt að nálgast ritgerðina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open) B A C K G R O U ND : Cancer patients experience multiple symptoms that affect their quality of life (QOL). Cancer related symptoms may be caused by the disease itself or its treatment, but factors like age, gender, and concurrent diseases may also influence the symptomatology. The symptoms-quality of life model shows the relationship between symptoms and QOL in cancer patients. G O A L OF P R O J E C T: To review the literature on quality of life and symptomatology among cancer patients, to pull together a model that explains the relationship between symptoms and quality of life and to test selected aspects of the model. P A R T I C I P A N T S: 150 cancer patients on opioids, 62 (41%) men and 88 (59%) women, all Caucasians. The patients ranged in age from 20-92 years with a mean (SD) age of 64,7 (12,7) years. R E S E A R C H D E S I G N: Descriptive, cross-sectional, and c...
Pain Management Nursing, 2014
To establish the scope of the problem of chronic pain in the population, we need to extend the fo... more To establish the scope of the problem of chronic pain in the population, we need to extend the focus on prevalence, the most frequently studied factor. Among other important factors is the complex relationship between the temporal characteristics of pain and their impact on peoples' lives. The purpose of the present study was to describe the characteristics of chronic pain, including pattern, severity, location, spread, and duration, in a population-based sample and to investigate the relationships between pain pattern and impact on the individual's life measured by interference with life and health-related quality of life (HRQoL). In this cross-sectional study, a postal questionnaire measuring pain characteristics, life interference (Brief Pain Inventory), and HRQoL (Short Form 36 Health Survey), was sent to a sample of 4,500 individuals, randomly drawn from the Icelandic National Register. The total response rate was 36.9% and was significantly higher among native Icelanders (40.6%) than individuals of non-Icelandic origin (8.6%).The prevalence of chronic pain ($3 months) was 47.5% with mean duration of 9.3 years, and 31.9% reported constant pain. Participants with constant pain reported higher life interference scores and less HRQoL than participants with intermittent or periodic pain. Hierarchical stepwise regression analyses showed that pain pattern and severity accounted for 44.4% variance for life interference. The range of the variances for these variables for the five domains of HRQoL was from 7.3% (mental health) to 53.3% (bodily pain). Pain pattern and severity are the most significant predictors of the
Scandinavian Journal of Caring Sciences, 2012
The aim of this study was to evaluate the psychometric properties of the Icelandic version of the... more The aim of this study was to evaluate the psychometric properties of the Icelandic version of the Modified Patients' Perceived Involvement in Care Scale (M-PICS), I-PICS, an instrument measuring patients' perceptions of pain-related communication with health care providers (HCP). The M-PICS was translated into Icelandic according to standard procedures for forward and backward translation. The questionnaire consisted of 20 items measuring four constructs: (i) the degree to which the HCP was perceived as controlling the information-exchange process; (ii) to what extent patients sought or shared information with their HCP; (iii) patients' perceived encouragement to raise questions and discuss their symptoms with their health care provider and (iv) patients' perceived participation in decision-making during the health care visit. The response options for each item ranged from one to five on a 5-point Likert scale, where higher scores indicated higher endorsement. One hundred and forty-nine participants with pain lasting longer than three months (77.2% women; mean age, 49.9 years) completed the questionnaire. To examine the construct validity of the I-PICS, a confirmatory factor analysis was performed, specifying four factors in congruence with the theoretical underpinnings of the original modified scale (M-PICS). Of the 20 items, 19 were retained, and the I-PICS factor structure was for the most part identical to the M-PICS, with the exception of three items that moved between factors and one item that did not fall decisively on one specific factor. Internal consistency (alpha) for the four factors ranged from 0.74 to 0.86 and was 0.86 for the total scale. The mean score on the total I-PICS was 2.67 on a one to five scale, ranging from 1.21 to 4.28 (possible range, 1-5). This study supports the four-factor structure of the M-PICS and that the I-PICS is a valid and reliable instrument for assessing patient-HCP communication.
Journal of Nursing Scholarship, 2007
Purpose-To provide an update on the Representational Approach to patient education. Organizing Co... more Purpose-To provide an update on the Representational Approach to patient education. Organizing Construct-The development and testing of theoretically sound interventions are essential for advancing the science of patient education. The Representational Approach to patient education was introduced in 2001 as an intervention theory that could guide the content and process of a wide-range of educational interventions. Since that time several specific interventions based on the approach have been developed and tested, resulting in modifications to the Representational Approach. Methods-Four intervention trials based on the Representational Approach are discussed: the Representational Intervention to Decrease cancer Pain (RIDcancerPain), Patient-Centered Advance Care Planning (PC-ACP), an Individualized Representational Intervention to Improve Symptom management (IRIS), and the Written Representational Intervention to Ease Symptoms (WRITE symptoms). Results-Findings from these trials support that interventions based on the Representational Approach are efficacious. In addition, these trials provided critical information to strengthen the approach and to extend it to novel clinical problems and delivery modes. Conclusion-The Representational Approach to patient education appears to be adequately flexible to guide interventions in different patient care situations, while also sufficiently structured to be replicable and testable.
Oncology Nursing Forum, 2003
➤ The vast majority of participants calling the Cancer Information Service (CIS) responded that t... more ➤ The vast majority of participants calling the Cancer Information Service (CIS) responded that they would be willing to participate in a telephone-delivered educational intervention for either pain management or family quality of life. ➤ The numbers of willing participants and the short time to collect data support the feasibility of conducting telephone-based interventions through CIS. ➤ The number and types of concerns regarding pain management and family quality of life reported by patients and significant others calling CIS suggest a need for nursing interventions. ➤ These results provide researchers with data needed to demonstrate to funding sources that conducting a study of a telephone-delivered intervention using CIS would be feasible.
Supportive Care in Cancer
The purpose of this study was to examine attitudinal barriers to cancer pain management and their... more The purpose of this study was to examine attitudinal barriers to cancer pain management and their relationship to pain, analgesic use, clinical, and demographic variables, as well as QOL, in a large sample of patients receiving strong opioids for pain in three European countries. Participants in the present study were 555 patients with cancer, 18 years and older recruited from six centers in Germany, Iceland, and Norway. All had received strong opioids for at least 72 h. Data was collected with the Barriers Questionnaire-II, the Brief Pain Inventory, and the European Organization for Research and Treatment of Cancer QLQ-C30. The mean (SD) age of patients was 61.68 (12.35) years and 53% were men. Most common diagnoses were gastrointestinal, lung, prostate, and breast cancer. The mean (SD) time from diagnosis was 32.24 (44.55) and 4.97 (9.64) months from start of opioid therapy. Mean (SD) pain severity was 3.19 (1.93) on a 0 to 10 scale, and 46.5% reported worst pain of 7 or higher. Attitudinal barriers had a mean (SD) of 1.95 (0.82) on a 0-5 scale, with fear of addiction as the strongest barrier across countries 2.85 (1.49). Barrier scores increased with age, and were higher among men than women. Higher barrier scores were associated with higher pain severity and interference, and lower performance status, but not with global health-QOL. Patients who had been on opioids for a shorter time reported higher barriers. Attitudinal barriers are frequent in cancer pain patients on opioids and are associated with less effective pain control.
International journal of nursing studies, Jan 16, 2017
The Pain Resource Nurse program is a widely disseminated, evidence-based, nursing staff developme... more The Pain Resource Nurse program is a widely disseminated, evidence-based, nursing staff development program, designed to improve pain management in hospitals. The program has shown promising results, but has never been tested with a rigorous research design. Our objective was to test the effectiveness of the Pain Resource Nurse program. Hypothesized outcomes included improvements in nurses' knowledge, attitudes, and assessment practices, and in patients' participation in decision-making, adequacy of pain management, pain severity, time spent in severe pain, pain interference, and satisfaction. Cluster randomized controlled trial. A 650-bed university hospital in Iceland Participants: The sample consisted of a) patients ≥18 years of age, native speaking, hospitalized for at least 24h, alert and able to participate; and b) registered nurses who worked on the participating units. Twenty three surgical and medical inpatient units were randomly assigned to the Pain Resource Nurse...
European Journal of Oncology Nursing, 2016
To examine the attitudes, practices and perceived barriers in relation to a sexual health care ed... more To examine the attitudes, practices and perceived barriers in relation to a sexual health care educational intervention among oncology health care professionals at the Landspítali-National University Hospital of Iceland. The design was quasi experimental, pre - post test time series. A comprehensive educational intervention project, including two workshops, was implemented over a two year time period. A questionnaire was mailed electronically to all nurses and physicians within oncology at baseline (T1, N = 206), after 10 months (T2, N = 216) and 16 months (T3, N = 210). The response rate was 66% at T1, 45% at T2 and 38% at T3. At all time points, the majority of participants (90%) regarded communication about sexuality part of their responsibilities. Mean scores on having enough knowledge and training, and in six of eight practice issues increased significantly over time. Overall, 10-16% reported discussing sexuality-related issues with more than 50% of patients and the frequency was significantly higher among workshop attendants (31%) than non-attendants (11%). Overall, the most common barriers for discussing sexuality were "lack of training" (38%) and "difficult issue to discuss" (27%), but the former barrier decreased significantly by 22% over time. The intervention was successful in improving perception of having enough knowledge and training in providing sexual health care. Still, the issue remains sensitive and difficult to address for the majority of oncology health care professionals. Specific training in sexual health care, including workshops, should be available to health care professionals within oncology.
Scandinavian Journal of Pain, 2012
Supportive Care in Cancer, 2013
Spirituality is one of the main aspects of palliative care. The concept is multidimensional and e... more Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being. Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology. Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith. Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.
Nursing Forum, 2014
To explore the concept of quality pain management (QPM) in adult hospitalized patients. Pain is c... more To explore the concept of quality pain management (QPM) in adult hospitalized patients. Pain is common in hospitalized patients, and pain management remains suboptimal in some settings. A concept evaluation based on Morse et al.'s method. Of more than 5,000 articles found, data were restricted to 37 selected key articles published in peer-reviewed journals. Data were extracted from the selected articles and then synthesized according to the following: definition, characteristics, boundaries, preconditions, and outcomes. QPM relates to the Structure: organizationally supported evidence-based policies, competent staff, interprofessional and specialized care, and staff accountability; Process: screening, assessment/reassessment and communication of pain and its treatment, patient/family education, individualized evidence-based treatment, embedded in safe, effective, patient-centered, timely, efficient, and equitable services; and Outcomes: reduced pain severity and functional interference, decreased prevalence/severity of adverse consequences from pain or pain treatment, and increase in patient satisfaction. QPM is a multifaceted concept that remains poorly defined in the literature. Studies should aim to develop valid, reliable, and operational measures of the pillars of QPM and to look at the relationship among these factors. Authors need to state how they define and what aspects of QPM they are measuring.
Cancer Nursing, 2010
The overall survival gain of cancer chemotherapy is estimated to be small, and some claim that it... more The overall survival gain of cancer chemotherapy is estimated to be small, and some claim that it rarely improves quality of life (QOL). The purpose of this population-based study was to describe QOL and symptoms of anxiety and depression, over time, in a group of Icelandic cancer patients receiving chemotherapy. Quality of life was measured with the Icelandic version of Cancer Rehabilitation Evaluation System, Short Form (CARES-SF), and symptoms of anxiety and depression, with the Icelandic version of Hospital Anxiety and Depression Scale (HADS). Enrolled into the study were 144 patients, 90 women and 54 men; mean (SD) age was 55 (12.1) years. Although QOL was found relatively good during the period of chemotherapy, it was significantly worse after 3 and 6 months compared to baseline. Quality of life was found worst in the sexual and physical domains. At all time points, a significant association was found between symptoms of anxiety and depression and QOL with those reporting symptoms of either anxiety or depression experiencing worse QOL. The good QOL found during the period of chemotherapy is a positive finding. The results, however, call for an intense assessment, over time, of physical symptoms, anxiety, and depression, as well as sexuality issues.
Health Expectations, 2014
Background Individuals with chronic pain are among the most frequent users of health care. Still,... more Background Individuals with chronic pain are among the most frequent users of health care. Still, a significant percentage does not utilize health care for pain. A range of factors predict chronic pain-related health care utilization.
Scandinavian Journal of Pain, 2013