Introduction: Computational sciences have significantly contributed to characterizing airway disease phenotypes, complementing medical expertise. However, comparing studies that derive phenotypes is challenging due to varying decisions made during phenotyping. We conducted a systematic review to describe studies that utilized unsupervised computational approaches for phenotyping obstructive airway diseases in children and adults. Methods: We searched for relevant papers published between 2010 and 2020 in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. Additional sources included conference proceedings, reference lists, and expert recommendations. Two reviewers independently screened studies for eligibility, extracted data, and assessed study quality. Disagreements were resolved by a third reviewer. An in-house quality appraisal tool was used. Evidence was synthesized, focusing on populations, variables, and computational approaches used for deriving phenotypes. Results: Of 120 studies included in the review, 60 focused on asthma, 19 on severe asthma, 28 on COPD, 4 on asthma-COPD overlap (ACO), and 9 on rhinitis. Among asthma studies, 31 focused on adults and 9 on children, with phenotypes related to atopy, age at onset, and disease severity. Severe asthma phenotypes were characterized by symptomatology, atopy, and age at onset. COPD phenotypes involved lung function, emphysematous changes, smoking, comorbidities, and daily life impairment. ACO and rhinitis phenotypes were mostly defined by symptoms, lung function, and sensitization, respectively. Most studies used hierarchical clustering, with some employing latent class modeling, mixture models, and factor analysis. The comprehensiveness of variable reporting was the best quality indicator, while reproducibility measures were often lacking. Conclusion: Variations in phenotyping methods, study settings, participant profiles, and variables contribute to significant differences in characterizing asthma, severe asthma, COPD, ACO, and rhinitis phenotypes across studies. Lack of reproducibility measures limits the evaluation of computational phenotyping in airway diseases, underscoring the need for consistent approaches to defining outcomes and selecting variables to ensure reliable phenotyping.

Purpose: Medication non-adherence is a global public health issue influenced by various factors, including the quality and comprehensiveness of medication information provided to patients. Migrants, particularly women, face unique healthcare and societal challenges in their new home countries. This study aims to explore Arabic-speaking migrant women’s experiences and perspectives on medication information and use.

Methods: This study was part of the Equal Health program, a health promotion initiative established in socially vulnerable areas to address health inequities. Arabic-speaking women aged 40–80 years with chronic illnesses participated in multistage focus group sessions exploring their experiences with medication information from healthcare, medication use, and perspectives on necessary improvements in medication information at hospital discharge. The sessions were conducted in Arabic, audio-recorded, transcribed verbatim, and translated into Swedish for analysis. Data were analyzed using Braun and Clark’s six-phase reflexive thematic analysis.

Results: Four multistage focus group sessions with 15 participants were conducted. The analysis generated three themes: receiving or not receiving professional medication information, medication adherence patterns, and needs and suggestions for improved medication information—a call for action. Participants reported inadequate medication information from physicians, particularly at the time of discharge from the hospital, and described instances of intentional and unintentional non-adherence. Suggestions for improvement included providing written medication information at discharge in their native language, using interpreters, and including a current medication list detailing overall medication information and potential drug interactions.

Conclusion: This study highlights inadequate medication information provision to Arabic-speaking migrant women, which may impact medication use and pose patient safety risks. Although the adherence patterns of the study subjects resembled those of the general population, unique barriers require additional healthcare support. This study can inform healthcare practices and establish a foundation for further research on medication information and use in this group, including comparisons with native-born individuals.

Background: Involving family members in the care process leads to higher-quality patient care. However, this requires collaboration among various healthcare professionals. At interprofessional training wards, healthcare students learn to work together across different disciplines. However, there is limited knowledge about family members’ involvement in the patient care process during interprofessional education in clinical settings. Aim: This study aimed to explore family members’ experience of involvement in the patient care process on an interprofessional training ward. Method: An inductive content analysis was applied on data from individual interviews with 19 family members of patients admitted to an interprofessional training ward.Results: Family members experienced that they had to be involved in the patient care process to bridge knowledge between the patient and the interprofessional student team in order to influence healthcare and have control over the situation. Moreover, they wanted to be acknowledged as family members and needed transparency in the patient care process. Family members’ involvement was governed by the patient’s needs and influenced by the degree of trust in the interprofessional student team. Conclusion: Interprofessional education activities should focus more on family members’ involvement in the interprofessional training ward.

BackgroundIn endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity.MethodsThe colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items.ResultsThe Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM.ConclusionThe PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.

BACKGROUND: Effective prehospital care for acute chest pain critically relies on ambulance nurses' adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses' adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines.

METHODS: An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes Regarding Practice Guidelines instrument was translated into Swedish. Both instruments were validated through cognitive interviews and expert reviews. To ascertain its reliability, a test‒retest was conducted. The construct validity of the Adherence Instrument was assessed via principal component analysis on the basis of a polychoric correlation matrix.

RESULTS: The developed Adherence Instrument was refined to 18 items and showed strong validity and reliability. Similarly, the Attitudes Regarding Practice Guidelines instrument, refined to 12 items, demonstrated strong validity and reliability. Principal component analysis of the Adherence Instrument identified five components: professional evidence-based practice, assessment of symptoms, confidence in skills, clinical autonomy, and guideline clarity and education. These components accounted for 64.5% of the total variance and demonstrated strong reliability, with an ordinal alpha of 0.84 for the entire scale.

CONCLUSION: The psychometric properties of the Adherence Instrument were satisfactory and will be useful in prehospital emergency care to measure attitudes and adherence towards acute chest pain guidelines.

Volt hockey is a team sport developed for persons with physical disabilities. Because family members are important resources to enable sports participation, the purpose of this study was to illuminate experiences of volt hockey from family members’ perspectives. Focus group interviews were conducted, including 20 family members, and the verbatim transcripts were inductively analysed using reflexive thematic analysis. Family members saw the value of enabling participation in volt hockey, being an inclusive team sport that brings enjoyment and strengthens social relationships within, and outside of, the family. Trying to facilitate sport participation, the need for material resources and other actors was emphasised, such as personal assistance, funders, and healthcare professionals informing about the sport and the engagement of the volt hockey clubs. In conclusion, involvement in volt hockey is emotionally and socially rewarding for family members, but there is a need for additional enablers to allow the sport to grow. 

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. Study data was collected between 2015-2019 from students from 13 different programs (N=3,496) before an annual institutional interprofessional program. Students completed the IPECC-SET, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of the role of different health professions.  Student groups were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programs (p<.05). Specifically, health information management/health informatics, dental, medicine, and nursing students expressed relatively higher SE, whereas physical and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health care professions (p<.01) and gender (p<.01) contributed significantly to predict perceived SE for competence in ICP, while amount of previous contact with other health professions did not (p=.42).  Findings highlight the value of IPE designed with consideration of specific learner needs.

OBJECTIVE: Individuals with severe asthma often report poor Health-related quality of life (HRQoL) and more research is essential to increase understanding of how they may be helped to improve HRQoL. The main aim of the current paper is to evaluate HRQoL, and possible factors influencing HRQoL, in individuals with severe asthma. The aim is also to explore associations among anxiety, depression, beliefs of medication, self-efficacy, and HRQoL among individuals with severe and other asthma as well as those with no asthma.

METHODS: = 902) were recruited from West Sweden Asthma Study, a population-based study, which includes both questionnaire surveys and clinical examinations.

RESULTS: Individuals with severe asthma had worse physical HRQoL (measured with SF-8) than those with other and no asthma (median 48.4, 51.9, and 54.3, respectively). They also had worse mental HRQoL (median 46.7) and reported higher anxiety and depression scores (measured using HADS, median 5.0 and 3.5, respectively) compared to no asthma (median 4.0 and 2.0, respectively). HRQoL was particularly affected among women with severe asthma. Individuals with severe asthma believed that their asthma medication was more necessary than those with other asthma, but they reported more concern for the medication. Asthma control and packyears predicted physical HRQoL and anxiety predicted mental HRQoL among individuals with severe asthma.

CONCLUSIONS: Efforts to improve asthma control and to reduce anxiety may improve HRQoL in individuals with severe asthma. Especially, women with severe asthma seem to need support to improve their HRQoL. Reducing concerns with asthma medication is most likely essential as high concerns may lead to poor adherence, which in turn may negatively affect asthma control and HRQoL.

Background Medication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient’s medication use at home.

Aim In preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients and data collection to reduce medication discrepancies at discharge and improve medication adherence and (2) to explore the outcomes of the interventions.

Method Participants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed.

Results Of 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores.

Conclusion Based on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.

Interprofessional education aims to foster healthcare students’ ability to collaborate in interprofessional teams with the patients at the center of care as active participants. However, little is known about how patients experience this collaboration. Therefore, this study aimed to explore patients’ experiences of being involved in the interprofessional team of healthcare students at a clinical training ward in Sweden. A descriptive design with a qualitative approach was used. Data were collected through semi-structured individual interviews with 22 patients. Braun and Clarke’s reflexive thematic analysis was used. The main finding was that patients were only included as passive participants. Although most patients wanted to be involved, they were hindered due to their health condition or excluded from care planning and decision-making. The patients needed family members’ support to be involved. However, this need was not recognised by the interprofessional team of healthcare students. Patient involvement must be highlighted as an important component of interprofessional education initiatives. Further research is needed to explore family members’ perspectives on involvement in interprofessional training ward settings.