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Audulv, Åsa
Publications (10 of 30) Show all publications
Warner, G., Packer, T. L., Kervin, E., Sibbald, K. & Audulv, Å. (2019). A systematic review examining whether community-based self-management programs for older adults with chronic conditions actively engage participants and teach them patient-oriented self-management strategies. Patient Education and Counseling
Open this publication in new window or tab >>A systematic review examining whether community-based self-management programs for older adults with chronic conditions actively engage participants and teach them patient-oriented self-management strategies
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2019 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To identify whether community-based Self-Management Programs (SMPs) actively engaged, or taught, individuals patient-oriented strategies; and whether having these attributes led to significant differences in outcomes. Methods: This systematic review included randomized controlled trials (RCTs)and cluster RCTs reporting on community-based SMPs with a group component for older adults with chronic conditions. The ways SMPS actively engaged participants and whether they taught patient-oriented strategies were analyzed. All study outcomes were reported. Results: The 31 included studies demonstrated community-based SMP programs actively engaged participants and provided strategies to improve health behaviour or care of their condition. Few included strategies to help manage the impact of conditions on their everyday lives. Seventy-nine percent of studies reported significant differences; variations in sample sizes and outcomes made it difficult to conclude whether having these attributes led to significant differences. Conclusion: SMPs are not supporting older adults to use strategies to address the impact of conditions on their everyday lives, addressing the needs of older adults with multiple conditions, nor assessing outcomes that align with the strategies taught. Practice implications: Health-care providers delivering SMPs to older adults need to tailor programs to the needs of older adults and assess whether participants are using strategies being proposed. 

Keywords
Chronic condition management, Older adults, Self-management programs, Systematic review
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-36836 (URN)10.1016/j.pec.2019.07.002 (DOI)
Note

Available online 2 July 2019

Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved
Kneck, Å. & Audulv, Å. (2019). Analyzing variations in changes over time: development of the Pattern-Oriented Longitudinal Analysis approach. Nursing Inquiry, 26(3), Article ID e12288.
Open this publication in new window or tab >>Analyzing variations in changes over time: development of the Pattern-Oriented Longitudinal Analysis approach
2019 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 26, no 3, article id e12288Article in journal (Refereed) Published
Abstract [en]

Longitudinal qualitative research in nursing is rare but becoming more common. Data collection and analysis over time provide some intriguing possibilities to better understand processes, development, and change in illness experience, healthcare organizations, and self-management. This paper aims to present a process for analyzing qualitative longitudinal data material, namely the Pattern-Oriented Longitudinal Analysis approach (POLA). We developed this approach after synthesizing experiences from two longitudinal qualitative projects and comparing our procedures and reflections with the relevant literature. Using the POLA approach, researchers can describe complexity and variation in changes over time. During the analysis process, emphasis is put on visualizing and identifying change at both an individual and a group level. Ontological and epistemological assumptions for the approach are also described. The benefit of this approach is the possibility to describe complexity and diversity in processes over time, which is important for the development of nursing knowledge. The analysis approach can be further used and developed by researchers seeking to understand variance or contextual features in processes and changes over time.

Keywords
data collection methods, longitudinal, qualitative studies, research methodology, time
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-35860 (URN)10.1111/nin.12288 (DOI)000475968900003 ()30834658 (PubMedID)
Available from: 2019-03-25 Created: 2019-03-25 Last updated: 2019-08-12Bibliographically approved
Kephart, G., Packer, T., Audulv, Å. & Warner, G. (2019). The structural and convergent validity of three commonly used measures of self-management in persons with neurological conditions. Quality of Life Research, 28(2), 545-556
Open this publication in new window or tab >>The structural and convergent validity of three commonly used measures of self-management in persons with neurological conditions
2019 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, no 2, p. 545-556Article in journal (Refereed) Published
Abstract [en]

Purpose

Self-management ability is commonly assessed in chronic disease research and clinical practice. The purpose of this study was to assess the structural and convergent validity of three commonly used self-management outcome measures in a sample of persons with neurological conditions.

Methods

We used data from a Canadian survey of persons with neurological conditions, which included three commonly used self-management measures: the Partners in Health Scale (PIH), the Patient Activation Measure (PAM), and the Self-Efficacy for Managing a Chronic Disease Scale (SEMCD). Confirmatory factor analysis was used to assess the structural and convergent validity of the three measures.

Results

When treated as single-factor constructs, none of the measurement models provided a good fit to the data. A four-domain version of the PIH was the best fitting model. Confirmatory factor analysis suggests that the three tools measure different, but correlated constructs.

Conclusions

While the PAM, PIH and SEMCD scales are all used as measures of patient self-management, our study indicates that they measure different, but correlated latent variables. None, when treated as single, uni-dimensional construct, provides an acceptable fit to our data. This is probably because self-management is multi-dimensional, as is consistently shown by qualitative evidence. While these measures may provide reliable summative measures, multi-dimensional scales are needed for clinical use and more detailed research on self-management.

Keywords
Self-management, Self-care, Patient activation, Self-efficacy, Confirmatory factor analysis, Construct validity, Structural validity, Convergent validity
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-35085 (URN)10.1007/s11136-018-2036-8 (DOI)000457880300025 ()30390217 (PubMedID)2-s2.0-85055998389 (Scopus ID)
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2019-03-18Bibliographically approved
Audulv, Å., Ghahari, S., Kephart, G., Warner, G. & Packer, T. (2019). The Taxonomy of Everyday Self-management Strategies (TEDSS): A framework derived from the literature and refined using empirical data. Patient Education and Counseling, 102(2), 367-375
Open this publication in new window or tab >>The Taxonomy of Everyday Self-management Strategies (TEDSS): A framework derived from the literature and refined using empirical data
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2019 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 102, no 2, p. 367-375Article in journal (Refereed) Published
Abstract [en]

Objective: To extend our understanding of self-management by using original data and a recent concept analysis to propose a unifying framework for self-management strategies.

Methods: Longitudinal interview data with 117 people with neurological conditions were used to test a preliminary framework derived from the literature. Statements from the interviews were sorted according to the predefined categories of the preliminary framework to investigate the fit between the framework and the qualitative data. Data on frequencies of strategies complemented the qualitative analysis.

Results: The Taxonomy of Every Day Self-management Strategies (TEDSS) Framework includes five Goal-oriented Domains (Internal, Social Interaction, Activities, Health Behaviour and Disease Controlling), and two additional Support-oriented Domains (Process and Resource). The Support-oriented Domain strategies (such as information seeking and health navigation) are not, in and of themselves, goal focused. Instead, they underlie and support the Goal-oriented Domain strategies. Together, the seven domains create a comprehensive and unified framework for understanding how people with neurological conditions self-manage all aspects of everyday life.

Conclusions: The resulting TEDSS Framework provides a taxonomy that has potential to resolve conceptual confusion within the field of self-management science.

Practice Implications: The TEDSS Framework may help to guide health service delivery and research.

Keywords
Adaptation, Chronic disease, Neurological conditions, Qualitative, Self-care, Self-management, Taxonomy, TEDSS Framework
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-34415 (URN)10.1016/j.pec.2018.08.034 (DOI)000458372200022 ()30197252 (PubMedID)2-s2.0-85052968003 (Scopus ID)
Projects
Patient reported self-management measurments for people with chronic conditions (PRISMcc)
Available from: 2018-09-14 Created: 2018-09-14 Last updated: 2019-03-18Bibliographically approved
Rönngren, Y., Björk, A., Audulv, Å., Enmarker, I., Kristiansen, L. & Haage, D. (2018). Educational nurse-led lifestyle intervention for persons with mental illness.. International Journal of Mental Health Nursing, 27(3), 1022-1031
Open this publication in new window or tab >>Educational nurse-led lifestyle intervention for persons with mental illness.
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2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 1022-1031Article in journal (Refereed) Published
Abstract [en]

Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.

Keywords
clinical practice, educational intervention, healthy lifestyle support, interpersonal relationship, severe mental illness
National Category
Clinical Medicine
Identifiers
urn:nbn:se:miun:diva-32479 (URN)10.1111/inm.12410 (DOI)000431999300011 ()29171905 (PubMedID)2-s2.0-85035026741 (Scopus ID)
Available from: 2017-12-05 Created: 2017-12-18 Last updated: 2018-05-31Bibliographically approved
Rönngren, Y., Björk, A., Kristiansen, L., Haage, D., Enmarker, I. & Audulv, Å. (2018). Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting. International Journal of Mental Health Nursing, 27(1), 390-399
Open this publication in new window or tab >>Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting
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2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 390-399Article in journal (Refereed) Published
Abstract [en]

Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16–25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.

Keywords
health information management, mental illness, primary health care, young adult
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-30608 (URN)10.1111/inm.12333 (DOI)000419717100039 ()28374967 (PubMedID)2-s2.0-85017454831 (Scopus ID)
Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2019-08-06Bibliographically approved
Rönngren, Y., Björk, A., Haage, D., Audulv, Å. & Kristiansen, L. (2018). Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support. Perspectives in psychiatric care, 54(2), 309-316
Open this publication in new window or tab >>Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support
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2018 (English)In: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 54, no 2, p. 309-316Article in journal (Refereed) Published
Abstract [en]

Purpose

The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life.

Design and Methods

The findings are based on focus groups and the researchers’ experiences of conducting the program as well as using the assessment tools.

Findings

The acceptability of the program and the assessment tools was mainly satisfactory.

Practice Implications

The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.

Keywords
cognitive support, interpersonal relationship, nurse-led lifestyle intervention, physical activity, severe mental illness
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-32016 (URN)10.1111/ppc.12239 (DOI)000429719400029 ()28901554 (PubMedID)2-s2.0-85029367484 (Scopus ID)
Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2019-02-18Bibliographically approved
Packer, T., Fracini, A., Audulv, Å., Alizadeh, N., van Gaal, B. G., Warner, G. & Kephart, G. (2018). What we know about the purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: A scoping review. Patient Education and Counseling, 101(4), 579-595
Open this publication in new window or tab >>What we know about the purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: A scoping review
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2018 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 4, p. 579-595Article in journal (Refereed) Published
Abstract [en]

Objectives:

To identify self-report, self-management measures for adults with chronic conditions, and describe their purpose, theoretical foundation, dimensionality (multi versus uni), and scope (generic versus condition specific). Methods: A search of four databases (8479 articles) resulted in a scoping review of 28 self-management measures. Results: Although authors identified tools as measures of self-management, wide variation in constructs measured, purpose, and theoretical foundations existed. Subscales on 13 multidimensional tools collectively measure domains of self-management relevant to clients, however no one tool’s subscales cover all domains. Conclusions: Viewing self-management as a complex, multidimensional whole, demonstrated that existing measures assess different, related aspects of self-management. Activities and social roles, though important to patients, are rarely measured. Measures with capacity to quantify and distinguish aspects of self-management may promote tailored patient care. Practice implications: In selecting tools for research or assessment, the reason for development, definitions, and theories underpinning the measure should be scrutinized. Our ability to measure self-management must be rigorously mapped to provide comprehensive and system-wide care for clients with chronic conditions. Viewing self-management as a complex whole will help practitioners to understand the patient perspective and their contribution in supporting each individual patient.

Keywords
Self-management, outcome measure, chronic disease, scoping review, measurement
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-32594 (URN)10.1016/j.pec.2017.10.014 (DOI)000428618600003 ()29239734 (PubMedID)2-s2.0-85035132544 (Scopus ID)
Projects
Developing a patient-centred, clinically relevant measure of self-management for individuals with multiple chronic conditions
Available from: 2017-12-22 Created: 2017-12-22 Last updated: 2019-02-18Bibliographically approved
Audulv, Å. & Kneck, Å. (2017). How to analyze time and change in qualitative longitudinal materials?: Insights from a literature review of longitudinal qualitative studies in nursing.. Paper presented at The Future Direction of European Nursing and Nursing Research 2017. BMC Nursing, 16, 10-10
Open this publication in new window or tab >>How to analyze time and change in qualitative longitudinal materials?: Insights from a literature review of longitudinal qualitative studies in nursing.
2017 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, p. 10-10Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background Longitudinal qualitative research can give new insights in social processes and experiences over time. In recent years, there has been a growing interest in conducting longitudinal qualitative research within nursing. However, the definition of what constitutes longitudinal qualitative research is unclear, the methodological literature scarce, and the variation of procedures great. This review of longitudinal qualitative articles within the nursing field aims to identify and describe various types of qualitative longitudinal approaches. Materials and Method Searches in pubmed identified over a hundred qualitative nursing articles with data collection over time. These articles were analyzed regarding 1) described analysis procedure, 2) how the results related to aspects of time and change, and 3) if results were person oriented vs category oriented. Results Five different types of longitudinal qualitative approaches were identified. In total, a large part of the papers described as having a longitudinal design performed a data collection over time, but did not integrate ideas of time or change in their analysis or results. Four fruitful approaches to analyzing longitudinal qualitative data were identified; time-line, pool, phase and pattern-oriented approaches. Articles classified as using any of these approaches have a clear perspective of time or change in the results. However, depending on type of approach different aspects of time, change, and process are in focus. Further, using different approaches yielded different kinds of results. Conclusion All approaches have pros and cons and researchers need to make informed decisions when choosing which approach they will take when analyzing qualitative longitudinal material.

Keywords
longitudinal, qualitative method, qualitative analysis
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-32597 (URN)10.1186/s12912-017-0218-2 (DOI)
Conference
The Future Direction of European Nursing and Nursing Research 2017
Available from: 2017-12-22 Created: 2017-12-22 Last updated: 2018-01-19Bibliographically approved
Rising Holmström, M., Häggström, M., Audulv, Å., Junehag, L., Coyne, I. & Söderberg, S. (2017). To integrate and manage diabetes in school: Youth's expereinces of living with Type 1 diabetes in relation to school- a qualitative study. International Diabetes Nursing, 14(2-3)
Open this publication in new window or tab >>To integrate and manage diabetes in school: Youth's expereinces of living with Type 1 diabetes in relation to school- a qualitative study
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2017 (English)In: International Diabetes Nursing, ISSN 2057-3316, E-ISSN 2057-3324, Vol. 14, no 2-3Article in journal (Refereed) Published
Abstract [en]

In Sweden, each year approximately 700 children develop Type 1 diabetes. Living with the illness is a challenge for youth and requires adjustments to lifestyle, and to manage school. The aim was to describe youths’ experiences of living with Type 1 diabetes in relation to school. A qualitative research design was used and interviews were performed with eight girls and five boys with Type 1 diabetes. The interviews were subjected to qualitative content analysis. Three themes were identified: to be friends with the diabetes, striving for normality and receiving support from others. Results showed a need to increase the understanding of T1D and diabetic competence within the Swedish school system and knowledge of youths’ own experiences is vital in this work. Living with T1D was a struggle for normality, independency and the youth needed to be friends with diabetes to handle everyday self-management. Although there are demanding life and school circumstances, it eventually becomes possible for the youth to handle the illness and to integrate and manage diabetes in school.

Keywords
Type 1 diabetes, experiences, qualitative content analysis, school, self-management, youth
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32368 (URN)10.1080/20573316.2017.1375599 (DOI)
Projects
Diabetes i skolan DiS
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-09-19Bibliographically approved
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