The Course of Fatigue during the First 18 Months after First-Ever Stroke: A Longitudinal Study

Background. Little is known about the course of poststroke fatigue. Objectives. To describe the course of poststroke fatigue in relation to the patient's level of physical functioning, depressive symptoms, and self-reported history of prestroke fatigue. Methods. A longitudinal study using structured face-to-face interviews, questionnaires, and patients' medical records. Data were collected from 95 patients in Norway with first-ever stroke. Fatigue was measured with the Fatigue Severity Scale 7 item version and assessed for change between the acute phase, six, 12, and 18 months after stroke using 2-way ANOVA repeated-measures analyses. Results. The patients' level of fatigue did not change over time. However, those who reported prestroke fatigue showed a relatively high level of fatigue over time in the poststroke period, while patients with no history of pre-stroke fatigue showed a stable course of relatively low fatigue over time. Conclusion. Studies on poststroke fatigue should control for the patient's pre-stroke fatigue level

Sleep-Wake Patterns during the Acute Phase after First-Ever Stroke

This study describes the pattern of day and night sleep and explores relationships between these patterns and sociodemographic and clinical factors as well as sleep environmental context and the patient's subjective sleep quality. Data from 110 patients with first-ever stroke was collected by structured interview surveys, medical record, and objective estimated sleep data from wrist actigraphy. The variability in estimated sleep is large. Half the patients slept either <6 hours or >8 hours per night, and 78% had more than nine awakenings per night. Men slept less than women, and patients sleeping at home had fewer awakenings than those who slept in hospital. It was estimated sleep during daytime in all, except 4, patients. Longer stay in hospital was related to more daytime sleep, and the subjective sleep quality correlated with estimated sleep time, wake time, and wake percentage

Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version

Aim: This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA‐E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change. Background: While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature. Method: Cross‐sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA‐E2 was translated into Norwegian according to standardized procedures. Findings: Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non‐Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour. Conclusion: The URICA‐E2 was for the most part replicated from Reed’s original work. The result of the cluster analysis of the items associated with the factor ‘Action’ suggests that these do not adequately measure the factor

Pressure Ulcer in Norway—A Snapshot of Pressure Ulcer Occurrence across Various Care Sites and Recommendations for Improved Preventive Care

Pressure ulcers (PU) are common in all care settings, although most ulcers are preventable. Much evidence exists on Hospital Acquired Pressure Ulcers (HAPU), however, few studies describe PU in community care. From a Norwegian perspective, little is known about pressure ulcer prevalence and prevention strategies across the variety of healthcare sectors. Therefore, this study explored PU prevalence and preventive care in home care, nursing homes and hospitals. Seventeen postgraduate wound care students collected data. A data collection instrument by Jordan O’Brien and Cowman was used together with an online forum in which students described how to improve practice to reduce PU incidence. This study showed that pressure ulcers are a problem across all care settings in Norway; however, nursing homes had the highest proportion of at risk patients and the highest prevalence. By implementing the care bundle provided by the Patient Safety Programme across all care settings, increasing staff competency and make sure that access to appropriate equipment for beds and chairs is readily available, a structured and evidence based approach to prevention could be ensured

Forebygging av fotsår hos pasienter med diabetes

The progression of diabetes is often accompanied by complications which can include leg and foot ulcers. The increase in the prevalence and incidence of diabetes has serious implications for the management of subsequent complications. The purpose of this article is to elaborate on major risk factors and assessment for nurses caring for patients with diabetes, and to outline nursing intervention in order to prevent diabetic ulcers. Effective intervention saves the patient from unnecessary pain and problems and might, in the best case, prevent amputation. This article is based upon the investigations and experiences of two nursing students in finding the best evidence for preventing diabetic ulcers during their clinical practice in a home care setting

The Course of Fatigue during the First 18 Months after First-Ever Stroke: A Longitudinal Study.

Background. Little is known about the course of poststroke fatigue. Objectives. To describe the course of poststroke fatigue in relation to the patient's level of physical functioning, depressive symptoms, and self-reported history of prestroke fatigue. Methods. A longitudinal study using structured face-to-face interviews, questionnaires, and patients' medical records. Data were collected from 95 patients in Norway with first-ever stroke. Fatigue was measured with the Fatigue Severity Scale 7 item version and assessed for change between the acute phase, six, 12, and 18 months after stroke using 2-way ANOVA repeated-measures analyses. Results. The patients' level of fatigue did not change over time. However, those who reported prestroke fatigue showed a relatively high level of fatigue over time in the poststroke period, while patients with no history of pre-stroke fatigue showed a stable course of relatively low fatigue over time. Conclusion. Studies on poststroke fatigue should control for the patient's pre-stroke fatigue level

The course of fatigue during the first 18 months after first-ever stroke: a longitudinal study,” Stroke Research and Treatment, vol

Background. Little is known about the course of poststroke fatigue. Objectives. To describe the course of poststroke fatigue in relation to the patient&apos;s level of physical functioning, depressive symptoms, and self-reported history of prestroke fatigue. Methods. A longitudinal study using structured face-to-face interviews, questionnaires, and patients&apos; medical records. Data were collected from 95 patients in Norway with first-ever stroke. Fatigue was measured with the Fatigue Severity Scale 7 item version and assessed for change between the acute phase, six, 12, and 18 months after stroke using 2-way ANOVA repeated-measures analyses. Results. The patients&apos; level of fatigue did not change over time. However, those who reported prestroke fatigue showed a relatively high level of fatigue over time in the poststroke period, while patients with no history of pre-stroke fatigue showed a stable course of relatively low fatigue over time. Conclusion. Studies on poststroke fatigue should control for the patient&apos;s pre-stroke fatigue level

Incontinence-associated dermatitis (IAD) : prevalence and associated factors in 4 hospitals in Southeast Norway

PURPOSE: The aim of this study was to investigate the prevalence and severity of incontinence-associated dermatitis (IAD) and associated factors in acute care settings in Southeast Norway. DESIGN: Descriptive, multisite epidemiologic survey. SUBJECTS AND SETTING: The study setting was 29 wards across 4 hospitals, in a hospital trust in the southeast of Norway. Data were collected from 340 patients (age ≥ 18 years). More than half (56.2%) were 70 years or older (median age category 70-79 years) and 53.3% were male. METHODS: Data collection was conducted in parallel with a pressure injury prevalence study undertaken in 2016. A modified Pressure Injury Prevalence Minimum Data Set, including documentation of fecal or urinary incontinence, use of indwelling fecal collection system or urinary catheter, and presence of IAD, was completed. RNs participating in the study were trained by the researchers on skin assessment and data extraction from the electronic medical record. Descriptive statistics were used for prevalence fi gures; the Kruskal-Wallis and χ 2 tests were used to determine associated factors. RESULTS: Analysis revealed that 16.5% (56 out of 340) of the sample were incontinent. The prevalence of IAD in the total population was 7.6% (26 out of 340). The prevalence of IAD was 29% (16 out of 56) among patients with urinary or fecal incontinence. Of those identified with IAD, 5.2% (18 out of 340) had category 1 (red intact skin) and 2.4% (8 of 340) had category 2 (red skin with breakdown). Bivariate analysis revealed that fecal incontinence ( P < .001), immobility ( P < .01), and 70 years or older ( P < .03) were associated with IAD. CONCLUSIONS: The overall prevalence (patients with and without incontinence) of IAD was lower than reported in prior studies; frequent use of indwelling urinary catheters and a relatively low prevalence of incontinence may explain this finding. Similar to prior studies, almost 1 in 3 patients who were incontinent suffered from IAD, showing a need for evidence-based guidelines to prevent IAD in hospitalized patients. Findings suggest that particular attention should be given to prevent IAD among patients with fecal incontinence patients, 70 years and older, and those with immobility