Association between person-centred care and healthcare providers’ job satisfaction and work-related health

__Objective__ This scoping review aimed to explore and describe the research on associations between person- centred care (PCC) and healthcare provider outcomes, for example, job satisfaction and work- related health. __Design__ Scoping review. __Eligibility criteria__ Studies were included if they were empirical studies that analysed associations between PCC measurement tools and healthcare providers outcomes. __Search strategy__ Searches in PubMed, CINAHL, Psychinfo and SCOPUS databases were conducted to identify relevant studies published between 2001 and 2019. Two authors independently screened studies for inclusion. __Results__ Eighte

Symptom recognition and health care seeking among immigrants and native Swedish patients with heart failure

<p>Abstract</p> <p>Background</p> <p>It is not known what patient perceptions or beliefs lead to beneficial decisions or response patterns in symptom interpretation among heart failure (HF) patients, especially immigrants. The aim of this study was to explore and compare symptom recognition and health care seeking patterns among immigrants and native Swedes with HF.</p> <p>Methods</p> <p>The study used a qualitative design. Semi-structured interviews were conducted with 42 patients with HF, of whom 21 were consecutively selected immigrants and 21 were randomly selected Swedish patients. The interviews were analysed using content analysis.</p> <p>Results</p> <p>A majority of the immigrant patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. Twice as many immigrants as Swedes were unaware of "what the illness experience entailed" and which symptoms indicated worsening of HF.</p> <p>Conclusion</p> <p>The symptoms that patients sought care for, were similar among immigrants and Swedes. However, when interpreting symptoms more immigrants were unaware of the connection between the symptoms/signs and their HF condition. More tailored educational interventions might improve recognition of worsening symptoms in immigrant patients with chronic heart failure.</p

Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

<p>Abstract</p> <p>Background</p> <p>Chronic heart failure (CHF) is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors.</p> <p>To characterise patients with CHF who seek an emergency department (ED) because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital.</p> <p>Method</p> <p>Patients (n = 2,648) seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF.</p> <p>Results</p> <p>Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate.</p> <p>Conclusion</p> <p>The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.</p

ExerCube vs. Personal Trainer: Evaluating a Holistic, Immersive, and Adaptive Fitness Game Setup

Today's spectrum of playful fitness solutions features systems that are clearly game-first or fitness-first in design; hardly any sufficiently incorporate both areas. Consequently, existing applications and evaluations often lack in focus on attractiveness and effectiveness, which should be addressed on the levels of body, controller, and game scenario following a holistic design approach. To contribute to this topic and as a proof-of-concept, we designed the ExerCube, an adaptive fitness game setup. We evaluated participants' multi-sensory and bodily experiences with a non-adaptive and an adaptive ExerCube version and compared them with personal training to reveal insights to inform the next iteration of the ExerCube. Regarding flow, enjoyment and motivation, the ExerCube is on par with personal training. Results further reveal differences in perception of exertion, types and quality of movement, social factors, feedback, and audio experiences. Finally, we derive considerations for future research and development directions in holistic fitness game setups

Osimertinib in T790M-positive and -negative patients with EGFR-mutated advanced non-small cell lung cancer (the TREM-study)

Abstract Objectives: In non-small cell lung cancer patients with acquired resistance to first- or second-generation EGFR-TKIs, osimertinib is approved in the presence of the T790 M resistance mutation. We assessed the efficacy of osimertinib in both T790M-positive and T790M-negative patients. Materials and methods: The TREM-study is an investigator-initiated, multi-centre, single-arm, phase 2 clinical trial conducted in five Northern European countries. Patients with progression on at least one previous EGFR-TKI were assigned to treatment with 80 mg of osimertinib daily until radiological progression or death. Patients were included regardless of the presence of T790 M. The primary endpoint was objective response rate (ORR). Results: Of 199 included patients, 120 (60 %) were T790M-positive, 52 (26 %) were T790M-negative and 27 (14 %) had unknown T790M-status. 24 % had brain metastases and 15 % had an ECOG performance status of 2. Overall ORR was 48 % (95 % CI, 41 %–55 %), 60 % (51 %–69 %) for T790M-positive patients and 28 % (15 %–41 %) for T790M-negative patients, p &lt; 0.001. ORR for patients with co-occurring del19 vs L858R was 61 % vs 32 %, p = 0.001. Duration of response was similar between the T790M-positive and –negative groups (11.8 vs 10.7 months, p = 0.229). Overall median progression-free survival (PFS) was 8.9 months (95 % CI, 7.4–10.5), and 10.8 vs 5.1 months for T790M-positive vs –negative patients (HR 0.62, p = 0.007). Median overall survival (OS) was 17.9 months (95 % CI, 14.4–21.3). For T790M-positive vs –negative median OS was 22.5 vs 13.4 months, (HR 0.55, p = 0.002). Conclusions: This study confirms the efficacy of osimertinib for T790M-positive patients. There was also clinically significant activity of osimertinib in a proportion of T790M-negative patients. Clinical trial registration: This trial is registered with ClinicalTrials.gov (NCT02504346)