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33. Development and psychometric properties of a short version of the Patient Continuity of Care Questionnaire.

Author

Safstrom, Emma, Arestedt, Kristofer, Hadjistavropoulos, Heather D., Liljeroos, Maria, Nordgren, Lena, Jaarsma, Tiny, and Stromberg, Anna

Subjects
*EXPERIMENTAL design, *PATIENT aftercare, *MEDICAL quality control, *STATISTICS, *RELIABILITY (Personality trait), *RESEARCH, *ANALYSIS of variance, *RESEARCH methodology, *REGRESSION analysis, *CONTINUUM of care, *PSYCHOMETRICS, *CRONBACH'S alpha, *PATIENTS' attitudes, *T-test (Statistics), *HOSPITAL care, *CHI-squared test, *DESCRIPTIVE statistics, *FACTOR analysis, *DIFFERENTIAL item functioning (Research bias), *RESEARCH funding, *QUESTIONNAIRES, *STATISTICAL sampling, *DATA analysis, *DATA analysis software, *HEART diseases, *DISCHARGE planning, RESEARCH evaluation
Abstract

Introduction: Hospitalization due to cardiac conditions is increasing worldwide, and follow‐up after hospitalization usually occurs in a different healthcare setting than the one providing treatment during hospitalization. This leads to a risk of fragmented care and increases the need for coordination and continuity of care after hospitalization. Furthermore, international reports highlight the importance of improving continuity of care and state that it is an essential indicator of the quality of care. Patients' perceptions of continuity of care can be evaluated using the Patient Continuity of Care Questionnaire (PCCQ). However, the original version is extensive and may prove burdensome to complete; therefore, we aimed to develop and evaluate a short version of the PCCQ. Methods: This was a psychometric validation study. Content validity was evaluated among user groups, including patients (n = 7), healthcare personnel (n = 15), and researchers (n = 7). Based on the results of the content validity and conceptual discussions among the authors, 12 items were included in the short version. Data from patients were collected using a consecutive sampling procedure involving patients 6 weeks after hospitalization due to cardiac conditions. Rasch analysis was used to evaluate the psychometric properties of the short version of the PCCQ. Results: A total of 1000 patients were included [mean age 72 (SD = 10), 66% males]. The PCCQ‐12 presented a satisfactory overall model fit and a person separation index of 0.79 (Cronbach's α:.91, ordinal α:.94). However, three items presented individual item misfits. No evidence of multidimensionality was found, meaning that a total score can be calculated. A total of four items presented evidence of response dependence but, according to the analysis, this did not seem to affect the measurement properties or reliability of the PCCQ‐12. We found that the first two response options were disordered in all items. However, the reliability remained the same when these response options were amended. In future research, the benefits of the four response options could be evaluated. Conclusion: The PCCQ‐12 has sound psychometric properties and is ready to be used in clinical and research settings to measure patients' perceptions of continuity of care after hospitalization. Patient or Public Contribution: Patients, healthcare personnel and researchers were involved in the study because they were invited to select items relevant to the short version of the questionnaire. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Factors associated with increased physical activity among patients prescribed physical activity in Swedish routine health care including an offer of counselor support : a 1-year follow-up

Author

Andersen, Pia, Holmberg, Sara, Arestedt, Kristofer, Lendahls, Lena, and Nilsen, Per

Subjects
Male, Sweden, Counseling, Physical activity on prescription, Patient characteristics, Predictors, Public Health, Environmental and Occupational Health, Health care characteristics, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Counselors, Humans, Female, Prospective Studies, Delivery of Health Care, Exercise, Follow-Up Studies
Abstract

Background The study addresses knowledge gaps in research regarding influences of routine health care delivery of physical activity on prescription (PAP). The aim was to investigate if patient and health care characteristics are associated with increased physical activity 1 year after prescription among patients offered counselor support in addition to health care professionals’ prescription. The study was conducted in primary and secondary care in a Swedish health care region. Methods All PAP recipients during 1 year were invited (N = 1503) to participate in this observational prospective study. Data were collected from medical records and questionnaires (baseline and follow-up). Descriptive statistics and multiple logistic regression analysis were used. The outcome variable was increased physical activity after 1 year. Study variables were patient and health care characteristics. Results Three hundred and fifty-five patients with complete follow-up data were included. The mean age was 62 years (SD = 14; range, 18–90) and 68% were females. Almost half (47%) had increased physical activity 1 year after PAP. Multiple logistic regression analysis showed that increased physical activity at follow-up was positively associated with lower baseline activity, counselor use, and positive perception of support. Counselor users with low baseline activity had higher odds ratio for increased physical activity at follow-up than non-users (OR = 7.2, 95% CI = 2.2–23.5 vs. OR = 3.2, 95% CI = 1.4–7.5). Positive perception of support was associated with increased physical activity among counselor users but not among non-users. Conclusions An increase in physical activity after PAP was related to low baseline activity, positive perception of support, and use of counselor support after PAP. Qualified counseling support linked to PAP seems to be important for achieving increased physical activity among patients with lower baseline activity.

Published
2022

43. Development and validation of a new Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) with focus on symptom burden

Author

Walfridsson Ulla, Arestedt Kristofer, and Stromberg Anna

Subjects
Arrhythmias, Symptom burden, Disease-specific questionnaire, Questionnaire development, Validation, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract Background Arrhythmias can appear with a variety of symptoms, all from vague to pronounced and handicapping symptoms. Therefore, patient-reported outcomes (PROs) concerning symptom burden are important to assess and take into consideration in the care and treatment of patients with arrhythmias. The main purpose was to develop and validate a disease-specific questionnaire evaluating symptom burden in patients with different forms of arrhythmias. Methods A literature review was conducted and arrhythmia patients were interviewed. Identified symptoms were evaluated by an expert panel consisting of cardiologists and nurses working daily with arrhythmia patients. SF-36 and Symptoms Checklist (SCL) were used in the validation of the new questionnaire Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA). Homogeneity was evaluated with Spearman´s correlations and Cronbach´s alpha coefficient (α) was used to evaluate internal consistency. Construct validity was evaluated using item-total correlations and convergent and discriminant validity. For this, Spearman´s correlations were calculated between the ASTA symptom scale, SCL and SF-36. Concurrent validity was validated by Spearman´s correlations between the ASTA symptom scale and SCL. Results The correlations between the different items in the ASTA symptom scale showed generally sufficient homogeneity. Cronbach´s coefficient was found to be satisfactory (α = 0.80; lower bound 95 % CI for α = 0.76). Construct validity was supported by item-total correlations where all items in the symptom scale were sufficiently correlated (≥0.3). Convergent and discriminant validity was supported by the higher correlations to the arrhythmia-specific SCL compared to the generic SF-36. Concurrent validity was evaluated and there were sufficiently, but not extremely strong correlations found between the ASTA symptom scale and SCL. Conclusions The nine items of the ASTA symptom scale were found to have good psychometric properties in patients with different forms of arrhythmias. Arrhythmia patients suffer from both frequent and disabling symptoms. The validated ASTA questionnaire can be an important contribution to PROs regarding symptom burden in arrhythmia patients.

Published
2012
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44. The associations between physical activity and appetite in patients with heart failure – a prospective observational study

Author

Andreae, Christina, Lorraine Evangelista, Arestedt, Kristofer, and Stromberg, Anna

Subjects
Omvårdnad, Nursing
Abstract

Introduction: Physical activity and appetite both play a crucial role for health outcomes and quality of life in patients with heart failure. Nevertheless, both of these key functions are frequently decreased in patients with heart failure. Whilst most attention focuses independently on the physical activity levels, the associations with appetite has been insufficiently investigated. The aim was therefore to explore the associations between physical activity and appetite in community dwelling heart failure patients. Methods: This prospective observational study consisted of 186 patients with symptomatic heart failure of whom 56 (30%) were women and 130 (70%) were men. Mean age was 70.7 (SD=11 years), the majority had NYHA-class II, 114 (63%). Objective and subjective methods were used to measure physical activity include a wearable actigraph (SenceWear) for 4 days and six minutes’ walk test. The actigraph calculate total energy expenditure, active energy expenditure, number of steps and METs daily average index. Patients also stated their physical activity level on a numeric rating scale. A self-reported questionnaire, the Council on Nutrition Appetite Questionnaire was used to assess appetite. Simple linear regression was conducted to explore the associations between physical activity and appetite at baseline and at 18-month follow-up. Results: In general, the levels of physical activity in this sample was low and appetite was poor. There was a significant association between objective physical activity measures and appetite at baseline ranging between (p=

Published
2018

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