All posts by Malin Johansson Östbring

Outcome measure project publication

We congratulate the CESAR-project “Development of outcome measure” to a publication earlier this year.

A scoping review and mapping exercise comparing the content of patient-reported
outcome measures (PROMs) across heart disease-specific scales
, Algurén et al, Journal of Patient-Reported Outcomes, 2020.

The project aims to develop a comprehensive generic PROM-instrument for patients with heart diseases, to be used in clinic and reserach to evaluate effects of person-centered care and other interventions. In this scoping review the authors identified 34 PROMs for various heart diseases and have mapped the items of these to WHO’s International Classification of Functioning, Disability and Health (ICF). Based on the findings the CESAR-project suggest that 10 Body functions, 13 aspects of Activities & Participation, and 2 aspects of Environmental factors should be included in a generic PROM for patients with different types of heart diseases in order to capture patients’ experiences of their health status from a bio-psycho-social perspective.

Congratulations Dr Israelsson



Cesar Network congratulate Johan Israelsson for a great dissertation defense on the 13th of March. The title of the thesis is “Health-related quality of life after cardiac arrest”.

Johans opponent, Hans Morten Lossius, Professor from Stavanger participated via Zoom. Even so,  Johan and Hans Morten still succeeded to have an interesting discussion.


CESAR member participates in large international study


CESAR member Johan Israelsson has participated in a large international study with the title “Variability in functional outcome and treatment practices by treatment center after outofhospital cardiac arrest: analysis of International Cardiac Arrest Registry” recently published in Intensive Care Medicine,

The study analysed data from the International Cardiac Arrest Registry (INTCAR), with the aim to examine variation in functional outcome and in-hospital management with regard to center, for patients suffering out-of-hospital cardiac arrest (CA). The INTCAR is an international (centers from Europe and the US) database including patients admitted to an intensive care unit after suffering CA. In the present study a total of 3855 patients were included. There were major variability (from 11% to 63%) in good outcome between centers, also after adjusting for patient-related factors. High performing centers were characterized by 1) having shorter time to goal temperature when initiating target temperature management (TTM), 2) more often using 33°C as goal temperature for TTM, 3) being more likely to perform percutaneous coronary intervention in unconscious patients and 4) using a variation of methods for prognostication, when compared to low performing centers. The authors conclude that center-specific differences in functional outcome exist. These differences are partially explained by differences in treatment.



Masters student visit


As a masters student from Utrecht University, the Netherlands, I am working on my master thesis. Being an ICU nurse, I encounter such a large proportion of my patients experiencing severe thirst. So when I had the opportunity to work with Tiny Jaarsma on measuring thirst I didn’t think twice ! In my graduation project I am now looking at the reliability and validity of the Thirst Distress Scale for patients with Heart Failure (TDS-HF) in a population of ICU patients. In March I have had the opportunity to come to Linköping and Norrköping to meet Tiny and others to work on my project. It has been a great experience to meet with researchers from LIU and Karolinska Institutet and share ideas. I have felt very welcome. Thanks to all of you !

Marleen Flim

ACNAP webinar; Clinical Cases on Heart Failure

This week Anna Strömberg, Tiny Jaarsma and Ekaterini Lambrinou held a great webinar arranged by ACNAP.

The learning objectives were;

  • Develop and/or test clinical skills on heart Failure clinical cases
  • Develop and /or test knowledge and clinical skills in assessing, diagnosing and managing cases in heart failure
  • Present two clinical cases on acute decompensated heart failure and on the management of chronic heart failure
  • Learn useful and evidence-based practical information on the care of heart failure patients from an acute event to the management of chronic heart failure
  • Learn how to develop evidence-based algorithms or pathways for the care of patients with heart failure




American Heart Congress – Chicago 10th-12th November 2018

The AHA congress that was compressed to three scientific sessions days were held in the windy city of Chicago. AHA is a great congress where everyone interested in cardiovascular research can find once home. McCormick place is one of the largest convention center in north US and a time schedule was a good way to keep on track of the 4000 abstracts and 800 sessions that was presented from more than 100 countries!

Many interesting presentations include mindfulness and yoga for patients with atrial fibrillation; nightmares and insomnia in CVD; C vitamin intake in heart failure; depression in ICD recipients and family care givers and frailty in AMI were held. CESAR member Prof Anna Strömberg presented the development of different health techniques for example new tools in monitoring symptoms in patients with heart failure.  Photo: Maria Liljeroos.


Christina Andreae, PhD talked about physical activity and appetite in heart failure. Patients who are more physical active have better appetite both at short and long-term follow-up and therefore health care professionals should recognize physical activity and appetite jointly as physical activity might improve appetite and poor nutrition. Photo: Anna Strömberg.


In a MAIN event, Janet E Fulton talked about physical activity as the most important component in maintaining CVD health. In the same session, prof Rusell Pate presented that individuals knowledge and skills are key to achieve physical activity goals, he also stressed that local laws and regulations, relations between organizations, social institutions, families, friends and social network are of importance to achieve global physical activity goals.    






Every steps counts! Walking 2000 more steps per day associate with 8% lower risk for having adverse patient outcomes! Presented by William E Kraus, Durham, NC.



Wendy Dusenbury presented that sexual dysfunction in stroke is common and affect both men and women. Health care providers should open up for questions about sexual dysfunction in stroke rehabilitation programs. Interventions targeting both patient and partner are needed.





CESAR member prof Tiny Jaarsma moderated an interesting session title “Challenging issues and emerging therapies in the management of sexual dysfunction after CV events”. Photo: Maria Liljeroos



Even though the first study of sodium restrictions was published 1941 there is still hot ongoing discussions on how sodium restrictions affect patients with heart failure.

This was a full packed session, very enjoyable panel discussion of pros and cons on sodium restrictions in heart failure.   






Nice art from Poland by Magdalena Abakanowicz 2003, Chicago 13 Nov 2018


Greetings from a nice windy City Chicago!

Christina Andreae










Cesar congratulats the teleyoga group to the Forte grant!

CESAR medlemmar har fått ett anslag från FORTE 3.9 miljoner för forskning om effekter av teleyoga på fysisk funktionsförmåga, hälsorelaterad livskvalitet, psykiskt välbefinnande, biomarkörer, sömn och kognition hos personer med långvarig sjukdom. Huvudsökande var Anna Strömberg och medsökande var CESAR medlemmarna Tiny Jaarsma, Ingela Thylén, Leonie Klompstra, och Peter Johansson samt kardiolog Urban Alehagen, hälsoekonom Jenny Alwin och Lottie Orvelius omvårdnadsforskare inom intensivvård. Projektet genomförs på universitetssjukhuset i Linköping, Vrinnevisjukhuset i Norrköping och Länssjukhuset Ryhov i Jönköping.

 Sammanfattning av ansökan: Många äldre personer med långvarig sjukdom är fysiskt inaktiva och har svårt att lämna hemmet för att delta i rehabilitering. Vår hypotes är att teleyoga i hemmet med en yogainstruktör och andra deltagare i grupp via weblänk och instruktioner hur man dagligen själv gör medicinsk yoga med hjälp av en app kan vara en metod för att öka psykisk och fysisk livskvalitet, den fysiska funktionen och förmågan att klara av dagliga aktiviteter.

Medicinsk yoga är en form av Kundaliniyoga med enkla rörelser, andningsövningar och meditation. Yoga har visat effekt på livskvalitetet, men tidigare studier har endast inkluderat små selekterade urval. För äldre personer med långvarig sjukdom kan det vara svårt att delta i vanliga yogaklasser. Vi har utvecklat en teleyoga intervention och vill nu utvärdera effekterna med avseende på livskvalitet, fysisk funktionsförmåga, symtom på ångest och depression, biomarkörer för stress och inflammation, sömn och kognition hos äldre personer med långvarig sjukdom. Vi kommer även att mäta sjukvårdskonsumtion, upplevelser av och tillfredställelse med yogan och tekniken. Utvärderingen sker genom att 150 äldre personer över 65 år med långvarig sjukdom rekryteras från tre sjukhus (ett universitetssjukhus och två länssjukhus) och lottas till en intervention med medicinsk yoga i hemmet med teknikstöd eller ett individualiserat träningsprogram. Teleyogan kommer att omfatta yogasessioner i grupp, 2 gånger/vecka som leds av en certifierad yogainstruktör via weblänk till en surfplatta kombinerat med en app i surfplattan med instruktioner hur man genomför medicinsk yoga på egen hand mellan de instruktörsledda yogasessionerna. Data om livskvalitet, funktionsförmåga, ångest och depression, biomarkörer, sömn och kognition kommer att samlas in vid baslinjemätning, efter 3 och 6 månader. Denna studie tar ett nytt grepp på rehabilitering av långvarigt sjuka äldre genom att utvärdera en medicinsk teleyoga på distans i hemmet.

Med vänlig hälsning