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Test-retest reliability calculated by Kappa analysis for occasion 1 and occasion 2.
Source publication
The purpose of this study was to evaluate the psy- chometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A conven- ience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was exami...
Context in source publication
Context 1
... Cronbach's alpha coefficient for the original version was found to be acceptable for both the complete instrument with a range from 0.699 - 0.712, and for the subscales (KHOS-I and KHOS-B) with a ranged from 0.535 -0.703 on the first occasion and from 0.723 -0.731 on the second occasion ( Table 1). Test-retest reliability according to ICC was ranged from 0.285 -0.710 ( Table 2). One of the items (6%) showed good agreement, nine items (56.5%) showed moderate agreement and 6 items (37.5%) showed fair agreement between the two occasions. ...
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... 114 KHOS is reported to have satisfactory face and content validity, internal consistency and test-retest reliability. 36,114,115 Cronbach's alpha in the thesis was 0.50--0.64. ...
Abstract [en]
Introduction: Surgical patients need knowledge to participate in their own care and to engage in self-care behaviour in the perioperative period which is important for their recovery. Patient education facilitates such knowledge acquisition and several methods can be used to facilitate it, for example, face-to-face education and brochures or using information technology such as website or computer games. Healthcare professionals have been slow to seize the possibilities that information technology has to offer within the field, including the use of serious games. To optimise patient education, the information is needed on the patients’ needs and preferences and what they think about the idea of using a serious game to learn about self-care.
Aim: The overall aims of this thesis were to describe the knowledge expectations of surgical patients, to describe how surgical patients want to learn, and to explore the potential use of serious games in patient education.
Methods: This thesis includes four studies that used both quantitative and qualitative data to describe aspects of patient learning in relation to surgery. Study I has a prospective and comparative design with survey data collected before surgery and before hospital discharge from 290 patients with osteoarthritis undergoing knee arthroplasty. Data was collected on fulfilment of knowledge expectations and related factors. Study II is a cross-‐sectional study in 104 patients with heart failure who had been scheduled for cardiac resynchronisation therapy (CRT) device implantation. Data was collected on knowledge expectations and related factors. In Study III the perceptions of 13 surgical patients towards novel and traditional methods to learn about post-operative pain management are explored in a qualitative interview study using content analysis. Study IV describes the development and evaluation of a serious game to learn about pain management with the participation of 20 persons recruited from the public. The game was developed by an interdisciplinary team following a structured approach. Data on the efficacy and usability of the game was collected in one session with questionnaires, observations and interviews.
Results: Participants reported high knowledge expectations. Knowledge expectations were highest within the bio-physiological knowledge dimension on disease, treatment and complications and the functional dimension on how daily activities are affected, both of which include items on self-care. Most participants wanted to know about the possible complications related to the surgery procedure. In none of the knowledge dimensions the expectations of participants were fulfilled. Participants received most knowledge on the physical and functional issues and received least on the financial and social aspects of their illness. The main predictor of fulfilment of knowledge expectations was having access to knowledge in the hospital from doctors and nurses. Trust in the information source and own motivation to learn shaped how the participants thought about different learning methods. Although the participants were open to using novel learning methods such as websites or games they were also doubtful about their use and called for advice by healthcare professionals. To develop a serious game with the goal to learn about pain management, theories of self-care and adult learning, evidence on the educational needs of patients about pain management and principles of gamification were found useful. The game character is a surgical patient just discharged home from hospital who needs to attend to daily activities while simultaneously managing post-operative pain with different strategies. Participants who evaluated a first version of the serious game improved their knowledge and described usability of the game as high. They were positive towards this new learning method and found it suitable for learning about pain management after surgery in spite of some technical obstacles.
Conclusions: Surgical patients have high knowledge expectations about all aspects of their upcoming surgery and although they prefer direct communication with healthcare professionals as a source for knowledge they might be open to try using more novel methods such as games. Preliminary short-‐term results demonstrate that a serious game can help individuals to learn about pain management, and has the potential to improve knowledge. A careful introduction, recommendation, and support from healthcare professionals is needed for implementation of such a novel method in patient education.
Abstract [is]
Fræðsla gerir sjúklingum betur kleift að taka þátt í umönnun sinni sem er mikilvægt fyrir bata eftir skurðaðgerð. Sjúklingafræðslu má veita með ýmsum aðferðum, til dæmis munnlega, með bæklingum eða með því að nota upplýsingatækni á formi vefsíðna eða kennslutölvuleikja. Heilbrigðisstarfsfólk hefur verið lengi að tileinka sér möguleika upplýsingatækninnar í sjúklingafræðslu, þar með talið notkun kennslutölvuleikja. Þörf er á meiri þekkingu um fræðsluþarfir skurðsjúklinga en jafnframt um viðhorf sjúklinga til nýrra námsaðferða. Kennslutölvuleikir eru ein leið sem gæti gagnast sjúklingum en notagildi þeirra hefur lítið verið rannsakað.
Meginmarkmið þessarar ritgerðar var að lýsa væntingum skurðsjúklinga til fræðslu, lýsa því hvernig þeir vilja læra og að kanna möguleika kennslutölvuleikja í sjúklingafræðslu.
Ritgerðin samanstendur af fjórum rannsóknargreinum. Notuð vorumegindleg og eigindleg rannsóknargögn til að lýsa ýmsum hliðum náms einstaklinga sem fara í skurðaðgerð. Rannsókn I er framsýn samanburðarrannsókn sem gerð var á 290 sjúklingum með slitgigt sem gengust undir hnéliðskipti. Gögnum var safnað með spurningalistum fyrir skurðaðgerð og fyrir útskrift af sjúkrahúsi um uppfyllingu væntinga til fræðslu og tengda þætti. Rannsókn II er þversniðsrannsókn með þátttöku 104 sjúklinga með hjartabilun sem voru á leið í aðgerð til að fá ígræddan sérstakan hjartagangráð (e. cardiac resynchronisation therapy (CRT)). Gögnum var safnað með spurningalistum, fyrir ígræðsluna, um væntingar til fræðslu og tengda þætti. Rannsókn III er eigindleg rannsókn með þátttöku 13 sjúklinga sem nýlega höfðu farið í liðskiptaaðgerð eða hjartaskurðaðgerð. Gögnum var safnað með viðtölum þar sem sjúklingar lýstu viðhorfum sínum til nýrra og hefðbundinna aðferða til að læra um verkjameðferð eftir skurðaðgerð. Gögnin voru greind með innihaldsgreiningu. Rannsókn IV lýsir þróun og mati á kennslutölvuleik til að læra um verkjameðferð eftir skurðaðgerð, með þátttöku 20 sjálfboðaliða. Leikurinn var þróaður af þverfaglegum hópi hjúkrunarfræðinga og tölvunarfræðinga. Gagnsemi og notagildi leiksins voru metin með spurningalistum, áhorfi og viðtölum.
Þátttakendur höfðu miklar væntingar til fræðslu. Væntingar voru mestar á sviði lífeðlisfræði um atriði er sneru að sjúkdómi, meðferð og fylgikvillum og á sviði færni um áhrif veikinda á daglegar athafnir. Bæði sviðin fela í sér atriði um sjálfsumönnun. Flestir þátttakendur vildu fá fræðslu um mögulega fylgikvilla skurðaðgerðar. Væntingar voru ekki uppfylltar á neinu þekkingarsviði þó best á sviði lífeðlisfræði og færni en síst er vörðuðu fjárhag og félagslegan stuðning í tengslum við veikindi. Væntingar voru best uppfylltar meðal þeirra sem höfðu góðan aðgang að fræðslu á spítalanum frá hjúkrunarfræðingum og læknum.
Viðhorf þátttakenda til mismunandi námsaðferða mótaðist af trausti á fræðslumiðli og eigin áhugahvöt. Þátttakendur voru opnir fyrir notkun nýjunga á borð við vefsíður og kennslutölvuleiki en jafnframt nokkuð tortryggnir og töldu mikilvægt að fá ráðleggingar og aðstoð heilbrigðisstarfsfólks við slíka notkun.
Kenningar um sjálfsumönnun og nám fullorðinna, aðferðir leikjahönnunar og tiltæk þekking á fræðsluþörfum sjúklinga um verkjameðferð voru notaðar til grundvallar við hönnun kennslutölvuleiksins. Persóna leiksins er nýlega útskrifuð af sjúkrahúsi eftir skurðaðgerð og þarf að sinna daglegum athöfnum jafnframt því að meðhöndla verki sína. Þátttakendur rannsóknarinnar sem lögðu mat á kennsluleikinn bættu þekkingu sína og töldu nothæfni leiksins mikla. Þeir voru jákvæðir gagnvart þessari nýju námsaðferð og fannst hún henta vel til að læra um verkjameðferð eftir skurðaðgerð þrátt fyrir nokkra tæknilega örðugleika.
Sjúklingar hafa miklar væntingar til fræðslu fyrir skurðaðgerð. Þeir kjósa helst að leita þekkingar hjá heilbrigðisstarfsfólki en eru þó opnir fyrir að prófa nýjungar eins og kennslutölvuleiki. Fyrstu niðurstöður sýndu að kennslutölvuleikur getur hjálpað einstaklingum að læra um verkjameðferð. Við innleiðingu nýjunga innan sjúklingafræðslu er vönduð kynning, meðmæli og stuðningur af hálfu heilbrigðisstarfsfólks mikilvægur fyrir viðtökur sjúklinga.
... The test-retest reliability was satisfactory. In the study by Svedberg et al. (2012), the corresponding values were .72, .73, ...
Background:
The prevalence of joint arthroplasties is increasing internationally, putting increased emphasis on patient education.
Purpose:
This study describes information and control preferences of patients with joint arthroplasty in seven European countries, and explores their relationships with patients' received knowledge.
Methods:
The data (n = 1,446) were collected during 2009-2012 with the Krantz Health Opinion Survey and the Received Knowledge of Hospital Patient scale.
Results:
European patients with joint arthroplasty had low preferences. Older patients had less information preferences than younger patients (p = .0001). In control preferences there were significant relationships with age (p = .021), employment in healthcare/social services (p = .033), chronic illness (p = .002), and country (p = .0001). Received knowledge of the patients did not have any relationships with information preferences. Instead, higher control preferences were associated with less received knowledge.
Conclusion:
The relationship between European joint arthroplasty patients' preferences and the knowledge they have received requires further research.
... High scores reflect strong preferences for information or behavioural control. KHOS is reported to have satisfactory face and content validity, internal consistency and test-retest reliability (Krantz et al. 1980, Leino-Kilpi et al. 2009, Svedberg et al. 2012). ...
Background
Arthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients and their spouses. Patient education is linked to and promotes the recovery process and can improve the outcome after elective hip or knee replacement. Fulfilment of knowledge expectations is essential for enabling people to become empowered during the period of recovery.
Aim
The overall aim was to explore the association between empowering knowledge and patients’ quality of recovery after elective hip or knee replacement.
Methods
The design of the four papers was descriptive, prospective and comparative. Consecutively included patients and their spouses from Cyprus, Finland, Greece, Iceland and Sweden answered questionnaires before surgery and at discharge from hospital. Data was collected during the years 2009-2012. Relationships and associations between a number of factors and fulfilment of knowledge expectations, and patients’ quality of recovery were investigated. Comparisons between patients undergoing hip or knee replacement and between patients and their spouses were made.
Results
Patients and their spouses had similar knowledge expectations, and these were not fulfilled during the hospital stay. Spouses had less fulfilled knowledge expectations compared with the patients. Swedish patients and spouses had less fulfilled knowledge expectations compared with the Icelandic and Finnish ones. Patients who experienced the hospital stay as meeting their general expectations had more fulfilled knowledge expectations compared with those who did not.
Access to knowledge was the main predictor of the variance in fulfilment of knowledge expectations. Negative emotions, such as depressive state and impa-tience, were associated with less fulfilled knowledge expectations. For patients undergoing hip replacement, a higher level of professional education was associated with less fulfilled knowledge expectations. For patients undergoing knee replacement, a history of employment in social services or healthcare was associated with less fulfilled knowledge expectations.
Patients’ experience of greater satisfaction with care was associated with better quality of recovery for both kinds of arthroplasty. Patients with fulfilled knowledge expectations experienced better quality of recovery. The spouse-related factors, namely uncertainty and depressive state, were associated with lower quality of recovery. Factors associated with greater quality of recovery among the patients were spouses with a history of employment in social services or health care, and nurses explaining matters concerning the care and treatment for the spouses.
Conclusion
Patients and their spouses had high knowledge expectations that were not fulfilled during the hospital stay. Patients’ emotional state and their access to knowledge were important for their fulfilment of knowledge expectations. Patients’ and spouses’ emotional state also played an important role in determining the patients’ quality of recovery, and greater satisfaction with care among the patients was associated with better quality of recovery.
These results emphasise the need to detect patients and their spouses in need of support in their preparation and recovery process. It is therefore important to assess patients’ and spouses’ personal knowledge expectations, and adapt to their emotional state while fulfilling them.
The content of patient education should be personalised in future care, and informal caregivers should be seriously taken into account during the period of early recovery. The results of this thesis can be used in the development and testing of person-centred educational interventions for patients undergoing elective hip or knee replacements.
... High scores reflect strong preferences for information or behavioural control (33). The KHOS questionnaire has been used in different countries among family members (23,28,34) and patients (20,24). The Cronbach's alpha for KHOS is reported as 0.54-0.76 ...
In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach
... High scores reflect strong preferences for behavioural control and/or information. KHOS is reported to have satisfactory face and content validity, internal consistency and test–retest reliability for people older than 65 with cardiac disease, as well as for ambulatory surgical patients (Leino-Kilpi et al. 2009, Svedberg et al. 2012). In this study, the Cronbach's alpha was 0Á50 for KHOS-I and 0Á65 for KHOS-B. ...
To describe the possible differences between knowledge expectations and received knowledge of patients undergoing elective knee arthroplasty in Iceland, Sweden and Finland and also to determine the relationship between such a difference and both background factors and patient satisfaction with care.
Knee arthroplasty is a fast-growing and a successful treatment for patients with osteoarthritis. Patient education can improve surgery outcomes, but it remains unknown what knowledge patients expect to receive and actually acquire during the perioperative period and what factors are related to that experience.
Descriptive, prospective survey.
In total, 290 patients answered questionnaires about their expectations (Knowledge Expectations of hospital patients - scale) before surgery and about received knowledge (Received Knowledge of hospital patients - scale) and satisfaction with hospital care (Patient Satisfaction Scale) at discharge. Sociodemographics, clinical information, accessibility to knowledge from healthcare providers (Access to Knowledge Scale), and preferences for information and behavioural control (Krantz Health Opinion Survey) were collected as background data.
Patients` knowledge expectations were higher (mean 3·6, SD 0·4) than their perception of received knowledge (mean 3·0, SD 0·7). Multiple linear regression analysis showed that access to knowledge, information preferences and work experience within health- or social care explained 33% (R²) of the variation in the difference between received and expected knowledge. Patients reported high satisfaction with their care except regarding how their family was involved.
Patients undergoing knee arthroplasty receive less knowledge than they expect, and individual factors and communication with healthcare providers during hospitalisation are related to their experience. The content of patient education and family involvement should be considered in future care.
The results strengthen the knowledge base on the educational needs of knee arthroplasty patients and can be used to develop and test new interventions.
... The test-retest reliability was also satisfactory [3,24,29]. The instrument has also been evaluated in a Swedish context and showed a good internal consistency reliability for the overall scale 0.71 and the subscales 0.72 and 0.73 as well as moderate test-retest reliability [30]. ...
The aim of this pilot study was to explore and com-pare preferences for involvement and preferences for information among men and women who had suf-fered from cardiac disease. A convenience sample of 79 respondents (47 men and 32 women) was recruited from The National Association of Heart and Lung Patients in Sweden at ten local meeting places in dif-ferent areas. Krantz Health Opinion Survey, KHOS, a 16-item self-rating questionnaire, was used to mea- sure patients’ desire for involvement in healthcare. The results indicate that patients’ information pref-erences and behavioural preferences are not very high though the total score in KHOS was 5.47. A dif-ference between the genders was also found, seen as higher scores in females than males; 5.93 vs 4.44, p = 0.032, indicating that women prefer a more active role in decision making than men do. The main prac-tical conclusion drawn from this empirical study is that patients are still not as active in seeking informa-tion or in behavioural involvement as is desirable.
Background:There is a lack of data about the information preferences of patients and their partners after a myocardial infarction.Aim:This paper explores anxiety, depression, coping and the desire to be actively involved in care in relation to age, gender and education level in myocardial infarction patients and partners.Methods:One hundred and twenty-eight patients and their partners answered the Swedish version of the Krantz Health Opinion Survey, the Hospital Anxiety and Depression Scale, and the Mastery Scale one year after the patient's myocardial infarction.Results:More active roles in decision-making during care were desired by females, younger patients and partners, and patients and partners with higher education levels. Female partners reported more anxiety than male partners, and female patients reported more depression than male patients. No differences between groups were detected in coping; overall coping was rated high.Conclusions:Secondary prevention should consist of person-centred support to both the patients and their partners, since factors such as age, gender and education level can influence information preferences during patient care.
