Marit Helen Andersen

• Borge, Christine Råheim; Wahl, Astrid Klopstad; Larsen, Marie Hamilton; Andersen, Marit Helen; Stavdal, Malene & Hermansen, Åsmund (2026). Validation of the Health Literacy Competencies (IOHLC) instrument in Norwegian interdisciplinary health care professionals in specialist health care service. Journal of Interprofessional Education & Practice. 45. doi: 10.1016/j.xjep.2026.100838. Fulltekst i vitenarkiv Vis sammendrag

  Background Few instruments exist to capture interdisciplinary healthcare professionals' (HCPs) health literacy (HL) sensitivity, such as knowledge, skills, and attentive attitudes, to pursue HL when communicating with patients and their caregivers effectively. Objective This study aims to report on the psychometric properties of The Instrument of Health Literacy Competencies (IOHLC) using confirmatory factor analysis (CFA) procedures on data from a sample of HCPs working in specialist healthcare services in Norway. Methods The nine scales of the original Chinese IOHLC were translated and adapted from English into Norwegian using a forward-backward translation procedure and cognitive interviews. For the psychometric evaluation, a cross-sectional survey of 288 HCPs was conducted in a medium-sized hospital in Norway from July 2022 to September 2022. The statistical analysis included correlation analysis (Persons R), internal consistency (Cronbach's alpha), and CFA. Results The cognitive interviews led to changes in wording and the inclusion of an additional item in the survey. Nine one-factor models resulted in an acceptable fit (i.e., >0.6), comprising 36of the 40 items in the original version. Four items were excluded due to a low loading. In the final version, comprising 36 items, the alpha for internal consistency was 0.7 and above. Conclusions The CFA analysis yielded 36 items from the original IOHLC with an acceptable model fit. Further studies on the psychometric properties of the Norwegian version in other settings and with a larger sample are needed.

• Brekke, Frida Kristine; Helseth, Sølvi; Vidnes, Tone Karine; Wahl, Astrid Klopstad; Larsen, Marie Hamilton & Fretland, Åsmund Avdem [Vis alle 8 forfattere av denne artikkelen] (2026). Health literacy in patients with colorectal liver metastases: A cross-sectional study. European Journal of Oncology Nursing. ISSN 1462-3889. 81. doi: 10.1016/j.ejon.2026.103147. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Health literacy influences surgical outcomes by affecting patients’ ability to understand information, manage their health and navigate the healthcare system. Yet, little is known about health literacy in patients with colorectal liver metastases. This study assessed health literacy across different domains and explored associations with sociodemographic and clinical factors aiming to identify knowledge gaps within this population. Design Cross-sectional. Methods A total of 122 patients with colorectal liver metastases were recruited between December 2021 and December 2024. Health literacy was assessed using the Health Literacy Questionnaire. Descriptive statistics were used to characterize the sample and to present the overall health literacy profiles. Associations between health literacy and selected sociodemographic and clinical variables were examined using, both univariate and multivariate linear regression analyses. Results Participants reported the greatest challenges in the Health Literacy Questionnaire domains “ability to find good health information” (mean score 3.98 ± 0.56, range 1-5) and “appraisal of health information” (mean score 2.63 ± 0.55, range 1-4). Lower health literacy scores were significantly associated with male gender, lower educational attainment, living alone, and the presence of comorbidity. Conclusion This study provides novel insights into the health literacy of patients with colorectal liver metastases and highlights the importance of identifying and addressing health literacy challenges in clinical care. Tailored communication and support may enhance treatment outcomes, particularly to vulnerable patient groups. Further research is needed to explore how health literacy impacts decision-making and treatment adherence in complex cancer care.

• Borge, Christine Råheim; Eik, Hedda; Wahl, Astrid Klopstad; Bragstad, Line Kildal; Sylwander, Charlotte & Hjorthaug, Kristin [Vis alle 26 forfattere av denne artikkelen] (2026). Health literacy research in primary healthcare services – A scoping review. Patient Education and Counseling. ISSN 0738-3991. 149, s. 109675–109675. doi: 10.1016/j.pec.2026.109675. Fulltekst i vitenarkiv Vis sammendrag

  Objective To systematically map existing evidence on health literacy among people with non-communicable diseases (NCDs) in primary healthcare. Methods An interdisciplinary research group conducted a scoping review following the Arksey and O’Malley framework, refined by Levac and Peters, and reported according to PRISMA-ScR. The review was registered in OSF and applied the Population–Concept–Context framework to define inclusion criteria. Searches were conducted in Medline, APA PsycInfo, Scopus, and Cochrane for studies published between 2000–2025. Peer-reviewed studies were screened in Rayyan, and data were charted and thematically analyzed through team-based consensus. Results The search identified 7952 studies, of which 106 studies met the inclusion criteria. Participants’ mean age was 59 years; 56% were female. Studies originated from 29 countries, mainly the USA, China, and Canada, with an increase after 2013. Three main themes were identified: (1) health literacy, social status, and ethnicity, (2) health literacy, disease, and health outcomes, and (3) health literacy, NCD knowledge, and self-management. Many studies reported associations between health literacy, and self-management, quality of life, and some clinical outcomes, but findings across designs and outcomes were heterogeneous and not consistently positive. Conclusions Improved communication, greater cultural competence, and tailored health literacy interventions are associated with better self-management and disease outcomes in non-communicable diseases, but most evidence is associative rather than causal, intervention effects are mixed, and research on health literacy experiences remains limited. Practice Implications More rigorously designed intervention studies and broader conceptualization and measurement of health literacy with multidimensional instruments are needed to strengthen the evidence and clarify how health literacy relates to social status, disease outcomes, and self-management in primary healthcare. Training healthcare professionals to assess and address health literacy is essential to promote equity and effective patient engagement.

• Sævik, Marte; Andersen, Marit Helen; Beitnes, Jan Otto; Aaberge, Lars & Halvorsen, Per Steinar (2025). Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months. Journal of Patient-Reported Outcomes. doi: 10.1186/s41687-025-00894-1. Fulltekst i vitenarkiv Vis sammendrag

  Aim The study aimed to determine the proportion of patients with significant improvements in Health-Related Quality of Life (HRQoL) 12 months after Transcatheter Aortic Valve Implantation (TAVI), using a threshold for physical function (PF) and physical role (RP) domains of the SF-36 questionnaire. Additionally, we explored shared baseline characteristics of patients reporting these improvements. Methodology In this prospective observational study, 88 patients with symptomatic, severe aortic stenosis (AS) and preserved ejection fraction were enrolled between April 2017 and February 2020. Exclusion criteria were clinical instability, pacemaker, chronic AF, comorbidities with life expectancy < 1 year. HRQoL was evaluated before and 12 months after transfemoral TAVI using the Norwegian version 2.0 of SF-36, and presented as mean (95% confidence interval). Other outcome measures were 6-minute walking test and NYHA- classification. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons as appropriate. Logistic regression or Chi2-test were used to explore associations between changes in PF and RP and clinical parameters. Statistical significance was set at p ≤ 0.05, and clinically significant changes in HRQoL were defined as increase of ≥ 15 points in the PF and RP categories. Results Mean age of the cohort was 80 ± 6 years. 44 (50%) patients reported clinically significant improvement in PF, and 46 (52%) in the RP domain. Baseline scores were significantly lower in patients reporting clinical improvement after TAVI, with PF scores pre intervention 43.07 (37.37–48.78) vs. 65.34 (59.01–71.68), p < 0.001, and RP 36.01 (29.56–42.46) vs. 59.92 (50.91–68.92), p < 0.001. No significant associations were found between improvement in domain scores and parameters from the routine baseline examination, but having ≥ 15-point improvement correlated to baseline PF and RP scores. Conclusion Our study highlights the importance of defining a uniform threshold for clinically significant improvement in the SF-36 HRQoL questionnaire for patients undergoing TAVI. Half of the patients reported favorable long-term outcome for PF and RP aspects of SF-36. This emphasizes the importance of HRQoL assessment in the preoperative work up for patients undergoing TAVI. Trial registration https://www.clinicaltrials.gov/ 05.04.2017 with ID NCT03107923.

• Vidnes, Tone Karine; Wahl, Astrid Klopstad; Larsen, Marie Hamilton; Meyer, Klaus; Hermansen, Åsmund & Andersen, Marit Helen (2025). Two-Year Follow-Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients—A Randomised Controlled Study. Journal of Renal Care. ISSN 1755-6678. 51(1). doi: 10.1111/jorc.70010. Fulltekst i vitenarkiv
• Vidnes, Tone Karine; Wahl, Astrid Klopstad; Larsen, Marie Hamilton; Meyer, Käthe Birgitte; Engebretsen, Eivind & Hermansen, Åsmund [Vis alle 10 forfattere av denne artikkelen] (2024). Effectiveness of a health communication intervention on health literacy in the first year following kidney transplantation – A randomized controlled study. Patient Education and Counseling. ISSN 0738-3991. 123. doi: 10.1016/j.pec.2024.108207. Fulltekst i vitenarkiv Vis sammendrag

  Objective: This study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. Methods: We randomized 195 patients during 2020–2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). Results: Results showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the “ability to appraise health information” Domain 5, (p-value = 0.002) and the “ability to navigate the healthcare system” Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. Conclusions: This study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. Practical implications: Current patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.

• Borge, Christine Råheim; Larsen, Marie Hamilton; Osborne, Richard H.; Aas, Eline; Kolle, Ingrid Tryland & Reinertsen, Rikke [Vis alle 15 forfattere av denne artikkelen] (2024). Impacts of a health literacy-informed intervention in people with chronic obstructive pulmonary disease (COPD) on hospitalization, health literacy, self-management, quality of life, and health costs – A randomized controlled trial. Patient Education and Counseling. ISSN 0738-3991. 123. doi: 10.1016/j.pec.2024.108220. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD). Methods: A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol. Results: Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ −6230, 95% CI [−6510 to −5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = − 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01). Conclusion: MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD. Practice implication: Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system.

• Vidnes, Tone Karine; Wahl, Astrid Klopstad; Larsen, Marie Hamilton; Meyer, Käthe Birgitte; Hermansen, Åsmund & Andersen, Marit Helen (2024). Health literacy profiles in kidney transplanted patients: A cluster analysis. Journal of Renal Care. ISSN 1755-6678. 50(4), s. 529–537. doi: 10.1111/jorc.12515. Fulltekst i vitenarkiv Vis sammendrag

  Background: Health literacy is important in chronic conditions, such as kidney transplantation. Understanding patients' health literacy profiles can assist tailoring follow‐up and educational programmes to the health literacy needs of vulnerable kidney transplant recipients. This approach enabled us to cluster patients according to their profiles of challenges and strengths in different health literacy domains. Objectives: This study aimed to identify different health literacy profiles within kidney transplant recipients and what characterized the different profiles. Design: Cross‐sectional study. Participants: One hundred ninety‐five kidney transplanted recipients were included. Measurements: We used the self‐reported Health Literacy Questionnaire and analyzed using Ward's method (hierarchical cluster approach). We also collected background characteristics and clinical variables, including psychological distress (Hopkins Symptoms Checklist) and perceived health status (visual analogue scale, EuroQol‐5D). Results: The analysis revealed four clusters with substantial differences in health literacy profiles. One cluster's patients had the most challenges in all health literacy domains constituting 24% of the sample. Compared to the other three clusters, this cluster was associated with shorter duration of kidney disease, higher number of patients in dialysis before transplantation, higher percentage of male patients, lower number of kidneys from living donors, higher number of patients not working and higher representation of psychological distress. All four clusters reported the most challenges in the same domain: the ability to critically appraise health information. Conclusion: In kidney transplant recipients, profiling clusters with the Health Literacy Questionnaire and Ward's method aids in identifying health literacy needs in vulnerable groups, enabling transplant professionals to offer tailored health literacy support.

• Gulseth, Eirik; Urdal, Andreas Martin; Andersen, Marit Helen; Falk, Ragnhild Sørum; Aksnes, Gunnar & Emblem, Ragnhild [Vis alle 8 forfattere av denne artikkelen] (2024). Mental health and health-related quality of life in adolescents surgically treated for hypospadias in childhood. Journal of Pediatric Urology. ISSN 1477-5131. doi: 10.1016/j.jpurol.2024.09.031. Fulltekst i vitenarkiv Vis sammendrag

  Background There is limited research and conflicting results on the mental health and health-related quality of life of individuals surgically treated for hypospadias in childhood. Furthermore, the significance of patient-reported outcomes (PRO) in hypospadias is growing. More research is necessary on these topics, particularly in adolescents. Objective We aimed to compare mental health, health-related quality of life, body satisfaction, self-esteem, penile appearance, and sexual function outcomes in 16-year-old adolescents who had surgery for hypospadias in childhood with a healthy comparison group. Study design The study involved 16-year-old adolescents who had surgery for hypospadias in one Norwegian hospital. An age-matched comparison group of healthy adolescents was previously recruited. The study assessed self-reported outcomes on mental health using the Strengths and Difficulties Questionnaire, health-related quality of life using the Pediatric Quality of Life Inventory, body satisfaction and self-esteem using the Self-Perception Profile for Adolescents, and genital perception and sexual function using the Pediatric Penile Perception Score and a non-validated structured interview. Results In total, 117 adolescents operated for hypospadias and 61 healthy adolescents were included. The outcomes for mental health and health-related quality of life were not statistically different between groups. However, 18 (16%) hypospadias patients were classified as cases/borderline on mental health outcomes, compared to 2 (3%) in the comparison group (p = 0.01). Patients classified as cases/borderline on mental health reported lower health-related quality of life, self-esteem, and more stressful life events. Self-reported penile appearance and sexual function were comparable between groups, however the proximal hypospadias group displayed lower satisfaction. Discussion Although the present study had generally positive outcomes, a significant finding was that a higher number of adolescents who had previously undergone hypospadias surgery during childhood were classified as cases or borderline cases with respect to mental health issues. Hypospadias surgery in childhood may pose challenges for some patients during adolescence, particularly in the proximal group. Regular monitoring by healthcare professionals is crucial in providing necessary support. A limitation is the small size of the subgroups. Conclusion Most patients report good mental health, quality of life, and self-esteem even though patients with hypospadias report more mental health issues than the comparison group. Proximal hypospadias were less satisfied with penile appearance and sexual function. However, due to the small sample size, conclusions about this group should be treated cautiously. Assessing self-reported outcomes in follow-ups is important to identify adolescents who had hypospadias surgery and are at risk for reduced mental health.

• Andersen, Marit Helen; Hermansen, Åsmund; Dahl, Kari Gire; Lønning, Kjersti; Meyer, Käthe Birgitte & Vidnes, Tone Karine [Vis alle 7 forfattere av denne artikkelen] (2024). Profiles of health literacy and digital health literacy in clusters of hospitalised patients: A single-centre, cross-sectional study. BMJ Open. 14(5). doi: 10.1136/bmjopen-2023-077440. Fulltekst i vitenarkiv Vis sammendrag

  Objective To investigate health literacy (HL) and digital health literacy (eHL) among patients hospitalised in surgical and medical wards using a cluster analysis approach. Design Cross‐sectional study using Ward’s hierarchical clustering method to measure cluster adequacy by evaluating distances between cluster centroids (a measure of cohesion). Different distances produced different cluster solutions. Setting and participants The study was conducted at a Norwegian university hospital. A total of 260 hospitalised patients were enrolled between 24 May and 6 June 2021. Data collection All data were collected by self-reported questionnaires. Data on HL and eHL were collected by the Health Literacy Questionnaire (HLQ) and the eHealth Literacy Questionnaire (eHLQ). We also collected data on background characteristics, health status and patient diagnosis. Results We found six HLQ clusters to be the best solution of the sample, identifying substantial diversity in HL strengths and challenges. Two clusters, representing 21% of the total sample, reported the lowest HLQ scores in eight of nine HLQ domains. Compared with the other clusters, these two contained the highest number of women, as well as the patients with the highest mean age, a low level of education and the lowest proportion of being employed. One of these clusters also represented patients with the lowest health status score. We identified six eHL clusters, two of which represented 31% of the total sample with the lowest eHLQ scores in five of seven eHLQ domains, with background characteristics comparable to patients in the low-scoring HLQ clusters. Conclusions This study provides new, nuanced knowledge about HL and eHL profiles in different clusters of patients hospitalised in surgical and medical wards. With such data, healthcare professionals can take into account vulnerable patients’ HL needs and tailor information and communication accordingly.

• Veshovda, Solveig; Eik, Hedda; Andersen, Marit Helen; Jahre, Henriette & Riiser, Kirsti (2023). Health literacy and musculoskeletal disorders in adolescents: a scoping review. BMJ Open. 13(6), s. 1–12. doi: 10.1136/bmjopen-2023-072753. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Health literacy (HL) related to musculoskeletal disorders (MSDs) in adolescents is a field with limited previous evidence. This study aimed to review and synthesise studies on MSDs and HL as well as various dimensions of HL in adolescents. Design Scoping review in accordance with Arksey and O’Malleys framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Search strategy The search strategy was performed in the following databases in November 2021 (initial search) and December 2022 (updated search); Medline, EMBASE, PsychINFO, Cochrane, CINAHL, ERIC, Web of Science and Google Scholar. Eligible studies involving MSDs and HL or either of the HL dimensions related to finding, understanding, appraising or applying health information in adolescents were considered. Any dimension of HL studied, the outcome measure(s) used to assess HL and the type of MSD examined were charted, reviewed and synthesised. A directed content analysis was used for the subjective interpretation of text data. Results A total of 16 841 studies were identified and 33 were eligible for inclusion. Ten articles presented HL with a definition or description in the theoretical background. The remaining 23 studies involved finding, understanding, appraising or applying health information, without using the term ‘health literacy’. Most of the studies addressed how adolescents understand (n=32), and apply (n=23) health information, while few studies focused on how they find (n=11) and appraise (n=7) musculoskeletal health information. Conclusion Few studies have addressed HL and MSDs in adolescents explicitly, while most studies have considered dimensions of HL. Our findings suggest that there is important work to be done to align conceptual understandings with the measurement of HL in adolescents and that further research should be carried out to explore how HL is distributed among adolescents with MSDs and how adolescents living with MSDs report their HL.

• Hermansen, Åsmund; Andersen, Marit Helen; Borge, Christine Råheim; Dahl, Kari Gire; Larsen, Marie Hamilton & Lønning, Kjersti [Vis alle 9 forfattere av denne artikkelen] (2023). Preliminary validity testing of the eHealth Literacy Questionnaire (eHLQ): a Confirmatory Factor Analysis (CFA) in Norwegian hospitalized patients. BMC Psychology. 11(1). doi: 10.1186/s40359-023-01449-z. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To perform the first psychometric analysis of the Norwegian version of the eHLQ using confirmative factor analysis (CFA) procedures in a population of patients admitted to hospital using a cross-sectional design. The eHLQ consists of 35 items capturing the 7-dimensional eHealth Literacy Framework (eHLF) which describes users’ attributes, user’s interaction with technologies and user’s experience with digital health systems. Methods: The 7 independent scales of the eHLQ was translated from Danish and culturally adapted into the Norwegian language following a standardised protocol. Assessment of construct validity of the eHLQ was undertaken using data from a cross-sectional survey of 260 patients hospitalized at a Norwegian University Hospital in the Oslo area during a two-week period in June 2021. The analysis included using correlation analysis (Pearsons R), internal consistency (Cronbach’s alpha) and confirmatory factor analysis (CFA). Results: All factor loadings were high to acceptable (i.e. > 0.6), except for five items which had somewhat lower loadings. Regarding internal consistency, alpha ranged from 0.73 to 0.90. For optimal CFA fit for the different scale models, correlated residuals were required for five of the seven scales. Overall our analysis shows an intermediate fit of the orginal construct. Scale intercorrelations were all below 0.8, indicating an overall acceptable discriminant validity between the 7 dimensions. Conclusions: The results from the CFA analysis indicate that for almost all 7 eHLQ scales, an acceptable model fit was achieved. The 260 hospitalized patients included in this study represented a variety of diagnoses, recruited from a geographically limited area. Further studies on psychometric properties of the Norwegian version of eHLQ in larger samples, diverse settings and by using more comprehensive approaches are warranted.

• Gulseth, Eirik; Urdal, Andreas Martin; Andersen, Marit Helen; Falk, Ragnhild Sørum; Aksnes, Gunnar & Emblem, Ragnhild [Vis alle 7 forfattere av denne artikkelen] (2023). Sexual well-being and penile appearance in adolescents operated for distal hypospadias in childhood. Journal of Pediatric Urology. ISSN 1477-5131. 19(3), s. 293.el–293.e8. doi: 10.1016/j.jpurol.2023.03.001. Fulltekst i vitenarkiv Vis sammendrag

  Background The importance of patient-reported outcomes (PRO) in hypospadias is increasing. However, more knowledge is needed concerning genital self-perception on appearance and function in adolescents. The complication rates for distal hypospadias is different from that for severe hypospadias, and expected outcomes related to sexual well-being and cosmetics may also differ. Objective To investigate 16-year-olds’ self-reported outcomes on penile appearance, sexual well-being, and voiding function in distal hypospadias, and compare with that of healthy male adolescents and a surgeon's view. Study design Sixteen-year-old patients operated for distal hypospadias were included in this cross-sectional study and compared to a group of healthy adolescents. The assessment tools included the adolescents’ self-perception on genital appearance and function measured by Pediatric Penile Perception Score (PPPS) and their responses to a structured interview. We also included information on clinical data from the electronic medical records, together with a physical examination and an uroflowmetry. Results Seventy patients and 61 healthy adolescents participated. Patients and the comparison group reported no differences on sexual well-being. The patients were satisfied with penile appearance, however their overall PPPS was significantly lower (8.9), compared to the comparison group (9.6, p = 0.03). Thirty-nine percent of patients had complications leading to re-interventions and reported lower scores on genital self-perception on appearance and function compared to those who had not re-interventions. Voiding function was normal. The surgeon's score on appearance was comparable to the patients’ score. Discussion A key finding in our study is the patients’ high satisfaction on sexual well-being, which was similar to healthy adolescents. The patients were also satisfied with penile appearance but scored significantly lower than the comparison group. Surgeons and patients had comparable scores on appearance; however, they seemed to emphasize different aspects of appearance. Our results on penile appearance and sexual well-being are comparable to those of other studies on distal hypospadias. In our study, re-interventions were associated with more negative genital self-perception on appearance and function, similar to findings in other studies. Conclusion Our results show overall positive satisfaction on sexual well-being, voiding function and penile appearance despite less satisfaction on penile appearance when compared with the comparison group. Satisfaction was reported to be good also in patients experiencing re-interventions.

• Wahl, Astrid Klopstad; Andersen, Marit Helen; Ødemark, John; Reisæter, Anna Varberg; Urstad, Kristin Hjorthaug & Engebretsen, Eivind (2022). The importance of shared meaning-making for sustainable knowledge translation and health literacy. Journal of Evaluation In Clinical Practice. ISSN 1356-1294. 28(5). doi: 10.1111/jep.13690. Fulltekst i vitenarkiv Vis sammendrag

  The aim of the present paper is to describe and discuss how recent theories about translation, bridging medical and humanistic understandings of knowledge translation, in the medical humanities can bring about a new understanding of health literacy in the context of patient education. We argue that knowledge translation must be understood as active engagement with contextual meaning, considering the understandings, interpretation, and expertise of both patient and health care provider (deconstruction of the distinction between biomedical and cultural knowledge). To illustrate our points, we will describe the case of Jim, a kidney transplant recipient who received standard patient education but lost the graft (the new kidney). If we apply Kristeva's view to this context, graft function is not merely biology but a complex biocultural fact. In this perspective, graft function is seen as a phenomenon that embraces translation between health as a biomedical phenomenon and healing as lived experience, and that opens for shared meaning-making processes between the patient and the health care provider. In Jim's case, this means that we need to rethink the approach to patient education in a way that encourages the patient's idiosyncratic way of thinking and experiencing, and to transform health information into a means for sustaining Jim's singular life – not biological life “in general.” The patient education programme did not take into consideration the singularities of Jim's biographical temporality, with its changes in everyday life, priorities, attitudes, and values. Hence, we claim that health literacy should involve a simultaneous interrogation of the patients and the health professional's constructions of knowledge.

• Borge, Christine Råheim; Larsen, Marie Hamilton; Osborne, Richard H; Engebretsen, Eivind; Andersen, Marit Helen & Holter, Ingrid Asbjørnsen [Vis alle 7 forfattere av denne artikkelen] (2022). How to co-design a health literacy-informed intervention based on a needs assessment study in chronic obstructive pulmonary disease. BMJ Open. 12(10). doi: 10.1136/bmjopen-2022-063022. Fulltekst i vitenarkiv Vis sammendrag

  Objective To develop a co-designed health literacy (HL)-informed intervention for people with chronic obstructive pulmonary disease (COPD) that enables them to find, understand, remember, use and communicate the health information needed to promote and maintain good health. Design This study used a co-design approach informed by the programme logic of the Ophelia (Optimising Health Literacy and Access) process. The co-design included workshops where possible solutions for an HL-informed intervention were discussed based on an HL needs assessment study. Settings Five workshops were performed in a local community setting in the specialist and municipality healthcare services in Oslo, Norway. Participants People with COPD, multidisciplinary healthcare professionals (HCPs) from the municipality and specialist healthcare services, and researchers (n=19) participated in the workshops. The co-designed HL-informed intervention was based on seven focus groups with people with COPD (n=14) and HCPs (n=21), and a cross-sectional study of people with COPD using the Health Literacy Questionnaire (n=69). Results The workshop co-design process identified 45 action points and 51 description points for possible intervention solutions to meet the HL needs of people with COPD. The final recommendation for an HL-informed intervention focused on tailored follow-up after hospitalisation, which uses motivational interviewing techniques, is based on the individual’s HL, self-management and quality of life needs and is implemented in cooperation with HCPs in both the specialist and municipality healthcare services. Conclusion During the codesign process, the workshop group generated several ideas for how to help patients find, understand, remember, use and communicate health information in order to promote and maintain good health. People with COPD need tailored follow-up based on their individual HL needs by HCPs that have knowledge of COPD and are able to motivate them for self-management tasks and help them to improve their quality of life (QOL) and decrease hospitalisation. Data availability statement No data are available. Norwegian regional ethical guidelines do not give permission to share data from research if they are not anonymous.

• Larsen, Marie Hamilton; Mengshoel, Anne Marit; Andersen, Marit Helen; Borge, Christine Råheim; Ahlsen, Birgitte & Dahl, Kari Gire [Vis alle 15 forfattere av denne artikkelen] (2022). “A bit of everything”: Health literacy interventions in chronic conditions – a systematic review. Patient Education and Counseling. ISSN 0738-3991. 105(10), s. 2999–3016. doi: 10.1016/j.pec.2022.05.008. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. Method: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant heterogeneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostly assessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. Conclusions: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions’ complexity. Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.

• Urstad, Kristin Hjorthaug; Andersen, Marit Helen; Larsen, Marie Hamilton; Borge, Christine Råheim; Helseth, Sølvi & Wahl, Astrid Klopstad (2022). Definitions and measurement of health literacy in health and medicine research: A systematic review. BMJ Open. 12(2). doi: 10.1136/bmjopen-2021-056294. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how health literacy is defined and measured in current health literacy research and to examine the relationship between health literacy definitions and instruments. Design Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources The MEDLINE, PsycINFO, ERIC and CINAHL databases were searched for articles published during two randomly selected months (March and October) in 2019. Eligibility criteria We included articles with a quantitative design that measured health literacy, were peer-reviewed and original, were published in the English language and included a study population older than 16 years. Data extraction and synthesis Six researchers screened the articles for eligibility and extracted the data independently. All health literacy definitions and instruments were considered in relation to category 1 (describing basic reading and writing skills, disease-specific knowledge and practical skills) and category 2 (social health literacy competence and the ability to interpret and critically assess health information). The categories were inspired by Nutbeam’s descriptions of the different health literacy levels. Results 120 articles were included in the review: 60 within public health and 60 within clinical health. The majority of the articles (n=77) used instruments from category 1. In total, 79 of the studies provided a health literacy definition; of these, 71 were in category 2 and 8 were in category 1. In almost half of the studies (n=38), health literacy was defined in a broad perspective (category 2) but measured with a more narrow focus (category 1). Conclusion Due to the high degree of inconsistency between health literacy definitions and instruments in current health literacy research, there is a risk of missing important information about health literacy considered be important to the initial understanding of the concept recognised in the studies.

• Smedman, Tor Magnus; Guren, Tormod Kyrre; Tveit, Magne Kjell; Thomsen, Maria; Andersen, Marit Helen & Line, Pål Dag [Vis alle 7 forfattere av denne artikkelen] (2022). Health-Related Quality of Life in Colorectal Cancer Patients Treated With Liver Transplantation Compared to Chemotherapy. Transplant International. ISSN 0934-0874. 35. doi: 10.3389/ti.2022.10404. Fulltekst i vitenarkiv Vis sammendrag

  Liver transplantation (LT) for patients with non-resectable colorectal liver metastases (CRLM) offers improved survival and has gained increased interest internationally the last years. The aim of this study was to describe the health-related quality of life (HRQoL) in patients with non-resectable CRLM receiving LT and how baseline HRQoL factors affect overall survival (OS). HRQoL data in the SECA (SEcondary CAncer) LT cohort was compared to data obtained from colorectal cancer patients starting first-line chemotherapy for metastatic disease in a clinical trial and data from a Norwegian normal population. HRQoL data from the QLQ-C30 questionnaire used in the SECA LT study and the NORDIC- VII study were reported. The relationship between patient-reported symptom burden at baseline and OS was investigated. In the SECA study longitudinal HRQoL assessment was used to describe the time until definitive deterioration as well as mean values at different time points. Patients in the SECA and NORDIC-VII studies reported similar baseline HRQoL. The median time until definitive deterioration in the transplanted patients was estimated to 36 months. In the SECA study appetite loss and pain at baseline had negative impact on OS (25.3 versus 71.7 months, p = 0.002 and 39.7 versus 71.7 months, p = 0.038, respectively). Despite a relapse in most of the LT patients the Global Health Score (GHS) remained good. Pain, and especially appetite loss at time of transplantation is associated with poor outcome after LT.

• Wahl, Astrid Klopstad; Osborne, Richard H; Larsen, Marie Hamilton; Andersen, Marit Helen; Holter, Ingrid Asbjørnsen & Borge, Christine Råheim (2021). Exploring health literacy needs in chronic obstructive pulmonary disease (COPD): Associations between demographic, clinical variables, psychological well-being and health literacy. Heart & Lung. ISSN 0147-9563. 50(3), s. 417–424. doi: 10.1016/j.hrtlng.2021.02.007. Fulltekst i vitenarkiv Vis sammendrag

  Background The World Health Organization (WHO) points to health literacy as an important factor in prevention and control of non-communicable diseases (NCDs), including COPD. Objective To investigate associations between selected demographic and clinical variables, psychological well-being and health literacy. Methods Health literacy was measured using the nine domain Health Literacy Questionnaire (HLQ) and one domain from the eHealth Literacy Questionnaire (eHLQ). Using data from a cross-sectional sample of 158 people with COPD, recruited from a hospital-based patient list period (2014-2016), multiple regression analyses were performed. Results The strongest associated variables with health literacy were psychological well-being, measured by the WHO-5 well-being index and education, indicating that higher psychological well-being and educational level are associated with higher levels of health literacy. Conclusion The present study highlights the importance of specifically looking to psychological factors in determining potentially health literacy needs among people with COPD.

• Borge, Christine Råheim; Larsen, Marie Hamilton; Osborne, Richard H; Engebretsen, Eivind; Andersen, Marit Helen & Holter, Ingrid Asbjørnsen [Vis alle 8 forfattere av denne artikkelen] (2021). Exploring patients’ and health professionals’ perspectives on health literacy needs in the context of chronic obstructive pulmonary disease. Chronic Illness. ISSN 1742-3953. doi: 10.1177/1742395321999441. Fulltekst i vitenarkiv Vis sammendrag

  Objective Persons with chronic obstructive pulmonary disease (COPD) require complex follow-up by healthcare professionals (HCPs) and may experience several health literacy (HL) needs. This study aimed to explore such needs in people with COPD and the HCPs who care for them. Methods From October 2016 to August 2017 a qualitative study with four focus groups (FG) were performed in people with COPD (n = 14) and three in multidisciplinary HCPs (n = 21). An inductive thematic analysis was used to investigate HL needs. Results Four HL needs emerged: 1) strengthening the feeling of security; 2) combating the burden of insufficient knowledge on COPD and lack of informational flow; 3) supporting motivation for endurance and self-management; and 4) strengthening dignity. Discussion This study highlights a gap between people with COPD who express important HL needs and HCPs’ capabilities to care for these needs. For HCPs to increase HL in such cases, HCPs need to improve their own HL. It is essential to find solutions on how to improve HL in HCPs who care for people with COPD and to increase the availability of interventions that increase HL in COPD. Education programs, health organizations, and governments should be aware of HL needs in such situations.

• Gulseth, Eirik; Urdal, Andreas Martin; Andersen, Marit Helen; Diseth, Trond H; Aksnes, Gunnar & Emblem, Ragnhild [Vis alle 7 forfattere av denne artikkelen] (2021). High satisfaction on genital self-perception and sexual function in healthy Norwegian male adolescents. Journal of Pediatric Urology. ISSN 1477-5131. 17(4), s. 555.E1–555.E8. doi: 10.1016/j.jpurol.2021.02.015. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad; Moum, Torbjørn Åge; Engebretsen, Eivind & Andersen, Marit Helen (2021). Renal recipients’ knowledge and self efficacy during first year after implementing an evidence based educational intervention as routine care at the transplantation clinic. BMC Nephrology. 22. doi: 10.1186/s12882-021-02468-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Following an implementation plan based on dynamic dialogue between researchers and clinicians, this study implemented an evidence-based patient education program (tested in an RCT) into routine care at a clinical transplant center. The aim of this study was to investigate renal recipients’ knowledge and self-efficacy during first year the after the intervention was provided in an everyday life setting. Methods The study has a longitudinal design. The sample consisted of 196 renal recipients. Measurement points were 5 days (baseline), 2 months (T1), 6 months (T2), and one-year post transplantation (T3). Outcome measures were post-transplant knowledge, self-efficacy, and self-perceived general health. Results No statistically significant changes were found from baseline to T1, T2, and T3. Participants’ levels of knowledge and self-efficacy were high prior to the education program and did not change throughout the first year post transplantation. Conclusion Renal recipients self-efficacy and insight in post-transplant aspects seem to be more robust when admitted to the hospital for transplantation compared to baseline observations in the RCT study. This may explain why the implemented educational intervention did not lead to the same positive increase in outcome measures as in the RCT. This study supports that replicating clinical interventions in real-life settings may provide different results compared to results from RCT’s. In order to gain a complete picture of the impacts of an implemented intervention, it is vital also to evaluate results after implementing findings from RCT-studies into everyday practice.

• Astrup, Guro Lindviksmoen; Rohde, Gudrun E.; Rimehaug, Stein Arne; Andersen, Marit Helen; Bernklev, Tomm & Bjordal, Kristin [Vis alle 11 forfattere av denne artikkelen] (2021). Comparing the use of patient-reported outcomes in clinical studies in Europe in 2008 and 2018: a literature review. Quality of Life Research. ISSN 0962-9343. 31. doi: 10.1007/s11136-021-02946-7. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Several guidelines for the use of patient-reported outcomes (PROs) in clinical studies have been published in the past decade. This review primarily aimed to compare the number and compliance with selected PRO-specifc criteria for reporting of clinical studies in Europe using PROs published in 2008 and 2018. Secondarily, to describe the study designs, PRO instruments used, patient groups studied, and countries where the clinical studies were conducted. Methods A literature search was conducted in MEDLINE to identify eligible publications. To assess the number of publications, all abstracts were screened for eligibility by pairs of reviewers. Compliance with PRO-specifc criteria and other key characteristics was assessed in a random sample of 150 eligible full-text publications from each year. Randomized controlled trials (RCTs) were assessed according to the full CONSORT-PRO checklist. Results The search identifed 1692 publications in 2008 and 4290 in 2018. After screening of abstracts, 1240 from 2008 and 2869 from 2018 were clinical studies using PROs. By full-text review, the proportion of studies discussing PRO-specifc limitations and implications was higher in 2018 than in 2008, but there were no diferences in the other selected PRO-specifc criteria. In 2018, a higher proportion of studies were longitudinal/cohort studies, included≥300 patients, and used electronic administration of PRO than in 2008. The most common patient groups studied were those with cancer or diseases of the musculoskeletal system or connective tissue. Conclusion The number of clinical studies from Europe using PROs was higher in 2018 than in 2008, but there was little diference in compliance with the PRO-specifc criteria. The studies varied in terms of study design and PRO instruments used in both publication years.

• Andersen, Marit Helen; Urstad, Kristin Hjorthaug; Larsen, Marie Hamilton; Henrichsen, Gina Fraas; Engebretsen, Eivind & Ødemark, John [Vis alle 10 forfattere av denne artikkelen] (2021). Intervening on health literacy by knowledge translation processes in kidney transplantation: A feasibility study. Journal of Renal Care. ISSN 1755-6678. s. 1–9. doi: 10.1111/jorc.12379. Fulltekst i vitenarkiv Vis sammendrag

  Background Patients awaiting kidney transplantation need to be prepared ahead of the upcoming transplantation by developing targeted pre- and post-transplant knowledge. On this background, we designed a new health literacy intervention, including a film and a counselling session, based on motivational interviewing for dialysis patients provided by dialysis nurses. Aim To explore patients' and nurses' experiences of the feasibility and acceptability of the intervention, focusing on the patient as a prepared knowledge actor. Design An explorative qualitative study. Participants and Methods Data included in-depth interviews with nine patients and three nurses who participated in the intervention. The interviews were audiotaped and analysed following Kvale and Brinkmann's method for thematic data analysis. Findings Three main themes were identified: a different kind of health intervention stimulating new insight; a challenging kind of health conversation and changed relationships and increased security. Conclusions Both the patients and the nurses had an overall positive attitude toward the intervention, providing a kind of dialogue to prepare dialysis patients going through kidney transplantation. The nurses found the MI methodology to be challenging. When introducing a comprehensive communication method like MI, potential training and supervision needs for the nurses must be addressed.

• Larsen, Marie Hamilton; Hermansen, Åsmund; Borge, Christine Råheim; Strumse, Yndis A. Staalesen; Andersen, Marit Helen & Wahl, Astrid Klopstad (2021). Health literacy profiling in persons with psoriasis – A cluster analysis. Skin Health and Disease (SHD). 1(2). doi: 10.1002/ski2.17. Fulltekst i vitenarkiv Vis sammendrag

  Objective:To explore health literacy (HL) profiles within a cohort of people with psoriasis. A cluster approach identifies groups of individuals that have similar HL profiles. The method unmasks sub-groups with particular HL strengths, or subgroups with limitations, which require tailored healthcare services to improve. Methods:A cross-sectional sample of 792 patients from the Norwegian Climate Helio Therapy Programme in Gran Canaria participated. The HL questionnaire assessed nine HL dimensions. Using Ward's Hierarchical Clustering Method (Stata version 16), we looked for subgroups of patients across the dimensions. We also explored whether these clusters had specific demographic features and associations to outcomes such as psoriasis knowledge, quality of life and self-management capacity. Result:The analysis revealed four unique clusters identifying clinically meaningful subgroups. Two groups stood out as especially interesting. One cluster representing 26.6% of the sample presented severe HL limitations associated with lower psoriasis knowledge, quality of life, self-management and self-efficacy. HL domains connected to cooperation with healthcare professionals showed deficient scores. The other cluster included a smaller percentage (7.7%) with high HL compared to the total sample. This cluster was associated with higher self-management, quality of life and better self-efficacy. Conclusion:The cluster analysis revealed substantial differences in HL profiles within the sample. These results support the importance of a holistic understanding of the HL needs and the vulnerabilities within a psoriasis cohort. Implementing one size fits all approaches, may not be sufficient in psoriasis context to target HL.

• Dahl, Kari Gire; Wahl, Astrid Klopstad; Urstad, Kristin Hjorthaug; Falk, Ragnhild Sørum & Andersen, Marit Helen (2021). Changes in Health Literacy during the first year following a kidney transplantation: Using the Health Literacy Questionnaire. Patient Education and Counseling. ISSN 0738-3991. s. 1–9. doi: 10.1016/j.pec.2020.12.028. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The study aimed to identify changes in health literacy (HL) and associated variables during the first year following a kidney transplantation. Methods A total of 196 transplant recipients were included in a prospective follow-up study. The patients answered the Health Literacy Questionnaire (HLQ) at 5 days, 8 weeks, 6 and 12 months following the kidney transplantation. Mixed linear models were used to analyze changes in HL and backward elimination was used to identify variables associated with HL. Results Two main patterns of change were identified: a) HL increased during the first 8 weeks of close follow-up and b) in several domains, the positive increase from 5 days to 8 weeks flattened out from 5 days to 6 and 12 months. Self-efficacy, transplant-related knowledge, and general health were core variables associated with HL. Conclusions Overall, HL increased during the 8 weeks of close follow-up following the kidney transplantation, while 6 months seem to be a more vulnerable phase. Furthermore, low self-efficacy, less knowledge, and low self-perceived health may represent vulnerable characteristics in patients. Practical implications Future kidney transplant care should take into account patients’ access to and appraisal of health information and social support, and draw attention to potentially vulnerable groups.

• Holmen, Heidi; Larsen, Marie Hamilton; Sallinen, Merja Helena; Thoresen, Lisbeth; Ahlsen, Birgitte & Andersen, Marit Helen [Vis alle 10 forfattere av denne artikkelen] (2020). En balansegang: helsepersonells erfaringer med mennesker med kronisk sykdom - en oversiktsartikkel av kvalitative studier. BestPractice nordic. Fulltekst i vitenarkiv
• Hoel, Anders Telle; Tofft, Louise; Bjørnland, Kristin; Gjone, Inger Helene; J., Catherine Teig & Øresland, Tom [Vis alle 8 forfattere av denne artikkelen] (2020). Reaching adulthood with Hirschsprung's disease: Patient experiences and recommendations for transitional care. Journal of Pediatric Surgery. ISSN 0022-3468. doi: 10.1016/j.jpedsurg.2020.05.015. Fulltekst i vitenarkiv Vis sammendrag

  Background/Purpose The need for transitional care has gained increased focus in the treatment of patients with congenital colorectal disorders. We aimed to acquire in-depth knowledge about the experiences of adult patients with Hirschsprung's disease (HD) and their suggestions for transitional care. Methods Binational study applying gender equal focus group interviews (FGI). Results Seventeen (9 men) of 52 invited patients with median age 29 (19–43) years participated. Three themes evolved from the FGI. “Scarred body and soul” describes the somatic and psychosocial challenges the patients experienced and “limited health literacy on HD” refers to the patients' lack of HD knowledge. “Absent transition” depicts missing transitional care and the patients' inability to find adult HD specialists. The adult HD patients strongly recommended transitional care from early teens with focus on information about HD and establishment of a peer-to-peer program. They also emphasized the possibility of being referred to a pelvic floor center. Conclusions HD negatively influences patients' somatic and psychosocial health in childhood, adolescence and adulthood. Adult HD patients strongly recommend transitional care from early teens and the possibility for referral to a center working with pelvic floor dysfunctions. Level of evidence IV Type of research Clinical

• Andersen, Marit Helen; Urstad, Kristin Hjorthaug; Larsen, Marie Hamilton; Engebretsen, Eivind; Ødemark, John & Eriksen, Anne [Vis alle 7 forfattere av denne artikkelen] (2020). Processes of knowing in the translation of a health communication intervention for dialysis patients awaiting kidney transplantation. Patient Education and Counseling. ISSN 0738-3991. 104(3), s. 1–7. doi: 10.1016/j.pec.2020.09.009. Fulltekst i vitenarkiv Vis sammendrag

  Objective To strengthen patients’ health literacy and their role as active knowledge actors, we developed a health communication intervention including a film-viewing and counselling session for patients awaiting kidney transplantation. We aimed to explore processes of knowing in the translation of the intervention. Methods We applied an ethnographic research approach, observing nine intervention sessions with patients and dialysis nurses. Afterwards, the patients and the nurses were interviewed in-depth. Data were analysed using Engebretsen’s modified version of Lonergans’ four-step model of knowing. Results The following knowing processes were identified: i) Knowing as meaning-making; ii) Knowing as acquiring confidence; and iii) Accessing professionals’ and peer experts’ knowledge. Divergent considerations were taken by the different knowledge actors, which had a direct influence on the knowing processes and knowledge translation. Conclusions The findings support active interactions between patients and healthcare providers in processes of knowing. These include self-conscious approaches and critical questioning in both parties. Practice implications For transplant professionals, this study demonstrates knowing processes in a real-life context. It also spotlights professional skills and attitudes regarding the importance of self-conscious questioning and a critical interrogating position (for both patients and providers).

• Dahl, Kari Gire; Andersen, Marit Helen; Urstad, Kristin Hjorthaug; Falk, Ragnhild Sørum; Engebretsen, Eivind & Wahl, Astrid Klopstad (2020). Identifying Core Variables Associated With Health Literacy in Kidney Transplant Recipients. Progress in transplantation. ISSN 1526-9248. 30(1), s. 38–47. doi: 10.1177/1526924819893285. Fulltekst i vitenarkiv
• Holmen, Heidi; Larsen, Marie Hamilton; Sallinen, Merja Helena; Thoresen, Lisbeth; Ahlsen, Birgitte & Andersen, Marit Helen [Vis alle 10 forfattere av denne artikkelen] (2020). Working with patients suffering from chronic diseases can be a balancing act for health care professionals - a meta-synthesis of qualitative studies. BMC Health Services Research. doi: 10.1186/s12913-019-4826-2. Fulltekst i vitenarkiv Vis sammendrag

  Background: The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Method: A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes. Results: Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 subcategories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions. Conclusion: Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support. Trial registration: PROSPERO number: CRD42019119052.

• Larsen, Marie Hamilton; Staalesen, Yndis; Borge, Christine Råheim; Andersen, Marit Helen & Wahl, Astrid Klopstad (2020). Relevant associations between alexithymia and health-literacy in persons with psoriasis. Journal of dermatological treatment (Print). ISSN 0954-6634. doi: 10.1080/09546634.2020.1756204. Fulltekst i vitenarkiv Vis sammendrag

  Strumse heter Staalesen Strumse og P er på Staalesen

• Fretland, Åsmund Avdem; Dagenborg, Vegar Johansen; Bjørnelv, Gudrun Maria Waaler; Aghayan, Davit; Kazaryan, Airazat M. & Barkhatov, Leonid [Vis alle 10 forfattere av denne artikkelen] (2019). Quality of life from a randomized trial of laparoscopic or open liver resection for colorectal liver metastases. British Journal of Surgery. ISSN 0007-1323. 106(10), s. 1372–1380. doi: 10.1002/bjs.11227. Fulltekst i vitenarkiv Vis sammendrag

  Background Most treatments for cancer cause a decline in patients' health‐related quality of life (HRQoL). Limiting this decline is a universal goal for healthcare providers. Using minimally invasive instead of open surgical techniques might be one way to achieve this. The aim of this study was to compare postoperative HRQoL after open and laparoscopic liver resection. Methods This was a predefined substudy of an RCT comparing open with laparoscopic liver resection. Patients with colorectal liver metastases were assigned randomly to open or laparoscopic parenchyma‐sparing liver resection. HRQoL was assessed with the Short Form 36 questionnaire at baseline, and 1 and 4 months after surgery. Results A total of 280 patients were randomized, of whom 273 underwent surgery (129 laparoscopic, 144 open); 682 questionnaires (83.3 per cent) were available for analysis. One month after surgery, patients in the laparoscopic surgery group reported reduced scores in two HRQoL domains (physical functioning and role physical), whereas those in the open surgery group reported reduced scores in five domains (physical functioning, role physical, bodily pain, vitality and social functioning). Four months after surgery, HRQoL scores in the laparoscopic group had returned to preoperative levels, whereas patients in the open group reported reduced scores for two domains (role physical and general health). The between‐group difference was statistically significant in favour of laparoscopy for four domains after 1 month (role physical, bodily pain, vitality and social functioning) and for one domain after 4 months (role physical). Conclusion Patients assigned to laparoscopic liver surgery reported better postoperative HRQoL than those assigned to open liver surgery. For role limitations caused by physical health problems, patients in the laparoscopic group reported better scores up to 4 months after surgery. Registration number: NCT01516710 ( http://www.clinicaltrials.gov).

• Hausken, John; Fretland, Åsmund Avdem; Edwin, Bjørn; Andersen, Marit Helen; Dagenborg, Vegar Johansen & Bjørnelv, Gudrun Maria Waaler [Vis alle 10 forfattere av denne artikkelen] (2019). Intravenous patient-controlled analgesia versus thoracic epidural analgesia after open liver surgery: a prospective, randomized, controlled noninferiority trial. Annals of Surgery. ISSN 0003-4932. 270(2), s. 193–199. doi: 10.1097/SLA.0000000000003209. Fulltekst i vitenarkiv
• Larsen, Marie Hamilton; Strumse, Yndis A. Staalesen; Andersen, Marit Helen; Borge, Christine Råheim & Wahl, Astrid Klopstad (2019). Associations between disease education, self-management support, and health literacy in psoriasis. Journal of dermatological treatment (Print). ISSN 0954-6634. 2:6, s. 603–609. doi: 10.1080/09546634.2019.1688233. Fulltekst i vitenarkiv
• Hjørnholm, Ulla; Larstorp, Anne Cecilie Kjeldsen; Andersen, Marit Helen & Høieggen, Aud (2019). Directly observed therapy prior to ambulatory blood pressure measurement (DOT-HTN) in uncontrolled hypertensive patients - Effect on blood pressure, safety and patient perception. Blood Pressure. ISSN 0803-7051. doi: 10.1080/08037051.2019.1633907. Fulltekst i vitenarkiv
• Engeseth, Marit; Enden, Tone Rønnaug; Andersen, Marit Helen; Sandset, Per Morten & Wik, Hilde Skuterud (2019). Does the Villalta scale capture the essence of postthrombotic syndrome? A qualitative study of patient experience and expert opinion. Journal of Thrombosis and Haemostasis. ISSN 1538-7933. s. 1–8. doi: 10.1111/jth.14557. Fulltekst i vitenarkiv Vis sammendrag

  Background The Villalta scale is recommended for diagnosing and grading of postthrombotic syndrome (PTS) in clinical studies, but with limitations in specificity and sensitivity. Objectives To explore the typical complaints of PTS through patients experience and expert opinion and relate this to the items of the Villalta scale. Patients/Methods A qualitative study design with focus group interviews including patients with PTS and health care workers experienced in PTS patient care. Results Typical PTS complaints were reflected within four main domains: (a) agonizing discomforts; patients without venous ulcers often described other discomforts than pain; (b) skin changes; these were common and sometimes present before deep vein thrombosis (DVT). Except for venous ulcers, skin changes were considered of less importance; (c) fluctuating heaviness and swelling during the day and with activity; (d) post‐DVT concerns; fear of DVT recurrence, health services failing to meet the patients’ expectations, and psychological and social restrictions. These findings are not necessarily captured or well reflected in the Villalta scale. Conclusion Our findings indicate that the Villalta scale does not capture typical PTS complaints or their importance to the patients. A revision of the diagnosis and grading should be considered.

• Haraldstad, Kristin; Wahl, Astrid Klopstad; Andenæs, Randi; Andersen, John Roger; Andersen, Marit Helen & Beisland, Elisabeth Grov [Vis alle 24 forfattere av denne artikkelen] (2019). A systematic review of quality of life research in medicine and health sciences. Quality of Life Research. ISSN 0962-9343. 28(10), s. 2641–2650. doi: 10.1007/s11136-019-02214-9. Fulltekst i vitenarkiv Vis sammendrag

  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 describe the country of origin, target groups, instruments, design, and conceptual issues. Methods A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor. Results QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items. Conclusion QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges

• Larsen, Marie Hamilton; Staalesen, Yndis; Borge, Christine Råheim; Osborne, Richard H; Andersen, Marit Helen & Wahl, Astrid Klopstad (2019). Health literacy - a new piece of the puzzle in psoriasis care? - results from a cross-sectional study. British Journal of Dermatology. ISSN 0007-0963. 06(18), s. 1506–1516. doi: 10.1111/bjd.17595. Fulltekst i vitenarkiv Vis sammendrag

  Background: Health literacy (HL) – the ability to seek, understand and utilize health information – is important for good health. Suboptimal HL has been associated with poorer health outcomes in other chronic conditions, although this has not previously been studied in patients with psoriasis. Objectives: To investigate the HL strengths and weaknesses of a cohort of patients with moderate‐to‐severe psoriasis. Another aim was to examine possible associations between patients’ quality of life, their demographic, clinical and self‐management characteristics, and dimensions of HL. Methods: A cross‐sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had received climate helio therapy from 2011 to 2016 (n = 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self‐management variables were analysed using bivariate correlation and a four‐step linear multiple regression model. Results: The scores on all HLQ dimensions indicated lower health literacy than other populations. The linear regression models showed a significant association between HL, quality of life and self‐management variables, with higher HL predicting higher quality of life, self‐efficacy and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy. Conclusions: Improving HL may be a useful strategy for reducing disparities in self‐management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self‐efficacy and quality of life may positively increase HL.

• Dahl, Kari Gire; Engebretsen, Eivind; Andersen, Marit Helen; Urstad, Kristin Hjorthaug & Wahl, Astrid Klopstad (2019). The trigger-information-response model: Exploring health literacy during the first six months following a kidney transplantation. PLOS ONE. 14(10). doi: 10.1371/journal.pone.0223533. Fulltekst i vitenarkiv Vis sammendrag

  The main objective of this study was to explore how kidney transplant recipients find, understand, and use health information, and make decisions about their health—also known as health literacy. Kidney transplant recipients must take an active part in their health following the transplantation, since a new organ requires new medication and focus on lifestyle to prevent side-effects and signs of organ rejection. Consequently, it is of major clinical relevance to explore how kidney transplant recipients understand and relate to health literacy. Ten kidney transplant recipients were interviewed at three weeks and again at six months post-transplantation. Design and analysis were inspired by constructivist grounded theory. The results of the study are presented through a model consisting of three phases: the trigger phase, the information phase, and the response phase. The participants were influenced by context and personal factors as they moved between three phases, as information seekers, recipients, and sharers. This study illustrates health literacy as an active process. It gives new insight into what motivates kidney recipients to find, share, and receive information, and how a hierarchy of resources is built and used.

• Andersen, Marit Helen; Wahl, Astrid Klopstad; Engebretsen, Eivind & Urstad, Kristin Hjorthaug (2019). Implementing a tailored education programme: renal transplant recipients’ experiences. Journal of Renal Care. ISSN 1755-6678. 45(2), s. 111–119. doi: 10.1111/jorc.12273. Fulltekst i vitenarkiv Vis sammendrag

  Background Patient‐centred education is a key element in the care of patients undergoing kidney transplantation. We implemented a tailored, evidence‐based education programme for the post‐transplant phase. Objective The aim of the study was to explore renal transplant recipients’ experiences of participating in a new, tailored, evidence‐based education programme. Methods An explorative qualitative design was chosen to elicit knowledge, insight and understanding of the renal transplant recipients’ perspectives. Twelve renal transplant recipients participated in semi‐structured interviews about eight weeks post‐transplant. The interviews were audiotaped and analysed using thematic data analysis inspired by Kvale and Brinkmann's method for meaning condensation. Findings Two main themes emerged: ‘Situated tailoring to the person's everyday life knowledge’, and ‘Tailoring as a standard procedure regardless of the person’. Conclusion The findings of the present study indicate that the renal transplant recipients experienced the new education programme to be tailored to individual needs. Our study also revealed that the recipients experienced the health care personnel to take different considerations into account when educating. Viewing knowledge as continuously changing from controlled study contexts into clinical settings, we here demonstrate the need to evaluate new knowledge also after being implemented.

• Gustavsen, Marte Theie; Midtvedt, Karsten; Lønning, Kjersti; Jacobsen, Thea Johnsen; Reisæter, Anna Varberg & Geest, Sabina De [Vis alle 9 forfattere av denne artikkelen] (2019). Evaluation of tools for annual capture of adherence to immunosuppressive medications after renal transplantation – a single‐centre open prospective trial. Transplant International. ISSN 0934-0874. 32(6), s. 614–625. doi: 10.1111/tri.13412. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad; Engebretsen, Eivind; Larsen, Marie Hamilton; Vidnes, Tone Karine & Stenwig, Anne G K [Vis alle 10 forfattere av denne artikkelen] (2018). Implementation of a new patient education programme for renal transplant recipients. Journal of Renal Care. ISSN 1755-6678. 44(2), s. 106–114. doi: 10.1111/jorc.12236. Fulltekst i vitenarkiv
• Bøe, Camilla; Bondevik, Hilde; Wahl, Astrid Klopstad & Andersen, Marit Helen (2018). Going through laparoscopic liver resection in patients with colorectal liver metastases – a qualitative study. Nursing Open. doi: 10.1002/nop2.206. Fulltekst i vitenarkiv Vis sammendrag

  Aim: Colorectal cancer is one of the most common cancers worldwide. Surgery is seen as the only curative treatment. There are two approaches to liver resection: open or laparoscopic surgery. Knowledge from the patient perspective can illuminate how it is experienced going through laparoscopic surgery. We aimed to study patient perspectives of the experience of undergoing laparoscopic liver resection surgery in patients with colorectal liver metastases. Design: This study has a qualitative research design. Nine patients participated in semi‐structured interviews 6 months after surgery. Data were analysed according to Kvale's five‐step analysis method. Results: Though the patients were satisfied with the laparoscopic approach, they expressed unmet informational needs about the new technique, time after discharge and surgery outcomes related to having metastatic cancer. Healthcare professionals should provide information and support that recognizes the needs of patients with cancer undergoing laparoscopic liver resection surgery.

• Lillehagen, Ida; Andersen, Marit Helen; Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad & Engebretsen, Eivind (2018). How does a new patient education programme for renal recipients become situated and adapted when implemented in the daily teaching practice in a university hospital? An ethnographic observation study. BMJ Open. 8:023005(11), s. 1–712. doi: 10.1136/bmjopen-2018-023005. Fulltekst i vitenarkiv Vis sammendrag

  Objective To understand how a new patient education programme for renal recipients becomes situated and adapted when implemented in daily hospital teaching practice. The analysis focuses in particular on how principles of individual tailoring and patient involvement are adapted. Design Ethnographic observation study. 19 teaching sessions were observed, resulting in 35 pages of data written observation notes. Setting A Norwegian University hospital. The study included the transplantation (TX) post, the medical post and the outpatient clinic. Participants 10 newly transplanted patients receiving the education programme, and 13 nurses trained in the new programme participated in the study. Results We observed that the nurses attempted to implement the programme’s core principles of individual tailoring and patient involvement as intended, but that patients found it difficult to formulate their knowledge needs and interest. Patients and nurses developed an approach to individual tailoring and patient involvement, which used knowledge about the patients’ life and experiences as basis for translating generalised knowledge into knowledge that is individualised and meaningful for the patient. The individual tailoring was however also limited, as the nurses balanced between responsibilities for the programme’s principles of individual adaption and patient involvement at the one hand, and responsibilities of safety and economy from a health systems perspective on the other hand. Conclusion Individual tailoring is observed to be a comprehensive practice which includes verbal, practical and emotional involvement with the patient’s life world. This extends the notion and practice of individual tailoring as selecting among predefined, generalised knowledge based on an initial mapping of the patients’ knowledge. While the adaptions to individual tailoring could have been seen as inaccurate implementation, in-depth analyses discloses that the extended approach to individual tailoring is in fact what retains the programme’s core principles in the implementation context.

• Verket, Nina Julie; Andersen, Marit Helen; Sandvik, Leiv; Tanbo, Tom Gunnar & Qvigstad, Erik (2018). Lack of cross-cultural validity of the Endometriosis Health Profile-30. Journal of Endometriosis and Pelvic Pain Disorders (JEPPD). ISSN 2284-0265. 10(2), s. 107–115. doi: 10.1177/2284026518780638. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The Endometriosis Health Profile-30 is a disease-specific patient-reported outcome measure of health-related quality of life. Cross-cultural validation of the Endometriosis Health Profile-30 has been performed for several translated versions. The aim of this study was to evaluate the measurement properties of a Norwegian version Endometriosis Health Profile-30. Methods: This study was designed as a cross-sectional anonymous postal questionnaire study. A total of 157 women with endometriosis were included during a period from 2012 to 2013. Women aged 18–45 years were recruited from the Norwegian Endometriosis Association. Principal components analysis with varimax rotation was used to assess construct validity. Short Form-36 was used to determine convergent validity. Cronbach’s alpha was used to measure internal consistency. Intraclass correlation coefficients and paired t-tests were used to evaluate test–retest reliability. Floor and ceiling effects were estimated. Results: Factor analysis resulted in a three and five-factor model for the core and modular questionnaire, respectively. Factor analysis could not support construct validity of the scales self-image and treatment. The Norwegian version Endometriosis Health Profile-30 demonstrated acceptable internal consistency and test–retest reliability, except for the scale relationship with children. Floor effects were observed for the scales self-image (20.1%), work life (33.9%), relationship with children (34.2%), and medical profession (20.5%). Conclusion: The construct self-image does not seem to be measured appropriately by the Norwegian version Endometriosis Health Profile-30, suggesting a lack of cross-cultural validity of the Endometriosis Health Profile-30. With multinational studies increasing, adequate translation, cross-cultural adaptation, and cross-cultural validation of instruments are essential to ensure equivalence in languages and cultures other than the original.

• Verket, Nina Julie; Uhlig, Till; Sandvik, Leiv; Andersen, Marit Helen; Tanbo, Tom Gunnar & Qvigstad, Erik (2018). Health‐related quality of life in women with endometriosis, compared with the general population and women with rheumatoid arthritis. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 97(11), s. 1339–1348. doi: 10.1111/aogs.13427. Fulltekst i vitenarkiv
• Lønning, Kjersti; Heldal, Kristian; Bernklev, Tomm; Brunborg, Cathrine; Andersen, Marit Helen & Lippe, Nanna von der [Vis alle 10 forfattere av denne artikkelen] (2018). Improved Health-Related Quality of Life in Older Kidney Recipients 1 Year After Transplantation. Transplantation direct. doi: 10.1097/TXD.0000000000000770. Fulltekst i vitenarkiv Vis sammendrag

  Background: We aimed to evaluate changes in health-related quality of life (HRQoL) in patients 65 years or older from time of kidney transplantation (KTx) until 1 year postengraftment. Methods: A single-center prospective study was conducted. HRQoL was measured pre-KTx and at 2, 6, and 12 months postengraftment using self-reported Kidney Disease and Quality of Life shortform version 1.3. Intraindividual scores before and after KTx were evaluated. Liu Comorbidity Index was registered at enlisting. short-form-36 scores were additionally compared with scores from an age-matched population. Results: From January 1, 2013, until November 30, 2016, a total of 289 waitlisted patients were included. By September 1, 2017, 134 had reached 1 year postengraftment, and valid questionnaires were available in 120 (90%) patients. Mean age at KTx was 71.6 years (±4.3 years), 71% were male. Living donor was used in 21%, and preemptive KTx was performed in 30% of the recipients. Median waiting time for KTx from deceased donor was 16 months (range, 0.6-50.5 months). A total of 79 (66%) recipients had a Liu Comorbidity Index score of 3 or less. All HRQoL scores except the domain social function improved at 2 months postengraftment and remained stable or continued to improve at 1 year. HRQoL scores 12 months postengraftment were similar to those described in an age-matched general population except for the domain social function which remained at a significantly lower level. Time in dialysis was the most important variable associated with impaired HRQoL postengraftment. Conclusions: HRQoL scores showed clinically significant improvement in older KTx recipients 1 year posttransplant.

• Syversen, Torgunn Bø; SØRENSEN, DAG WENDELBO; Foss, Stein & Andersen, Marit Helen (2018). Donation after circulatory death - an expanded opportunity for donation appreciated by families. Journal of Critical Care. ISSN 0883-9441. 43, s. 306–311. doi: 10.1016/j.jcrc.2017.09.002. Fulltekst i vitenarkiv
• Lønning, Kjersti; Midtvedt, Karsten; Bernklev, Tomm; Brunborg, Cathrine; Andersen, Marit Helen & Lippe, Nanna von der [Vis alle 10 forfattere av denne artikkelen] (2018). Changes in health related quality of life in older candidates waiting for kidney transplantation. Nephrology. ISSN 1320-5358. 23(10), s. 948–956. doi: 10.1111/nep.13117. Fulltekst i vitenarkiv
• Andresen, Brith; Døhlen, Gaute; Diep, Lien My; Lindberg, Harald L; Fosse, Erik & Andersen, Marit Helen (2018). Psychosocial and clinical outcomes of percutaneous versus surgical pulmonary valve implantation. Open heart. 5(1). doi: 10.1136/openhrt-2017-000758. Fulltekst i vitenarkiv
• Lønning, Kjersti; Midtvedt, Karsten; Heldal, Kristian & Andersen, Marit Helen (2018). Older kidney transplantation candidates' expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and older. BMJ Open. 8(6). doi: 10.1136/bmjopen-2017-021275. Fulltekst i vitenarkiv Vis sammendrag

  Objective: The aim was to study the expectations of improvement in life and health following kidney transplantation (KTx) in a population of wait-listed patients ≥65 years with end-stage kidney disease. Design: Qualitative research with individual in-depth interviews. Setting: Patients on dialysis enlisted for a KTx from a deceased donor were included from an ongoing study of older patients’ perspectives on KTx. Qualitative face-to-face interviews were conducted in a safe and familiar setting, and were analysed thematically using the theoretical framework of lifespan. Informants: Fifteen patients (median age 70 years, range 65–82) from all parts of Norway were interviewed. Informants were included consecutively until no new information was gained. Results: Two main themes were evident: receiving a kidney is getting life back and grasp the chance. In addition, the themes ‘hard to loose capacity and strength’, ‘reduced freedom’ and ‘life on hold’ described the actual situation and thereby illuminated the informants’ expectations. The informants tried to balance positive expectations and realism towards KTx, and they were hoping to become free from dialysis and to live a normal life. Conclusion: This study shows that older KTx candidates comprise a heterogeneous group of patients who take individual approaches that allow them to maintain autonomy and control while waiting for a transplant. This study provides new knowledge about the older KTx candidates relevant for clinicians, patients and researchers.

• Dueland, Svein; Line, Pål Dag; Hagness, Morten; Foss, Aksel & Andersen, Marit Helen (2018). Long‐term quality of life after liver transplantation for non‐resectable colorectal metastases confined to the liver. JBJS Open Access. 3(2), s. 180–185. doi: 10.1002/bjs5.50116. Fulltekst i vitenarkiv Vis sammendrag

  Background: Liver transplantation for patients with non-resectable colorectal liver metastases offers increased survival, with median overall survival of more than 5 years. The aim of this study was to compare quality of life before and up to 3 years after liver transplantation for colorectal liver metastases. Methods: Quality of life was assessed using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire version 3.0. The patients received the questionnaire before and up to 3 years after liver transplantation. Results: Some 23 patients were included in the analysis. Three months after liver transplantation they reported reduced quality of life (global health status scale), physical function and role function, and increased dyspnoea. At 6 months, global health status, physical function and role function had returned to pretransplant values. Three years after liver transplantation all symptom and function scores were comparable to baseline values. Patients with high scores for fatigue, pain and appetite loss at baseline had reduced 3-year overall survival. Conclusion: Patients with non-resectable colorectal liver-only metastases receiving liver transplantation had good long-term quality of life. Patients with high symptom scores before transplantation had reduced 3-year overall survival.

• Hjørnholm, Ulla; Aamodt, Josephine Jeanette Mikaela; Larstorp, Anne Cecilie Kjeldsen; Elmula, Fadl Elmula M. Fadl; Høieggen, Aud & Andersen, Marit Helen [Vis alle 7 forfattere av denne artikkelen] (2018). Directly Observed Therapy in Hypertension (DOT-HTN). I Burnier, Michel (Red.), Drug Adherence in Hypertension and Cardiovascular Protection. Springer Nature. ISSN 9783319765921. s. 57–85. doi: 10.1007/978-3-319-76593-8_6. Fulltekst i vitenarkiv
• Fretland, Åsmund Avdem; Dagenborg, Vegar Johansen; Bjørnelv, Gudrun Maria Waaler; Kazaryan, Airazat M.; Kristiansen, Ronny & Fagerland, Morten [Vis alle 17 forfattere av denne artikkelen] (2018). Laparoscopic Versus Open Resection for Colorectal Liver Metastases: The OSLO-COMET Randomized Controlled Trial. Annals of Surgery. ISSN 0003-4932. 267(2), s. 199–207. doi: 10.1097/SLA.0000000000002353. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To perform the first randomized controlled trial to compare laparoscopic and open liver resection. Summary Background Data: Laparoscopic liver resection is increasingly used for the surgical treatment of liver tumors.However, high-level evidence to conclude that laparoscopic liver resection is superior to open liver resection is lacking. Methods: Explanatory, assessor-blinded, single center, randomized superiority trial recruiting patients from Oslo University Hospital, Oslo, Norway from February 2012 to January 2016. A total of 280 patients with resectable liver metastases from colorectal cancer were randomly assigned to undergo laparoscopic (n ¼ 133) or open (n ¼ 147) parenchyma-sparing liver resection. The primary outcome was postoperative complications within 30 days (Accordion grade 2 or higher). Secondary outcomes included cost-effectiveness, postoperative hospital stay, blood loss, operation time, and resection margins. Results: The postoperative complication rate was 19% in the laparoscopicsurgery group and 31% in the open-surgery group (12 percentage points difference [95% confidence interval 1.67–21.8; P ¼ 0.021]). The postoperative hospital stay was shorter for laparoscopic surgery (53 vs 96 hours, P < 0.001), whereas there were no differences in blood loss, operation time, and resection margins. Mortality at 90 days did not differ significantly from the laparoscopic group (0 patients) to the open group (1 patient). In a 4-month perspective, the costs were equal, whereas patients in the laparoscopicsurgery group gained 0.011 quality-adjusted life years compared to patients in the open-surgery group (P ¼ 0.001). Conclusions: In patients undergoing parenchyma-sparing liver resection for colorectal metastases, laparoscopic surgery was associated with significantly less postoperative complications compared to open surgery. Laparoscopic resection was cost-effective compared to open resection with a 67% probability. The rate of free resection margins was the same in both groups. Our results support the continued implementation of laparoscopic liver resection. Keywords: colorectal liver metastases, cost and cost analysis, hepatectomy, laparoscopic, laparoscopy, liver resection, minimally invasive surgery, parenchyma-sparing liver surgery, randomized clinical trial, randomized controlled trial

• Andresen, Brith; Mishra, Vinod Kumar; Lewandowska, Milena; Andersen, Jack Gunnar; Andersen, Marit Helen & Lindberg, Harald L [Vis alle 8 forfattere av denne artikkelen] (2017). In-hospital cost comparison between percutaneous pulmonary valve implantation and surgery. European Journal of Cardio-Thoracic Surgery. ISSN 1010-7940. 51(4), s. 747–753. doi: 10.1093/ejcts/ezw378. Fulltekst i vitenarkiv Vis sammendrag

  OBJECTIVES: Today, both surgical and percutaneous techniques are available for pulmonary valve implantation in patients with right ventricle outflow tract obstruction or insufficiency. In this controlled, non-randomized study the hospital costs per patient of the two treatment options were identified and compared. METHODS: During the period of June 2011 until October 2014 cost data in 20 patients treated with the percutaneous technique and 14 patients treated with open surgery were consecutively included. Two methods for cost analysis were used, a retrospective average cost estimate (overhead costs) and a direct prospective detailed cost acquisition related to each individual patient (patient-specific costs). RESULTS: The equipment cost, particularly the stents and valve itself was by far the main cost-driving factor in the percutaneous pulmonary valve group, representing 96% of the direct costs, whereas in the open surgery group the main costs derived from the postoperative care and particularly the stay in the intensive care department. The device-related cost in this group represented 13.5% of the direct costs. Length-of-stay-related costs in the percutaneous group were mean $3885 (1618) and mean $17 848 (5060) in the open surgery group. The difference in postoperative stay between the groups was statistically significant (P<0.001). CONCLUSIONS: Given the high postoperative cost in open surgery, the percutaneous procedure could be cost saving even with a device cost of more than five times the cost of the surgical device. Keywords: Congenital pulmonary heart disease • Innovative techniques • Cost analysis • In-hospital costs

• Lillehol, Bodil Mørk; Lønning, Kjersti & Andersen, Marit Helen (2017). Exploring nurse managers’ perception of using the RAFAELA system as a management tool in a Norwegian hospital setting. Nursing Open. s. 1-7–1-7. doi: 10.1002/nop2.115. Fulltekst i vitenarkiv
• Meyer, Käthe Birgitte; Hartmann, Anders; Mjøen, Geir & Andersen, Marit Helen (2017). Relationships between clinical, self-reported, and donation specific outcomes: a prospective follow-up study 10 years after kidney donation. Annals of Transplantation. ISSN 1425-9524. 22, s. 148–155. doi: 10.12659/AOT.902330. Fulltekst i vitenarkiv Vis sammendrag

  Background: Long-term consequences of donor nephrectomy might be reduced kidney function, increased risk for cardiovascular disease, impaired quality of life, and fatigue. Few studies have investigated associations between clinical and self-reported outcomes in a long-term perspective. Thus, we aimed to investigate relationships between clinical, self-reported, and donation-specific outcomes in a nationwide cohort. Material/Methods: We conducted a prospective follow-up study and assessed pre- and post-donation data from 202 donors who donated in 2001–2004. During 2012–2013, data on donors’ self-reported (quality of life and fatigue) and donor-specific outcomes were collected. We performed linear regression for each component score of the generic instrument Short-Form, SF36v2, measuring quality of life, and the 5 domains of fatigue. Clinical parameters tested as independent variables were medical treatment of hyperlipidemia or hypertension, current smoking status, BMI, hemoglobin, and eGFR. Data were adjusted for age and gender. Results: Approximately 10 years after donation, 67 donors were hypertensive and 54 donors had eGFR <60 ml/min/1.73 m2. Mean increase in plasma creatinine was 16.6 μmol/l (SD=16.3). None of the clinical parameters were significant predictors for QoL. Female gender was significantly associated with general fatigue. There was a significant difference in perception of recognition from health personnel between donors with hypertension and donors without hypertension. Conclusions: Our results show no associations between clinical and self-reported outcomes. However, we found a significant relationship between hypertension and donation-specific outcomes. Hypertension or reduced kidney function was identified in a minority of the donors. The increased risk for fatigue among female donors needs more investigation.

• Meyer, Käthe Birgitte; Bjørk, Ida Torunn; Wahl, Astrid Klopstad; Lennerling, Annette & Andersen, Marit Helen (2017). Long-term experiences of Norwegian live kidney donors: Qualitative in-depth interviews. BMJ Open. 7(2), s. 1–7. doi: 10.1136/bmjopen-2016-014072. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. Design: Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. Participants: 16 donors representing all parts of Norway who donated a kidney in 2001–2004 participated in the study. The interviews were analysed using an interpretative approach. Results: The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics—tension still under the surface, ambivalence—healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Conclusions: Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation.

• Andersen, Marit Helen; Lønning, Kjersti; Bjørnelv, Gudrun Maria Waaler & Fagerström, Lisbeth (2016). Nursing intensity and costs of nurse staffing demonstrated by the RAFAELA system: liver versus kidney transplant recipients. Journal of Nursing Management. ISSN 0966-0429. 24(6), s. 798–805. doi: 10.1111/jonm.12384. Fulltekst i vitenarkiv Vis sammendrag

  Aim To compare nursing intensity and nurse staffing costs for liver transplant (LTx) vs. kidney transplant (KTx) patients through the use of the RAFAELA system (the OPCq instrument). Background High-quality patient care correlates with the correct allocation of nursing staff. Valid systems for obtaining data on nursing intensity, in relation to actual patient care needs, are needed to ensure correct staffing. Methods A prospective, comparative study of 85 liver and 85 kidney transplant patients. Nursing intensity was calculated using the Oulu Patient Classification (OPCq) instrument. The cost per nursing intensity point was calculated by dividing annual total nursing wage costs with annual total nursing intensity points. Results The results showed significantly higher nursing intensity per day for liver transplant patients compared to kidney transplant patients. The length of stay was the most important variable in relation to nursing intensity points per day. Conclusions The study demonstrated differences in nursing intensity and nurse staffing costs between the two patient groups. Implications for Nursing Management When defending nurse staffing decisions, it is essential that nurse managers have evidence-based knowledge of nursing intensity and nurse staffing costs.

• Meyer, Käthe Birgitte; Wahl, Astrid Klopstad; Bjørk, Ida Torunn; Wisløff, Torbjørn; Hartmann, Anders & Andersen, Marit Helen (2016). Long-term, self-reported health outcomes in kidney donors. BMC Nephrology. 17(8). doi: 10.1186/s12882-016-0221-y. Fulltekst i vitenarkiv Vis sammendrag

  Background The wide use of healthy persons as kidney donors calls for awareness of risks associated with donation. Live kidney donation may impair quality of life (QOL) and result in fatigue. Long-term data on these issues are generally lacking in the donor population. Thus we aimed to investigate long-term self-reported health outcomes in a nationwide donor cohort. Methods We assessed self-reported QOL, fatigue and psychosocial issues after donation in 217 donors representing 63 % of those who donated 8–12 years ago. QOL was measured using the generic Short Form-36 Health Survey (SF-36), fatigue using the Multidimensional Fatigue Inventory (MFI) and psychosocial issues using donor specific questions. For each of the 8 domains of SF-36 and the 5 domains of MFI, we performed generalized linear regression. Results Donors scored high on QOL with mean scores between 63.9 and 91.4 (scale 1–100) for the 8 subscales. Recognition from family and friends was associated with higher QOL scores in four domains. There were no significant gender differences. Fatigue scores were generally low. Females generally scored higher than males on all five dimensions of fatigue, although significantly only on two. Recipient still alive was associated with lower scores on mental fatigue. Regretting donors scored higher than average on all domains of fatigue. Recipient death, worries about own health and worsened relationship with the recipient influenced willingness to donate in retrospect. Donor age did not affect long-term health outcomes. Conclusions Eight till 12 years after donation QOL scores were generally high and improved with recogniton from family and friends. Fatigue was independent of donor age and more pronounced in females and in those who regretted donation.

• Fretland, Åsmund Avdem; Kazaryan, Airazat M.; Bjørnbeth, Bjørn Atle; Flatmark, Kjersti; Andersen, Marit Helen & Tønnessen, Tor Inge [Vis alle 11 forfattere av denne artikkelen] (2015). Open versus laparoscopic liver resection for colorectal liver metastases (the Oslo-CoMet study): study protocol for a randomized controlled trial. Trials. 16:73. doi: 10.1186/s13063-015-0577-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Laparoscopic liver resection is used in specialized centers all over the world. However, laparoscopic liver resection has never been compared with open liver resection in a prospective, randomized trial. Methods/Design The Oslo-CoMet Study is a randomized trial into laparoscopic versus open liver resection for the surgical management of hepatic colorectal metastases. The primary outcome is 30-day perioperative morbidity. Secondary outcomes include 5-year survival (overall, disease-free and recurrence-free), resection margins, recurrence pattern, postoperative pain, health-related quality of life, and evaluation of the inflammatory response. A cost-utility analysis of replacing open surgery with laparoscopic surgery will also be performed. The study includes all resections for colorectal liver metastases, except formal hemihepatectomies, resections where reconstruction of vessels/bile ducts is necessary and resections that need to be combined with ablation. All patients will participate in an enhanced recovery after surgery program. A biobank of liver and tumor tissue will be established and molecular analysis will be performed. Discussion After 35 months of recruitment, 200 patients have been included in the trial. Molecular and immunology data are being analyzed. Results for primary and secondary outcome measures will be presented following the conclusion of the study (late 2015). The Oslo-CoMet Study will provide the first level 1 evidence on the benefits of laparoscopic liver resection for colorectal liver metastases.

• Hustad, Nina Berger; Hellesø, Ragnhild & Andersen, Marit Helen (2015). A qualitative study of manager experiences using the RAFAELA system. Open Journal of Nursing. ISSN 2162-5336. 5, s. 1224–1232. doi: 10.4236/ojn.2015.511109. Fulltekst i vitenarkiv Vis sammendrag

  Objective: The objective was to explore manager experiences using the RAFAELA system. Background: The RAFAELA system was developed in Finland during the 1990s to create a work situation where patients’ care needs were balanced with personnel resources. The system is used in almost all hospitals in Finland and is implemented in several European countries. However, the system has never been evaluated outside Finland. This study, focusing on the managers’ perspective, represents the second report from a larger Norwegian evaluation project of the RAFAELA system. Methods: An explorative qualitative design was chosen. Data were collected by individual in-depth interviews at a university hospital in Norway during 2012-2013. A total of 10 informants in various management positions were interviewed. The tape-recorded interviews were transcribed verbatim, and the transcripts were analysed using Kvale’s method for content analysis. Results: Four main themes emerged from the qualitative data: making the invisible visible; a common language; a system for prospective planning; and a resource-demanding tool. Conclusions: The study indicated that the RAFAELA system provided useful information about the patients’ care needs and nursing activities. Also the system provided a common reference frame for discussing nursing, staffing and allocation. Although the managers considered the RAFAELA to be time consuming in the implementation phase, they considered the system to be an important tool.

• Engebretsen, Eivind; Andersen, Marit Helen; Urstad, Kristin Hjorthaug & Wahl, Astrid Klopstad (2014). Action Research in Implementation and Evaluation. Outline of a Study of a Training Programme for Kidney Transplant Recipients. I Johnsen, Berit Helene (Red.), Theory and Methodology in International Comparative Classroom Studies. Cappelen Damm Akademisk. ISSN 9788202470616. s. 256–266. Fulltekst i vitenarkiv
• Fagerström, Lisbeth; Lønning, Kjersti & Andersen, Marit Helen (2014). The RAFAELA system: A workforce planning tool for nurse staffing and human resource management. Nursing Management. ISSN 0744-6314. 21(2), s. 30–36. doi: 10.7748/nm2014.04.21.2.30.e1199. Fulltekst i vitenarkiv Vis sammendrag

  The RAFAELA system was developed in Finland during the 1990s to help with the systematic and daily measurement of nursing intensity (NI) and allocation of nursing staff. The system has now been rolled out across almost all hospitals in Finland, and implementation has started elsewhere in Europe and Asia. This article describes the system, which aims to uphold staffing levels in accordance with patients’ care needs, and its structure, which consists of three parts: the Oulu Patient Classification instrument; registration of available nursing resources; and the Professional Assessment of Optimal Nursing Care Intensity Level method, as an alternative to classical time studies. The article also highlights the benefits of using a systematic measurement of NI.

• Andersen, Marit Helen; Lønning, Kjersti & Fagerström, Lisbeth (2014). Testing Reliability and Validity of the Oulu Patient Classification Instrument—The First Step in Evaluating the RAFAELA System in Norway. Open Journal of Nursing. ISSN 2162-5336. 4, s. 303–311. doi: 10.4236/ojn.2014.44035. Fulltekst i vitenarkiv
• Andresen, Brith; Andersen, Marit Helen; Lindberg, Harald L; Døhlen, Gaute & Fosse, Erik (2014). Perceived health after percutaneous pulmonary valve implantation: In-depth interviews of patients and next-of-kin. BMJ Open. 4(7). doi: 10.1136/bmjopen-2014-005102. Fulltekst i vitenarkiv
• Andersen, Marit Helen & Wahl, Astrid Klopstad (2013). Patient experiences following liver transplantation due to liver metastases from colorectal cancer. European Journal of Oncology Nursing. ISSN 1462-3889. doi: 10.1016/j.ejon.2012.07.004. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad; Andersen, Marit Helen; Øyen, Ole & Hagen, Kåre Birger (2013). Limited evidence for the effectiveness of educational interventions for renal recipinets. Results from a systematic review of controlled clinical trials. Patient Education and Counseling. ISSN 0738-3991. 90(2), s. 147–154. doi: 10.1016/j.pec.2012.10.020. Fulltekst i vitenarkiv
• Vidnes, Tone; Wahl, Astrid Klopstad & Andersen, Marit Helen (2013). Patient experiences following liver transplantation due to liver metastases from colorectal cancer. European Journal of Oncology Nursing. ISSN 1462-3889. 17(3), s. 269–274. doi: 10.1016/j.ejon.2012.07.004. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Øyen, Ole; Andersen, Marit Helen; Moum, Torbjørn Åge & Wahl, Astrid Klopstad (2012). The effect of an educational intervention for renal recipients: a randomized controlled trial. Clinical Transplantation. ISSN 0902-0063. 26(3), s. E246–E253. doi: 10.1111/j.1399-0012.2012.01666.x. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad; Andersen, Marit Helen; Øyen, Ole & Fagermoen, May Solveig (2012). Renal recipients' educational experiences in the early post-operative phase - a qualitative study. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 26(4), s. 635–642. doi: 10.1111/j.1471-6712.2012.00972.x. Fulltekst i vitenarkiv
• Andersen, Marit Helen; Dueland, Svein; Hagness, Morten; Vidnes, Tone Karine; Finstad, Ellen Drolsum & Wahl, Astrid Klopstad [Vis alle 7 forfattere av denne artikkelen] (2012). Quality of life following liver transplantation in patients with liver metastases from colorectal carcinoma. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 26(4), s. 713–719. doi: 10.1111/j.1471-6712.2012.00984.x. Fulltekst i vitenarkiv
• Urstad, Kristin Hjorthaug; Andersen, Marit Helen; Øyen, Ole; Moum, Torbjørn & Wahl, Astrid Klopstad (2011). Patients' level of knowledge measured five days after kidney transplantation. Clinical Transplantation. ISSN 0902-0063. doi: 10.1111/j.1399-0012.2010.01355.x. Fulltekst i vitenarkiv
• Lohne, Vibeke; Drangsholt, Hanne Camilla Heer; Andersen, Marit Helen; Miaskowsky, Christine; Kongerud, Johny & Rustøen, Tone (2010). Qualitative study of pain of patients with chronic obstructive pulmonary disease. Heart & Lung. ISSN 0147-9563. 39(3), s. 226–234. doi: 10.1016/j.hrtlng.2009.08.002. Fulltekst i vitenarkiv
• Mathisen, Lars; Lingaas, Per Snorre; Andersen, Marit Helen; Hol, Per Kristian; Fredriksen, Per Morten & Sundet, Kjetil [Vis alle 9 forfattere av denne artikkelen] (2010). Changes in cardiac and cognitive function and self-reported outcomes at one year after coronary artery bypass grafting. Journal of Thoracic and Cardiovascular Surgery. ISSN 0022-5223. 140(1), s. 122–128. doi: 10.1016/j.jtcvs.2009.10.034. Fulltekst i vitenarkiv
• Hamidi, Vida; Andersen, Marit Helen; Øyen, Ole; Mathisen, Lars; Fosse, Erik & Kristiansen, Ivar Sønbø (2009). Cost effectiveness of open versus laparoscopic living-donor nephrectomy. Transplantation. ISSN 0041-1337. 87(6), s. 831–838. doi: 10.1097/TP.0b013e318199cfc9. Fulltekst i vitenarkiv
• Andersen, Marit Helen; Bruserud, Fanny; Mathisen, Lars; Wahl, Astrid; Hanestad, Berit Rokne & Fosse, Erik (2007). Follow-up interviews of 12 living kidney donors one yr after open donor nephrectomy. Clinical Transplantation. ISSN 0902-0063. 21(6), s. 702–709. doi: 10.1111/j.1399-0012.2007.00726.x. Fulltekst i vitenarkiv
• Mathisen, Lars; Andersen, Marit Helen; Andersen, Marit H.; Veenstra, Marijke; Wahl, Astrid & Hanestad, BR [Vis alle 8 forfattere av denne artikkelen] (2007). Quality of life can both influence and be an outcome of general health perceptions after heart surgery. Health and Quality of Life Outcomes. 5. doi: 10.1186/1477-7525-5-27. Fulltekst i vitenarkiv Vis sammendrag

  Background: Our aim was to investigate the existence of a reciprocal relationship between patients' assessment of quality of life and their appraisal of health. If present, this relationship will interfere with the interpretation of heart surgery's effect on overall quality of life. Methods: Path analysis was used to investigate reciprocal causal relationships between general health perceptions and overall quality of life before and after heart surgery. Longitudinal data from a study of coronary artery bypass surgery were used to model lagged, cross-lagged, and simultaneous paths over four time-points of assessment from before surgery to one year afterwards. The conceptual framework for the analysis was the Wilson and Cleary causal pathway model. General health perceptions were measured with the Short Form 36. Overall quality of life was measured with i) a single question regarding life satisfaction and ii) the multi-item Quality of Life Survey. Results: Acceptable model fit was obtained for reciprocal causation between general health perceptions and overall quality of life. Regression coefficients changed over different phases of rehabilitation. Serial correlation accounted for much of the variance within variables over time. Conclusion: The present analysis demonstrates that unidirectional models of causality are inadequate to explain the effect of heart surgery on overall quality of life. Overall quality of life can causally influence as well as be an outcome of health status after coronary artery bypass surgery.

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• Hansen, Ingrid Schrøder; Hårvig, Karina Roheim; Brudvik, Kristoffer Watten; Røsok, Bård Ingvald; Bjørk, Ida Torunn & Østergaard, Daniel [Vis alle 15 forfattere av denne artikkelen] (2025). A Randomized Controlled Trial of Resection Versus Thermal Ablation of Colorectal Cancer Liver Metastases (New Comet): Study Protocol. doi: 10.1245/s10434-025-17984-5. Fulltekst i vitenarkiv Vis sammendrag

  Background. The use of thermal ablation of liver tumors is rapidly increasing. This is despite a lack of high-level evidence of the oncologic efficacy of ablation. Ablation is most often used in cases where resection is not possible, but as the technique has improved it is increasingly used as a substitute for resection. Patients and Methods. New Comet is an international multicenter randomized controlled double-blinded, non inferiority trial comparing thermal ablation to resection of colorectal liver metastases. It will include 230 patients with colorectal liver metastases (up to 5 lesions, tumor size up to 3 cm) where thermal ablation and resection both are considered suitable treatment options for all lesions. The patients are randomized to either resection or ablation, and all lesions in each patient are treated with the same modaliity. Complete ablation will be verified with intraoperative computed tomography and ablation confirmation software. Conclusions. The primary endpoint is local tumor recurrence at 12 months. Secondary endpoints include overall survival, disease-free survival, time to surgical failure, health-related quality of life, complications, and cost-effectiveness (trial registration no.: NCT05129787).

• Borge, Christine Råheim; Andersen, Marit Helen & Stenberg, Una (2024). Kapittel 2. Hvordan arbeide med helsekompetanse i møte med pasienter og pårørende. I Helseth, Sølvi; Pettersen, Kjell Sverre & Wahl, Astrid Klopstad (Red.), Helsekompetanse Teori, forskning og praksis. Fagbokforlaget. ISSN 9788245043426. Fulltekst i vitenarkiv
• Borge, Christine Råheim; Larsen, Marie Hamilton; Osborne, Richard H.; Aas, Eline; Andersen, Marit Helen & Moum, Torbjørn [Vis alle 7 forfattere av denne artikkelen] (2024). Health literacy-informed intervention reduces hospitalization and health economic costs, while improving health literacy, self-management, and quality of life in Chronic Obstructive Pulmonary Disease (COPD). Fulltekst i vitenarkiv
• Borge, Christine Råheim; Larsen, Marie Hamilton; Osborne, Richard H; Aas, Eline; Andersen, Marit Helen & Moum, Torbjørn [Vis alle 7 forfattere av denne artikkelen] (2024). Health literacy-informed intervention reduces hospitalization and health economic costs, while improving health literacy, self-management, and quality of life in COPD. Fulltekst i vitenarkiv
• Veshovda, Solveig; Eik, Hedda; Andersen, Marit Helen; Jahre, Henriette & Riiser, Kirsti (2024). Helsekompetanse og muskelskjelettplager hos ungdom: en scoping review. Fulltekst i vitenarkiv
• Andenæs, Randi; Andersen, Marit Helen; Helseth, Sølvi; Haraldstad, Kristin; Rohde, Gudrun E. & Rokne, Berit [Vis alle 7 forfattere av denne artikkelen] (2024). Går vi baklengs inn i fremtiden, minister Hoel? Fulltekst i vitenarkiv
• Riiser, Kirsti; Eik, Hedda; Andersen, Marit Helen; Jahre, Henriette & Veshovda, Solveig (2022). Muskelskjelettplager og helsekompetanse hos ungdom- en scoping review. Fulltekst i vitenarkiv
• Riiser, Kirsti; Eik, Hedda; Andersen, Marit Helen; Jahre, Henriette & Veshovda, Solveig (2022). MUSKHEL- muskelskjelettplager og helsekompetanse hos ungdom. Fulltekst i vitenarkiv
• Larsen, Marie Hamilton; Strumse, Yndis S.S.; Borge, Christine Råheim; Andersen, Marit Helen & Wahl, Astrid Klopstad (2020). Viktige sammenhenger mellom aleksitymi og helsekompetanse hos pasienter med psoriasis som har deltatt i klimabehandling. BestPractice nordic. Fulltekst i vitenarkiv
• Astrup, Guro Lindviksmoen; Rohde, Gudrun E.; Rimehaug, Stein Arne; Andersen, Marit Helen; Bernklev, Tomm & Bjordal, Kristin [Vis alle 10 forfattere av denne artikkelen] (2020). Comparing the use of patient-reported outcomes in clinical studies in Europe in 2008 and 2018; a literature review. Fulltekst i vitenarkiv
• Tsarpali, Vasiliki; Lønning, Kjersti; Midtvedt, Karsten; Bernklev, Tomm; Lippe, Nanna Von der & Andersen, Marit Helen [Vis alle 7 forfattere av denne artikkelen] (2019). Getting Life Back »-Kidney Transplantation in the Elderly Patient. Fulltekst i vitenarkiv
• Tsarpali, Vasiliki; Lønning, Kjersti; Midtvedt, Karsten; Bernklev, Tomm; Lippe, Nanna Von der & Andersen, Marit Helen [Vis alle 7 forfattere av denne artikkelen] (2019). « Getting Life Back »-Kidney Transplantation in the Elderly Patient. Fulltekst i vitenarkiv
• Fretland, Åsmund Avdem; Hausken, Jon; Edwin, B; Andersen, Marit Helen; Dagenborg, Vegar Johansen & Kristiansen, Ronny [Vis alle 9 forfattere av denne artikkelen] (2018). Does ketorolac have an opioid sparing effect after open liver resection? Data from the Oslo-COMET trial. Fulltekst i vitenarkiv
• Haraldstad, Kristin; Wahl, Astrid Klopstad; Andenæs, Randi; Andersen, John Roger; Andersen, Marit Helen & Grov, Beisland Elisabeth [Vis alle 24 forfattere av denne artikkelen] (2018). A systematic snapshot review of quality of life research in medicine and health sciences. Fulltekst i vitenarkiv Vis sammendrag

  Background: Quality of life (QOL) has become established as a central concept and target for research and practice in the field of health and medicine. However, QOL is a complex concept that is interpreted and defined differently within and between disciplines, and so is also the case in health and medicine. Thus, there is a continuing philosophical debate about the meaning and content of QOL and how it should be measured. Aim: The aim of the present study was to perform a review of QOL research in medicine and health, and describe country of origin, target groups, instruments, design and conceptual issues Methods: A Systematic snapshot review were conducted with literature searches in the databases Scopus, covering Embase, MEDLINE, CINAHL and PsycINFO, to identify research studies on QOL and Health-related quality of life (HRQOL) published during one random week in November 2016. To evaluate the conceptual and methodological rigor, we used the 10 predefined criteria developed by Gill and Feinstein. Results: The findings show that QOL research is truly international, involves a variety of target groups, uses different research designs and a whole host of QOL measures. When it comes to evaluation according to the criteria developed by Gill and Feinstein, most articles still have a low-quality score; only 13 % of the articles provided a definition of the concept of QOL, few studies (6%) distinguished QOL from HRQOL. Criteria that were fulfilled most frequently were; i) stating the domains of QOL to be measured, ii) giving a reason for choosing the instruments they used, and iii) aggregating the results from multiple items. Conclusion. Knowledge about QOL is important for understanding the consequences of illness and treatment, and for medical decision-making. However, based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that most QOL studies in health and medicine have conceptual and methodological challenges.

• Andersen, Marit Helen (2016). Pasientnær forskning gir fordeler. Sykepleien Forskning. ISSN 1890-2936. Fulltekst i vitenarkiv
• Wahl, Astrid Klopstad; Urstad, Kristin Hjorthaug & Andersen, Marit Helen (2015). Pasientundervisning ved nyretransplantasjon fra forskning til hverdagspraksis. En studie av kunnskapstranslasjoner og implementering. Fulltekst i vitenarkiv
• Vidnes, Tone Karine; Bruserud, Fanny & Andersen, Marit Helen (2014). Mindre smerter etter nyredonasjon. Sykepleien Forskning. ISSN 1890-2936. Fulltekst i vitenarkiv
• Foss, Aksel; Andersen, Marit Helen; Hagness, Morten; Vidnes, Tone Karine; Finstad, Ellen Drolsum & Wahl, Astrid Klopstad [Vis alle 7 forfattere av denne artikkelen] (2010). Patient Survival and Quality of Life Following Liver Transplantation for Colorectal Liver Metastases. Liver transplantation. ISSN 1527-6465. 16(6), s. S189–S190. Fulltekst i vitenarkiv
• Gulseth, Eirik; Wæhre, Anne; Emblem, Ragnhild & Andersen, Marit Helen (2025). Expanded health-related quality of life in 16-year-old boys following childhood hypospadias surgery. Universitetet i Oslo. ISSN 9788234806674. Fulltekst i vitenarkiv Vis sammendrag

  Health-related quality of life (HRQoL) reflects an individual's functional status and perceived well-being across physical, mental, and social dimensions. In hypospadias—a penile congenital condition affecting about 1 in 300 boys—our understanding of HRQoL, especially among adolescents, is limited. Most research has focused on isolated HRQoL aspects rather than its multidimensional nature. Hypospadias surgery is mainly carried out in early childhood. Complications are common and often require multiple surgeries. Surgery for hypospadias in early childhood can impact adolescents’ quality of life, particularly in terms of sexual well-being, body image and mental health. This thesis aims to enhance knowledge of HRQoL in 16-year-old boys who have undergone hypospadias surgery. A cross-sectional study compared self-reported HRQoL among these boys with a healthy comparison group, collecting data from electronic medical records, validated questionnaires, and structured interviews at an outpatient clinic between March 2019 and March 2021. Healthy adolescents were recruited from schools in southeastern Norway. This study highlights positive results across most of the examined variables and can conclude that the patients experience good, expanded health-related quality of life. However, some individuals face challenges. More patients were classified as having mental health issues or being at risk for mental problems than in the healthy group. Additionally, patients with proximal hypospadias report lower satisfaction with the appearance of their penis and sexual well-being. In conclusion, the findings suggest that adolescents after hypospadias surgery report positive HRQoL outcomes overall. However, the increased mental health issues and specific challenges faced by the proximal group highlight the importance of follow-up after puberty. Additionally, comprehensive HRQoL assessments could help us identify individuals at risk and improve care strategies.

• Fosse, Erik; Andersen, Marit Helen; Lindberg, Harald & Døhlen, Gaute (2018). Percutaneous pulmonary valve implantation impact on clinical outcome, patients self-reported health, psychosocial function and hospital costs in patients with congenital heart disease. Universitetet i Oslo. Fulltekst i vitenarkiv
• Andersen, Marit Helen & Fosse, Erik Torgeir (2008). Patient-reported outcomes following living donor nephrectomy. Universitetet i Oslo. ISSN 9788280727268. Fulltekst i vitenarkiv Vis sammendrag

  Det utføres årlig over 200 nyretransplantasjoner i Norge, alle ved Rikshospitalet HF. Omlag 40 % utføres med nyre fra levende giver. Sykepleier og forsker Marit Helen Andersen og hennes medarbeidere har studert ulike aspekter ved uttak av nyre ved nyredonasjon, med hovedvekt på pasienterfaringer. I den første delen av arbeidet ble laparoskopisk (”kikkhulls”) kirurgi sammenlignet med standard åpen kirurgi med kliniske og pasientrapporterte mål, hvor loddtrekning fordelte halvparten til hver operasjonsmetode. Pasientene ble fulgt opp 1, 6 og 12 måneder etter inngrepet med spørsmål om helse og livskvalitet. I den andre delen av arbeidet ble 12 pasienter dybdeintervjuet ved en uke og ved et år etter inngrepet for å få en bedre forståelse av den unike pasientopplevelsen.<br><br> Resultatene fra den sammenlignende studien viste at pasientene i begge grupper opplevde redusert helse og livskvalitet den første tiden etter inngrepet, men at pasientene i det vesentlige var tilbake i normal form et år etter operasjonen. Videre syntes åpen kirurgi å være best når det gjaldt pasientsikkerhet og kirurgiske komplikasjoner. Imidlertid ga et ukomplisert laparoskopisk inngrep fordeler i form av mindre smerter og kortere rekonvalesensperiode. Dybdeintervjuene viste at selv om informantene var glade for å ha gitt nyre, kunne dette være en sammensatt og kompleks erfaring for noen: på den ene siden glede over å ha hjulpet et annet menneske, på den andre siden ubehag knyttet til det å gå gjennom operasjon. Ingen angret på at de ga nyre, selv om et mislykket transplantasjonsresultat påvirket opplevelsene i negativ retning. <br><br> Kombinasjonen av kunnskap fra ulike forskningsmetoder er med å sikre at bredden og detaljene i pasienterfaringene blir synlige. Pasienterfaringer er en viktig kunnskapskilde med tanke på å påvirke hva helsepersonell prioriterer å rette oppmerksomheten mot, og måten helsehjelp gis på. I dette tilfellet har studiene ført til bedre beslutningsgrunnlag i valg av behandlingsmetode ved klinikken, og forbedret informasjon til pasientene.

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