Inger Ekman

University of Gothenburg | GU · Department of Symptoms, Health and Care

Objective This study aimed to elucidate the meaning of lived experiences of support from social networks and the healthcare sector in persons with chronic pain. Design A qualitative, phenomenological hermeneutic method was used to analyse interview data. Setting Participants were recruited from patient organisations in Sweden. Participants Ten (...

Background: Person-centred care (PCC) is an approach based on ethical principles. To support operationalization of person-centred ethics in clinical practice a framework was developed by the Gothenburg Centre for Person Centred Care (GPCC). Both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are known for their high mo...

Aims This study aims to explore possible associations between self‐efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person‐centred care delivered by telephone. Methods and results This exploratory an...

Background In order to understand pathways of complex interventions, the Medical Research Council has suggested that process evaluations should be conducted alongside randomised controlled trials (RCTs). This paper presents a mixed methods process evaluation of a complex, person-centred eHealth intervention for persons on sick leave with common men...

Objective Chronic pain is a complex health problem affecting about one-fifth of the European population. It is a leading cause of years lived with disability worldwide, with serious personal, relational and socioeconomic consequences. Chronic pain and sick leave adversely affect health and quality of life. Thus, understanding this phenomenon is ess...

Background Healthcare and welfare systems worldwide are unprepared to accommodate the growing population of older people. Simultaneously, the cost of reactive care for older people is increasing. However, healthcare systems in many countries are reforming towards integrated and person-centred care with a focus on health promotion and proactive acti...

Aim: The study aim was to describe the content of person-centred health plans, formulated via telephone conversations between registered nurses and patients with chronic obstructive pulmonary disease and/or chronic heart failure. Method: Patients who had been hospitalised due to worsening chronic obstructive pulmonary disease and/or chronic hear...

Aim: To describe the non-significant results in nurses' outcomes after the implementation of person-centred care (PCC) and discuss if and how enablers of the WE-CARE roadmap for implementing PCC could abate the non-significant results. Design: In this paper, an innovative framework of enablers in the WE-CARE Roadmap is explained in relation to i...

Background The number of people seeking care for symptoms of exhaustion and stress is a major concern in several countries. The condition is a challenging and life-changing experience, and a deeper understanding of support to help people on sick leave due to stress-related exhaustion in their early stages is needed to facilitate recovery. Objectiv...

Background Although person-centered care (PCC) ensures high-quality care for patients, studies have shown that it is unevenly applied in clinical practice. The extent to which future health care providers are currently offered education in PCC at their universities is unclear. We aimed to clarify the PCC content offered to students as a basis for t...

Background Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients’ expe...

Background Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warra...

In healthcare systems patient engagement and care satisfaction are less than optimal. Different solutions have been proposed to recognise the patient in health care, including person-centred care. The University of Gothenburg Centre for Person-Centred Care (GPCC) steering committee formulated three ‘simple routines’ to initiate, integrate and safeg...

Person‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘a...

Background Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are characterized by severe symptom burden and common acute worsening episodes that often require hospitalization and affect prognosis. Although many studies have shown that person-centered care (PCC) increases self-efficacy in patients with chronic conditions,...

Why do so many people struggle with their medicines despite decades of research on medicines taking? Research into how people experience medicines in their everyday life remains scarce with the majority of research in this area of focusing on whether or not people take their medicines as prescribed. Hence, this study used a phenomenological hermene...

Background Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross‐disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two driv...

BACKGROUND Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warra...

Aim To determine the associations between person-centred care (PCC) and job strain, stress of conscience and intent to leave among healthcare professionals in Swedish hospital departments. Background Hospitals have experienced difficulty in retaining qualified healthcare personnel. Previous studies have shown that working in a person-centred envir...

Evidence is emerging of the potential of person-centred approaches to create partnerships between professionals and patients while also containing healthcare costs. This is important for enhancing outcomes in individuals with complex needs, who consistently report poor experiences with care. The shift towards person-centred care (PCC) is, however,...

An interdisciplinary group of clinical and non-clinical academics in Sweden created a research centre for the study of person-centred care (PCC) in long-term illness: the University of Gothenburg Centre for Person-Centred Care (GPCC). The GPCC steering committee formulated a position paper with three ‘simple routines’ to initiate, implement, and sa...

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used...

BACKGROUND Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are characterized by severe symptom burden and common acute worsening episodes that often require hospitalization and affect prognosis. Although many studies have shown that person-centered care (PCC) increases self-efficacy in patients with chronic conditions,...

Purpose Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden; moreover, many support needs of the carers are not met, leading to confusion, disappointment and frustration. We conducted an interview study to clarify t...

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...

Aim To evaluate the effects of PCC in the form of structured telephone support on self‐reported cardiac self‐efficacy in patients with COPD. Methods We enrolled 105 patients, aged ≥50 years, admitted to hospital and diagnosed with COPD from January 2015 to November 2016. The patients received usual care or PCC via telephone added to usual care. Th...

Objective The aim was to explore the experiences of a person-centred e-health intervention, in patients diagnosed with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Design Grounded theory was applied to gather and analyse data. Setting The study is part of a research project evaluating the effects of person-centred...

Introduction: Mental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave. Objective: This study aimed to explore patients' experiences of stress-related exhaustion. Design: A qualitative study with interview data analysed using a phenomenological hermeneuti...

Introduction The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person...

Background Person‐centred care (PCC) has been suggested as a potential means to improve the care of patients with chronic and long‐term disorders. In this regard, a model for PCC was developed by the University of Gothenburg Centre for Person‐Centred Care (GPCC). Objective The present study aimed to explore the theoretical frameworks, designs, con...

The purpose of this study was to explore the content and essential components of implemented person-centered care in the out-of-hospital context for older people (65+). Method A systematic review was conducted, searching for published research in electronic databases: PubMed, CINAHL, Scopus, PsycInfo, Web of Science and Embase between 2017 and 201...

Background A core feature of chronic obstructive pulmonary disorder (COPD) and chronic heart failure (CHF) is that symptoms may change rapidly because of illness progression. Thus, these chronic conditions are associated with high rehospitalisation rates. Person-centred care (PCC) has been shown to have several benefits for patients with COPD or CH...

Background: To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods: Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention pr...

Background Efforts have been made to implement a more person-centred healthcare approach in several countries. The cost-effectiveness of person-centred care is to a large extent unknown, even though it has been demonstrated to decrease total healthcare costs and to be cost-effective in some settings and conditions. The objective of this study is to...

The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. This paper presents an overview evaluation strategy for testing ‘Exploratory Health Laboratories’ to deliver these aims. Our strategy...

Introduction Fatigue is a prevalent symptom that is associated with various conditions. In patients with chronic heart failure (CHF), fatigue is one of the most commonly reported and distressing symptoms and it is associated with disease progression. Person-centred care (PCC) is a fruitful approach to increase the patient’s ability to handle their...

Background Costs associated with an ACS incident are most pronounced in the acute phase but are also considerably long after the initial hospitalisation, partly due to considerable productivity losses, which constitute a substantial part of the economic burden of the disease. Studies suggest that person-centred care may improve health-related quali...

Objective Little is known about the economic impact of takotsubo syndrome (TS) for patients and the health system after initial discharge from hospital. Therefore, the aim of this study was to describe the healthcare resource use and calculate direct healthcare costs for TS, from hospitalisation to 6 months after discharge, and explore the distribu...

To evaluate the effects of person-centred support via telephone in two chronically ill patient groups, chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF).221 patients ≥ 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six mon...

Background: Long term health conditions, including chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD), are one of the major challenges facing healthcare systems worldwide; and telehealth has been suggested as a safe option to promote self­management. The effectiveness of person­ centred care as a tool to improve health car...

Objective: The aim of this study was to describe peoples' experiences and expectations of support when living with chronic obstructive pulmonary disease (COPD). Method: We conducted and analysed face-to-face or telephone interviews with 17 individuals (aged 44-77 years) diagnosed with COPD. The interviewer asked open-ended questions aimed at enc...

Aim: To assess the long-term effect of person-centred care (PCC) in patients with acute coronary syndrome (ACS). Method: Patients with ACS were randomly assigned to treatment as usual (control group) or an added PCC intervention for six months. The primary endpoint was a composite score of changes in general self-efficacy≥five units, return to w...

Background: Personalised care planning is argued for but there is a need to know more about what the plans actually contain. Aim: To describe the content of person-centred health, plans documented at three healthcare levels for patients with acute coronary syndrome. Design: Patients with acute coronary syndrome aged under 75 years and admitted...

Aims: Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic hear...

Background: Ineffective medication management contributes to repeated hospitalisation and death among patients with heart failure. The meaning ascribed to medications and the influence of meaning on how patients manage medications is unknown. The purpose of this study was to explore the meaning and expectations associated with medication use in hi...

sbu bereder • rapport 260/2017 Statens beredning för medicinsk och social utvärdering Patientdelaktighet i hälso-och sjukvården Webbpublicerad januari 2017 Planerad slutlig version mars 2017 Observera att detta är en preliminär version. Ändringar kan komma att göras inför den slutliga versionen.

Objectives: To study the effects of person-centred care provided to patients with acute coronary syndrome, using four different health-related outcome measures. Also, to examine the performance of these outcomes when measuring person-centred care. Data and method: The data used in this study consists of primary data from a multicentre randomized...

Background Heart failure is a serious condition with high mortality and a high symptom burden. Most patients with heart failure will be taken care of in primary care but the knowledge of how the quality of care is perceived by patients with heart failure is limited. Objective The aim was to explore how patients with heart failure report quality of...

Objective The aim of the study was to investigate the meaning of narrated symptoms in connection to takotsubo syndrome. Design, method, participants and setting Qualitative study consisting of 25 interviews, 23 women and 2 men aged 39–84 and living in Region Västra Götaland, Sweden. The transcribed text was analysed with phenomenological hermeneut...

Background: The goal of total hip arthroplasty (THA) is optimal pain relief and a normalized health-related quality of life. Anxious patients describe more pain and more difficulties than non-anxious patients during rehabilitation after THA. The aims of the present study were twofold: (1) to identify vulnerable patients using the general self-effi...

Background: Takotsubo syndrome is a form of acute, reversible heart failure that has gained increasing attention. It affects mostly postmenopausal women, and its acute onset and symptoms mimic acute myocardial infarction. The distinct feature of takotsubo syndrome is the ballooning of a ventricle, but the complete pathophysiological mechanisms are...

Aim: The aim of this study was to evaluate the effects of person-centred care (PCC) after acute coronary syndrome (ACS) in relation to educational level of participants. Method: 199 Patients <75years with ACS were randomised to PCC plus usual care or usual care alone and followed for 6months from hospital to outpatient care and primary care. For...

Aim: To discuss methodological issues in relation to focus groups, based on a recent a recent study with telehealth professionals. Background: Focus groups are a popular in nursing research, but they come with particular implications for data collection and analysis, which require consideration. Critical reflection: We presumed that our approach to...

Objectives To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. Design 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed...

Background: Patients with cardiovascular diseases managed by a person-centered care (PCC) approach have been observed to have better treatment outcomes and satisfaction than with traditional care. eHealth may facilitate the often slow transition to more person-centered health care by increasing patients’ beliefs in their own capacities (self-effica...

Background: Person-centred care (PCC) aims to engage patients as active partners in their care and treatment to improve the management of their illness. Self-efficacy is an important concept and outcome in PCC as it refers to a patient's belief in their capability to manage the events that affect their lives. Recovery after acute coronary syndrome...

Background: The connection between stress and disease has been part of folk wisdom for a long time and has even made its way into our language with phrases such as 'scared to death' and 'a broken heart'. Takotsubo syndrome is a form of acute, reversible heart failure characterized by ballooning of the left ventricle. Post-menopausal women are prim...

The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and d...

Title: The nature of telehealth relationships from a nursing perspective. Insights from a qualitative focus group study. Authors: Birgit Heckemann, RN, MSc, PhD student 1,2 Lilas Ali, RN, PhD 1 Axel Wolf, RN, PhD 1 Steffen Sonntag, MD, Medical Director 3 Inger Ekman, Professor, RN, PhD 1 Institution: 1 The Gothenburg University Centre for Person...

To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome. 199 patients with acute coronary syndrome <75years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6months. In the intervention gr...

The Swedish approach to implementing person centred care is being led and evaluated by a dedicated unit established in 2010 at the University of Gothenburg. The unit focuses primarily on people living with long term conditions. It is funded by the Swedish government (€10m; £8m; $12m) as part of a broad initiative to stimulate research at Swedish un...

Discharge planning is important to bridge the gap between hospital and home. Many patients with chronic heart failure are often fragile elderly with co-morbidities and functional decline due to increased symptom burden. A structured Gothenburg person-centred care (gPCC) approach may promote better discharge-planning. To evaluate whether proactive c...

Costs of care for patients with chronic heart failure have been estimated at between 1% and 2% of the total health care expenditure in Europe and North America. Two-thirds are for inpatient care. Person-centred care (PCC) asserts that patients are persons and should not be reduced to their diseases alone. The aim of this study was to estimate the c...

Poor adherence to evidence-based medications in heart failure (HF) is a major cause of avoidable hospitalizations, disability, and death. To test the feasibility of improving medication adherence, we performed a randomized proof-of-concept study of a self-management intervention in high-risk patients with HF. Patients with HF who screened positivel...

Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect ha...

Objective: In this study the implementation of a care model was examined in a public hospital in Sweden. The aim was to identify, from the management perspective, barriers and facilitators with respect to the implementation. A further aim was to study the explanatory power of a theoretical framework, normalization process theory (NPT). Method: Semi...

Background Patient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new ca...

How will a European high quality health care system – that can be afforded by society and still capture the inevitable societal, medical and technical progress – look like in twenty years? The WE CARE project coordinates the development of a new roadmap for Research and Development (R&D) towards 2035 to achieve a breakthrough in increasing health c...

Background: Cardiac self-efficacy is a person's belief in his/her ability to manage the challenges posed by a coronary disease, and its role has been evaluated in several coronary populations using the Cardiac Self-Efficacy Scale (CSE Scale). Self-efficacy has an important role in person-centred care, however there is a lack of appropriate instrume...

Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reaso...

Background: Heart failure (HF) remains a primary cause of avoidable hospitalizations, disability and death. Taking evidenced-based medications is one component of guideline-based self-management, and is associated with improved clinical outcomes. Despite benefits, patients struggle with medication adherence in daily life and adherence remains less...

Modern care is often based on investigations such as laboratory markers and imaging - for example, x-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the poi...