Tone M Norekvål

• PhD
• Professor (Full) at Haukeland University Hospital

Background There are limited data regarding the utility of follow-up cardiac troponin (cTn) measurements after admission for acute chest pain and how long-term stability of myocardial injury and prognostic value differ when using cardiac troponin T (cTnT) or I (cTnI). Methods We measured high-sensitivity (hs)-cTnT (Roche Diagnostics) and hs-cTnI (...

Aims and Objectives To (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non‐surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International...

Aim: There are discrepancies between the information patients desire about adverse drug reactions (ADRs) and the information they receive from healthcare providers; this is an impediment to shared decision-making. This study aimed to establish whether patients received information about ADRs resulting from prescribed pharmacotherapy, before hospita...

Aims The recent rise in the number of nonagenarians (age ≥ 90 years) undergoing percutaneous coronary intervention (PCI) has revealed gaps in research, in particular on patients’ experiences. Therefore, the aim of the study was to explore and describe nonagenarians’ internal resources and their experiences of the in-hospital pathway. Methods and r...

Background Children and adolescents with complex health complaints are often referred to several different healthcare specialists for assessments and treatment. This may result in fragmented care, higher risks of medical errors, and sub-optimal health outcomes. The aim of this non-controlled open label trial was to evaluate the feasibility of imple...

Background: Cardiac troponin (cTn) concentrations and the associated long-term cardiovascular risk differ between women and men in the general population. Research question: In patients with acute chest pain, does the prognostic value of cTn differ between sexes as assessed by different cTn assays? Methods: This prospective cohort study included 15...

Objectives Patients presenting with symptoms suggestive of acute coronary syndrome (ACS) contribute to a high workload and overcrowding in the Emergency Department (ED). Accelerated diagnostic protocols for non-ST-elevation myocardial infarction have proved challenging to implement. One obstacle is the turnaround time for analyzing high-sensitivity...

Background Little is known about mental health following advanced cardiac procedures in the oldest patients. Aims To study changes in anxiety and depression from baseline to one- and six-month follow-up in older patients following transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Methods Prospective cohor...

Aim: Patients with symptomatic aortic valve stenosis are efficiently treated by aortic valve replacement (AVR), using a biological or mechanical valve. For some patients with mechanical valves, the metallic clicking sound may be problematic. The aim of this study was to investigate the perceived disturbance from the sound of a mechanical valve and...

Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This st...

Aim: In-hospital telemetry monitoring has been an integrated part of arrhythmia monitoring for decades. A substantial proportion of patients require arrhythmia monitoring during stays in non-intensive care units. However, studies exploring patients' experiences of telemetry monitoring are scarce. Therefore, the aim was to explore and describe pati...

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Novo Nordic Foundation Background An estimated 35% of heart disease occurs in individuals between 35 to 54 years of age, which is the prime child-bearing and parenting years. Even though heart disease often has a good prognosis, its treatment and symptoms ca...

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): The Western Norway Health Authority, The Norwegian Nurses Association Background A substantial proportion of patients with coronary artery disease do not achieve risk factors control, and are subsequently readmitted to hospital. In addition to decreased l...

Aims Fundamental roadblocks, such as non-use and low eHealth literacy, prevent the implementation of eHealth resources. The aims were to study internet usage for health information and eHealth literacy in patients after percutaneous coronary intervention (PCI). Further, we aimed to evaluate temporal changes and determine whether use of the internet...

Aims: Electronic health (eHealth) sources have great potential to improve patients' access to health information for self-management of secondary prevention after percutaneous coronary intervention (PCI). It remains unclear, however, whether patients are health-related digitally active and whether they have sufficient eHealth literacy. This study...

Background Telemetry monitoring is a cornerstone of care in in-hospital arrhythmia monitoring. Annually, a large number of patients experience arrhythmias that need to be monitored and treated during hospital stay. However, studies focusing on patients' experiences of telemetry monitoring are scarce. Purpose To explore and describe adult patients'...

Background Percutaneous coronary intervention (PCI) has demonstrated to be an effective treatment strategy also in octogenarian patients (≥80 years). However, limited studies describe patient-reported outcomes in older adults two months after the PCI procedure. Purpose To identify latent health profiles concerning fatigue, generic and disease-spec...

Background Health status, and clinical- and sociodemographic factors influence the type of follow-up care for patients after percutaneous coronary intervention (PCI). However, patients' perceived need for follow-up and how this is associated with health status, sociodemographic and clinical variables in countries with different follow-up after PCI...

Background Healthcare providers are commonly reluctant to inform patients about potential adverse drug reactions (ADRs) from prescribed therapy to avoid increasing the incidence of ADRs through the nocebo effect. However, patients need information on all aspects of prescribed therapy to facilitate informed decision-making and take ownership of thei...

Objective To determine patient perceptions of generic medicines 2 and 6 months after percutaneous coronary intervention (PCI), and to determine whether these perceptions moderate medication adherence. Design Prospective multicentre cohort study with repeated measures of perceptions of generic medicines and medication adherence. Setting The CONCAR...

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): The Western Norway Health Authority Background Evidence supports the use of electronic health (eHealth) programmes for patients with coronary artery disease. To date, there has been little attention toward patients’ preferences for the use of eHealth prog...

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): MTG Holding AS Introduction The number of octogenarians (≥80 years of age) receiving percutaneous coronary intervention (PCI) is rising. Evidence supports that PCI improves quality of life and functional status in this group. Optimal health-promoting behavio...

Funding Acknowledgements Type of funding sources: None. Background/Introduction As many use the internet as a major source of health information, eHealth literacy has emerged as a potential concept for digital health care consumption. Therefore, healthcare professionals need to consider the eHealth literacy of patients when delivering health infor...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Western Norway Health Authority 2017-2020 (no 912184) Norsk Sykepleierforbund - (Norwegian Nurses Association) Background Personalised follow-up care based on patients’ preferences may increase adherence to secondary prevention strategies. Still, some...

Background High levels of psychological distress and poor overall quality of life (QOL) have been identified among nursing students during the COVID-19 pandemic. The pandemic necessitated improvised reconstructions of educational curriculums and restrictions in clinical placement and training at campuses, possibly reducing educational quality. Obj...

Objective To describe the magnitude and predictors of symptom burden (SB) and quality of life (QoL) 3 months after hospital admission for acute chest pain. Design Prospective observational study. Setting Single centre, outpatient follow-up. Participants 1506 patients. Outcomes Scores reported for general health (RAND-12), angina-related health...

In the setting of established coronary artery disease (CAD), lower health literacy is associated with poor outcomes. The aim of this study was to determine whether health literacy at the index admission was associated with established CAD risk factors and with changes in CAD risk factors from baseline until 6 months after percutaneous coronary inte...

Background The RAND-36 and RAND-12 (equivalent to versions 1 of the SF-36 Health Survey and SF-12 Health Survey, respectively) are widely used measures of health-related quality of life. However, there are diverging views regarding how to create the physical health and mental health composite scores of these questionnaires. We present a simple appr...

se (A.H.P.) † These authors contributed equally to this work. Abstract: The rapid spread of the coronavirus disease 2019 (COVID-19) has led to high levels of fear worldwide. Given that fear is an important factor in causing psychological distress and facilitating preventive behaviors, assessing the fear of COVID-19 is important. The seven-item Fear...

To examine the psychometric properties of the Norwegian version of the Fear of COVID-19 Scale (FCV-19S), randomly selected individuals from a larger registry study were invited. We assessed the reliability and validity of the instrument in a sample of 1089 adults in Norway (response rate 73%). Internal consistency measured by Cronbach's alpha (0.88...

Background Generic medicines are bioequivalents to brand-name medicines, and compelling evidence for the safety and efficacy of generic medicines exists. However, negative perceptions about generic medicines can potentially reduce adherence to prescribed therapy and thereby efficacy of the treatment. Purpose To describe patients' perceptions of ge...

Background High levels of psychological distress and poor overall quality of life (QOL) have been identified among nursing students during the COVID-19 pandemic. The pandemic necessitated improvised reconstructions of educational curriculums and restrictions in clinical placement and training at campuses, possibly reducing educational quality. Obje...

Valvular heart disease is associated with significant mortality and morbidity, increased symptoms, and poor quality of life, as well as high rates of hospital readmission. There has been a rapid emergence in the past decade of minimally invasive transcatheter options for patients for high surgical risk patients with valve disease. Acquired valvular...

Cardiac arrhythmia is a common complication of acute coronary syndrome, cardiomyopathy, and inherited cardiac conditions. Other regulatory imbalances such as electrolyte disturbance, thyroid dysfunction, or drug interactions can also predispose to arrhythmias. Patients can be asymptomatic, but in many cases palpitations, dyspnoea, chest pain, or sy...

The ESC Textbook of Cardiovascular Nursing is the official textbook of the European Society of Cardiology (ESC) Association of Cardiovascular Nursing and Allied Professions. It aims to provide in-depth learning for nurses specializing in caring for patients with coronary heart disease, heart failure, valvular disease, arrhythmias, congenital heart...

Background: Patients need information on all aspects of prescribed drug therapy to make informed decisions about their treatment for autonomy. Purpose: This study assessed whether patients received information about potential adverse drug reactions (ADRs) from prescribed drug therapy before or after discharge following percutaneous coronary interve...

This chapter explores the concepts of function, frailty, and quality of life in patients with valvular heart disease awaiting valve intervention. Frailty is a geriatric syndrome that constitutes a potential risk for complications and further functional decline following valve treatment. Information about a person’s functional and frailty status add...

Background/Introduction Health information and secondary prevention strategies after percutaneous coronary intervention (PCI) are pivotal to reduce the risk of new cardiac events and achieve good quality of life. However, whether patients are digitally active and have sufficient electronic health literacy (eHL) skills to access, understand and use...

Background The RAND-36 and RAND-12 (equivalent to versions 1 of the Short-form-36 and Short-form-12 respectively) are widely used measures of health-related quality of life. However, there are diverging views regarding how to create the physical health and mental health composite scores of these questionnaires. We present a simple approach using an...

Background Chest pain is a common complaint in the general practitioner’s (GP) office. Computed tomography (CT) is one of the main diagnostic tools available for assessing coronary artery disease (CAD), with a low probability of a false-negative result (<1%). Despite normal CT findings, many patients with non-coronary chest pain believe they suffer...

Abstract Background The COVID-19 pandemic has caused significant disruptions in the implementation of programs across educational institutions. Nursing students, being both young adults and by practical training, part of the health care system, may be particularly vulnerable during the COVID-19 pandemic. The purpose of this study was to explore the...

Funding Acknowledgements The Western Norway Health Authority. OnBehalf The CONCARD-PCI Investigators Background In recent years an internet-based technology has become an important source for providing health information to patients after an acute cardiac event. Therefore, consideration of patients’ perceived eHealth literacy skills, is crucial f...

Aims Infective endocarditis is a complex and highly mortal disease requiring lengthy treatment. Physical and mental deconditioning is common. Nonetheless, rehabilitation is virtually unexplored in this population. The aim of this trial was therefore to investigate the effects of cardiac rehabilitation in patients following endocarditis. Methods an...

Purpose: To describe women's initial experiences and up to a year in retrospect of their life situation with a confirmed Takotsubo syndrome (TS) diagnosis. Method: A single case study literature review based on nine articles published by nurses was analyzed deductively using a nursing life dimension model. Results: All but one case was conducted on...

Background The COVID-19 pandemic has caused significant disruptions in the implementation of programs across educational institutions. Nursing students, being both young adults and by practical training, part of the health care system, may be particularly vulnerable during the COVID-19 pandemic. The purpose of this study was to explore the associat...

Hjertesvikt giver symptomer som ødem, dyspne, generell trettbarhet (fatigue) og redusert fysisk kapasitet. Tilstanden rammer 1-2 % av den voksne befolkningen. Hjertesvikt giver begrenset fysisk kapasitet og mindsket mulighet til å delta i hverdagslige aktiviteter. Kronisk hjertesvikt-patienter opplever søvnløse timer på natten og tretthet på dagtid...

Background Frailty status and patient-reported outcomes are especially pertinent in octogenarians following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) to guide treatment decisions and promote patient-centred care. Aim We aimed to determine if frailty changed 6 months after aortic valve replacement (...

Funding Acknowledgements Type of funding sources: None. Background Chest pain is a symptom closely linked to coronary disease (CAD) and a common complaint in the general practitioner’s office. Nevertheless, most of these complaints are benign and of non-coronary origin. Computed Tomography (CT) is the main diagnostic tool to investigate the corona...

Aims: The objective of this study was to examine baseline frailty status (including cognitive deficits) and important clinical outcomes, to inform shared decision-making in older adults receiving transcatheter aortic valve implantation (TAVI). Methods and results: We conducted a prospective, observational study of 82 TAVI patients, recruited 201...

Aims Early treatment is crucial to successful therapy in patients with acute myocardial infarction (MI). Prehospital delay is associated with increased morbidity and mortality. There is little empirical evidence of patients’ reflections on prehospital symptoms of MI and timely treatment at the time of discharge from hospital. To explore patients’ r...

Objectives Sleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients’ long-term sleep and delirium...

Background Knowledge about the association between frailty and self-reported health among patients undergoing heart valve surgery remains sparse. Thus, the objectives were to I) describe changes in self-reported health at different time points according to frailty status, and to II) investigate the association between frailty status at discharge an...

Background: Children with combined mental and somatic conditions pose a challenge to specialized health services. These cases are often characterized by multi-referrals, frequent use of health services, poor clinical and cost effectiveness, and a lack of coordination and consistency in the care. Reorganizing the health services offered to these ch...

Background Web-based technology has recently become an important source for sharing health information with patients after an acute cardiac event. Therefore, consideration of patients’ perceived electronic health (eHealth) literacy skills is crucial for improving the delivery of patient-centered health information. Objective The aim of this study w...

On behalf of the CONCARD Investigators. eHealth interventions are emerging as an effective alternative model for improving secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the effectiveness of different modes of delivery and components in eHealth secondary prevention programmes on adherence to treatment,...

Translation and psychometric evaluation of the adapted Danish version of the Heart Continuity of Care Questionnaire.

Introduction: Percutaneous coronary intervention (PCI) aims to provide instant relief of symptoms, and improve functional capacity and prognosis in patients with coronary artery disease. Although patients may experience a quick recovery, continuity of care from hospital to home can be challenging. Within a short time span, patients must adjust the...

Aims: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous corona...

BACKGROUND Web-based technology has recently become an important source for sharing health information with patients after an acute cardiac event. Therefore, consideration of patients’ perceived electronic health (eHealth) literacy skills is crucial for improving the delivery of patient-centered health information. OBJECTIVE The aim of this study...

NURSING RESEARCH AND CLINICAL SESSION TITLE: TRANSITIONS OF CARE ACROSS SETTINGS

Purpose Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to...

Objectives Sleeve gastrectomy (SG) is the most frequently performed bariatric surgery procedure worldwide, but reports on long-term quality of life (QOL) outcomes are scarce. We investigated 5-year trajectories in QOL and their associations with weight loss after SG. Design A prospective cohort study. Setting The study was conducted in a single N...

Purpose Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to...

Background Electronic health (e-Health) interventions are emerging as an effective alternative model for improving secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the effectiveness of different modes of delivery and components in e-Health secondary prevention programmes on adherence to treatment, modifia...

Results of the CopenHeart IE trial investigating the effects of comprehensive cardiac rehabilitation in patients following infective endocarditis

Background Correct electrode placement and proper skin preparation for cardiac telemetry monitoring of patients at risk for arrhythmias increase the quality of the arrhythmic surveillance. Inconsistent arrhythmia surveillance can compromise patient safety and care outcomes. An inspection of international literature demonstrates that nurses generall...

Background Continuity of cardiac care after hospital discharge is a priority, especially as healthcare systems become increasingly complex and fragmented. There are few available instruments to measure continuity of cardiac care, especially from the patient perspective. The aim of this study was (1) to translate and adapt the Heart Continuity of Ca...

Background: Sleep-disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep-disordered breathing...

Background: A person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery. Objective: We investigated the association between ESE, weight loss, and obesity-specific qual...

Background: The impact of different patterns of multimorbidity in heart failure (HF) on health outcomes is unknown. Objectives: The aim of this study was to test the hypothesis that, independent of the extent of comorbidity, there are distinctive phenotypes of multimorbidity that convey an increased risk for premature mortality in patients hospi...

Objectives To determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI). Design Prospective cohort study. Setting Tertiary university hospital covering the weste...

Background:: Delirium affects nearly half of octogenarian patients after aortic valve replacement, resulting in impaired cognition, reduced awareness and hallucinations. Although healthcare professionals and relatives are often present during episodes, the nature of interactions with them is scarcely studied, and little is known about their long-t...

Aims: Established surgical scores have limitations in delineating risk among candidates for transcatheter aortic valve implantation (TAVI). Assessment of frailty might help estimate themortality risk and identify patients likely to benefit from treatment. The aim of the study was to develop a frailty score to guide the decision for TAVI. Methods...

Background: Little evidence exists on whether cardiac rehabilitation is effective for patients after heart valve surgery. Yet, accepted recommendations for patients with ischaemic heart disease continue to support it. To date, no studies have determined what heart valve surgery patients prefer in a cardiac rehabilitation programme, and none have a...

Rationale, aims and objectives: Secondary prevention programmes reduce cardiovascular risk, but few studies have evaluated whether a nurse-led intervention for patients discharged early after myocardial infarction (MI) promotes self-management behaviour. The aim of this study was to evaluate the effect of an individual nurse-led counselling program...

Purpose: Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to...

Objectives To investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes. Design A cross-sectional survey with an 18-month follow-up. Setting One tertiary university hospital in Western Norway. Participants In all, 1436...

Background: Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpo...