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Maria Jaensson - One of the best experts on this subject based on the ideXlab platform.

  • association between functional health literacy and Postoperative Recovery health care contacts and health related quality of life among patients undergoing day surgery secondary analysis of a randomized clinical trial
    JAMA Surgery, 2018
    Co-Authors: Maria Halleberg Nyman, Karuna Dahlberg, Ulrica Nilsson, Maria Jaensson
    Abstract:

    Importance: Day surgery puts demands on the patients to manage their own Recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. Objective: To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of Recovery (SwQoR), and health-related quality of life. Design, Setting, and Participants: This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients. Main Outcomes and Measures: The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups. Results: Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor Recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts. Conclusions and Relevance: Inadequate FHL in patients undergoing day surgery was associated with poorer Postoperative Recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the Postoperative Recovery in patients undergoing day surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT02492191.

  • cost effectiveness of a systematic e assessed follow up of Postoperative Recovery after day surgery a multicentre randomized trial
    BJA: British Journal of Anaesthesia, 2017
    Co-Authors: Karuna Dahlberg, Anna Philipsson, Lars Hagberg, Maria Jaensson, M Hallebergnyman, Ulrica Nilsson
    Abstract:

    Abstract Background Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on Postoperative Recovery compared with standard care. Methods This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use. Results The mean cost for health-care consumption during 2 weeks after surgery was estimated at €37.29 for the intervention group and €60.96 for the control group. The mean difference was €23.66 (99% confidence interval −46.57 to − 0.76; P=0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of €4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P=0.75). The probability of the intervention being cost-effective was 71%. Conclusions This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of Postoperative Recovery. Clinical trial registration NCT02492191.

  • rapp a systematic e assessment of Postoperative Recovery in patients undergoing day surgery study protocol for a mixed methods study design including a multicentre two group parallel single blind randomised controlled trial and qualitative interview studies
    BMJ Open, 2016
    Co-Authors: Ulrica Nilsson, Karuna Dahlberg, Lars Hagberg, Maria Jaensson, Sigrid Odencrants, Ake Gronlund, Mats Eriksson
    Abstract:

    Introduction: Day surgery is a well-established practice in many European countries, but only limited information is available regarding Postoperative Recovery at home though there is a current lac ...

Marcus J Schultz - One of the best experts on this subject based on the ideXlab platform.

  • effect of an individualized versus standard pneumoperitoneum pressure strategy on Postoperative Recovery a randomized clinical trial in laparoscopic colorectal surgery
    British Journal of Surgery, 2020
    Co-Authors: Oscar Diazcambronero, Guido Mazzinari, Flor B Lorente, Garcia N Gregorio, Daniel Robleshernandez, L Olmedilla E Arnal, Martin A De Pablos, Marcus J Schultz
    Abstract:

    Background: It remains uncertain whether individualization of pneumoperitoneum pressures during laparoscopic surgery improves Postoperative Recovery. This study compared an individualized pneumoperitoneum pressure (IPP) strategy with a standard pneumoperitoneum pressure (SPP) strategy with respect to Postoperative Recovery after laparoscopic colorectal surgery. Methods: This was a multicentre RCT. The IPP strategy comprised modified patient positioning, deep neuromuscular blockade, and abdominal wall prestretching targeting the lowest intra-abdominal pressure (IAP) that maintained acceptable workspace. The SPP strategy comprised patient positioning according to the surgeon's preference, moderate neuromuscular blockade and a fixed IAP of 12 mmHg. The primary endpoint was physiological Postoperative Recovery, assessed by means of the Postoperative Quality of Recovery Scale. Secondary endpoints included Recovery in other domains and overall Recovery, the occurrence of intraoperative and Postoperative complications, duration of hospital stay, and plasma markers of inflammation up to Postoperative day 3. Results: Of 166 patients, 85 received an IPP strategy and 81 an SPP strategy. The IPP strategy was associated with a higher probability of physiological Recovery (odds ratio (OR) 2·77, 95 per cent c.i. 1·19 to 6·40, P = 0·017; risk ratio (RR) 1·82, 1·79 to 1·87, P = 0·049). The IPP strategy was also associated with a higher probability of emotional (P = 0·013) and overall (P = 0·011) Recovery. Intraoperative adverse events were less frequent with the IPP strategy (P < 0·001) and the plasma neutrophil–lymphocyte ratio was lower (P = 0·029). Other endpoints were not affected. Conclusion: In this cohort of patients undergoing laparoscopic colorectal surgery, an IPP strategy was associated with faster Recovery, fewer intraoperative complications and less inflammation than an SPP strategy. Registration number: NCT02773173 (http://www.clinicaltrials.gov).

Ulrica Nilsson - One of the best experts on this subject based on the ideXlab platform.

  • association between functional health literacy and Postoperative Recovery health care contacts and health related quality of life among patients undergoing day surgery secondary analysis of a randomized clinical trial
    JAMA Surgery, 2018
    Co-Authors: Maria Halleberg Nyman, Karuna Dahlberg, Ulrica Nilsson, Maria Jaensson
    Abstract:

    Importance: Day surgery puts demands on the patients to manage their own Recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. Objective: To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of Recovery (SwQoR), and health-related quality of life. Design, Setting, and Participants: This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients. Main Outcomes and Measures: The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups. Results: Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor Recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts. Conclusions and Relevance: Inadequate FHL in patients undergoing day surgery was associated with poorer Postoperative Recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the Postoperative Recovery in patients undergoing day surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT02492191.

  • cost effectiveness of a systematic e assessed follow up of Postoperative Recovery after day surgery a multicentre randomized trial
    BJA: British Journal of Anaesthesia, 2017
    Co-Authors: Karuna Dahlberg, Anna Philipsson, Lars Hagberg, Maria Jaensson, M Hallebergnyman, Ulrica Nilsson
    Abstract:

    Abstract Background Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on Postoperative Recovery compared with standard care. Methods This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use. Results The mean cost for health-care consumption during 2 weeks after surgery was estimated at €37.29 for the intervention group and €60.96 for the control group. The mean difference was €23.66 (99% confidence interval −46.57 to − 0.76; P=0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of €4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P=0.75). The probability of the intervention being cost-effective was 71%. Conclusions This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of Postoperative Recovery. Clinical trial registration NCT02492191.

  • rapp a systematic e assessment of Postoperative Recovery in patients undergoing day surgery study protocol for a mixed methods study design including a multicentre two group parallel single blind randomised controlled trial and qualitative interview studies
    BMJ Open, 2016
    Co-Authors: Ulrica Nilsson, Karuna Dahlberg, Lars Hagberg, Maria Jaensson, Sigrid Odencrants, Ake Gronlund, Mats Eriksson
    Abstract:

    Introduction: Day surgery is a well-established practice in many European countries, but only limited information is available regarding Postoperative Recovery at home though there is a current lac ...

Karuna Dahlberg - One of the best experts on this subject based on the ideXlab platform.

  • association between functional health literacy and Postoperative Recovery health care contacts and health related quality of life among patients undergoing day surgery secondary analysis of a randomized clinical trial
    JAMA Surgery, 2018
    Co-Authors: Maria Halleberg Nyman, Karuna Dahlberg, Ulrica Nilsson, Maria Jaensson
    Abstract:

    Importance: Day surgery puts demands on the patients to manage their own Recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. Objective: To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of Recovery (SwQoR), and health-related quality of life. Design, Setting, and Participants: This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients. Main Outcomes and Measures: The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups. Results: Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor Recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts. Conclusions and Relevance: Inadequate FHL in patients undergoing day surgery was associated with poorer Postoperative Recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the Postoperative Recovery in patients undergoing day surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT02492191.

  • cost effectiveness of a systematic e assessed follow up of Postoperative Recovery after day surgery a multicentre randomized trial
    BJA: British Journal of Anaesthesia, 2017
    Co-Authors: Karuna Dahlberg, Anna Philipsson, Lars Hagberg, Maria Jaensson, M Hallebergnyman, Ulrica Nilsson
    Abstract:

    Abstract Background Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphone-based application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on Postoperative Recovery compared with standard care. Methods This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use. Results The mean cost for health-care consumption during 2 weeks after surgery was estimated at €37.29 for the intervention group and €60.96 for the control group. The mean difference was €23.66 (99% confidence interval −46.57 to − 0.76; P=0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of €4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P=0.75). The probability of the intervention being cost-effective was 71%. Conclusions This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of Postoperative Recovery. Clinical trial registration NCT02492191.

  • rapp a systematic e assessment of Postoperative Recovery in patients undergoing day surgery study protocol for a mixed methods study design including a multicentre two group parallel single blind randomised controlled trial and qualitative interview studies
    BMJ Open, 2016
    Co-Authors: Ulrica Nilsson, Karuna Dahlberg, Lars Hagberg, Maria Jaensson, Sigrid Odencrants, Ake Gronlund, Mats Eriksson
    Abstract:

    Introduction: Day surgery is a well-established practice in many European countries, but only limited information is available regarding Postoperative Recovery at home though there is a current lac ...

Jaensson Maria - One of the best experts on this subject based on the ideXlab platform.

  • A journey to a new stable state-further development of the Postoperative Recovery concept from day surgical perspective : a qualitative study
    'BMJ', 2020
    Co-Authors: Nilsson Ulrica, Jaensson Maria, Hugelius Karin, Arakelian Erebouni, Dahlberg Karuna
    Abstract:

    Objective: This study aims to further develop the concept analysis by Allvinet alin 2007 and Lundmarket alin 2016 from the perspective of day-surgery patients. Also, to describe how patients experience Postoperative Recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept Postoperative Recovery. Design: Descriptive qualitative design with a theoretical thematic analysis. Setting: Six day-surgery departments in Sweden. Participants: Thirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected. Results: Four dimensions-physical, psychological, social and habitual-were confirmed. A total of eight subdimensions were also confirmed, two from Allvinet al's study and six from Lundmarket al's study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the Recovery process and gradually stabilised, reaching a new stable state. Conclusion: Postoperative Recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The Recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of Postoperative Recovery in order to support and understand the process of Postoperative Recovery is, therefore, recommended

  • Association Between Functional Health Literacy and Postoperative Recovery, Health Care Contacts, and Health-Related Quality of Life Among Patients Undergoing Day Surgery Secondary Analysis of a Randomized Clinical Trial
    'American Medical Association (AMA)', 2019
    Co-Authors: Hälleberg Nyman Maria, Nilsson Ulrica, Dahlberg Karuna, Jaensson Maria
    Abstract:

    Importance: Day surgery puts demands on the patients to manage their own Recovery at home according to given instructions. Low health literacy levels are shown to be associated with poorer health outcomes. Objective: To describe functional health literacy levels among patients in Sweden undergoing day surgery and to describe the association between functional health literacy (FHL) and health care contacts, quality of Recovery (SwQoR), and health-related quality of life. Design, Setting, and Participants: This observational study was part of a secondary analysis of a randomized clinical trial of patients undergoing day surgery and was performed in multiple centers from October 2015 to July 2016 and included 704 patients. Main Outcomes and Measures: The primary end point was SwQoR in the FHL groups 14 days after surgery. Secondary end points were health care contacts, EuroQol-visual analog scales, and the Short Form (36) Health Survey in the FHL groups. Results: Of 704 patients (418 [59.4%] women; mean [SD] age with inadequate or problematic FHL levels, 47 [16] years and 49 [15.1], respectively), 427 (60.7%) reported sufficient FHL, 223 (31.7%) problematic FHL, and 54 (7.7%) inadequate FHL. The global score of SwQoR indicated poor Recovery in both inadequate (37.4) and problematic (22.9) FHL. There was a statistically significant difference in the global score of SwQoR (SD) between inadequate (37.4 [34.7]) and sufficient FHL (17.7 [21.0]) (P < .001). The patients with inadequate or problematic FHL had a lower health-related quality of life than the patients with sufficient FHL in terms of EuroQol-visual analog scale scores (mean [SD], 73 [19.1], 73 [19.1], and 78 [17.4], respectively; P = .008), physical function (mean [SD], 72 [22.7], 75 [23.8], and 81 [21.9], respectively; P < .001), bodily pain (mean [SD], 51 [28.7], 53 [27.4], and 61 [27.0], respectively; P = .001), vitality (mean [SD], 50 [26.7], 56 [23.5], and 62 [25.4], respectively; P < .001), social functioning (mean [SD], 73 [28.2], 81 [21.8], and 84 [23.3], respectively; P = .004), mental health (mean [SD], 65 [25.4], 73 [21.2], and 77 [21.2], respectively; P < .001), and physical component summary (mean [SD], 41 [11.2], 42 [11.3], and 45 [10.1], respectively; P = .004). There were no differences between the FHL groups regarding health care contacts. Conclusions and Relevance: Inadequate FHL in patients undergoing day surgery was associated with poorer Postoperative Recovery and a lower health-related quality of life. Health literacy is a relevant factor to consider for optimizing the Postoperative Recovery in patients undergoing day surgery