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1.
  • Bergh, Håkan, 1958, et al. (författare)
  • Life events, social support and sense of coherence among frequent attenders in primary health care.
  • 2006
  • Ingår i: Public health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 120, s. 229-236
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of this survey was to compare stressful life events, social support and sense of coherence (SOC) between frequent attenders (FAs) and normal attenders (controls) in primary health care. STUDY DESIGN: A cross-sectional study was conducted in a primary healthcare centre in the south-west of Sweden. METHODS: A postal questionnaire was sent to 263 frequent attenders and 703 normal attenders. The questionnaire comprised sociodemographic variables and scales of stressful life events, social support and SOC. The results from the questionnaire were compared between the groups, and the significance of the variables in terms of attendance was tested in a multiple regression analysis. RESULTS: More of the FAs were secondarily single, they had more chronic diseases and were more often living on a sickness/disablement pension than the controls. FAs did not report more stressful life events than the controls nor was their experience of events more negative. Social support was as strong among FAs as among controls, and it had no significant effect on their frequent attendance. FAs had a significantly weaker SOC compared with controls. The variables that significantly influenced frequent attendance were high age [odds ratio (OR) = 1.02], chronic disease (OR = 3.08), sickness/disablement pension (OR = 2.46) and SOC (OR = 0.97). CONCLUSIONS: SOC had a significant influence on frequent attendance in primary health care, but stressful life events and social support did not. FAs did not report more stressful life events. However, due to an inadequate coping strategy, indicated by a weak SOC, the life events probably caused them more symptoms and diseases, and thereby a higher consulting frequency.
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2.
  • Haraldsson, Katarina, et al. (författare)
  • Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life : A grounded theory study
  • 2011
  • Ingår i: Stress and Health. - Chichester : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 27:2, s. E61-E70
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.
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3.
  • Haraldsson, Katarina, 1958, et al. (författare)
  • Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress.
  • 2008
  • Ingår i: Public health. - London : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:1, s. 25-33
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress. STUDY DESIGN: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden. METHODS: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment. RESULTS: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls' sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls' sense of well-being was maintained in two areas and deteriorated in four areas. CONCLUSION: Massage and mental training helped to maintain adolescents' very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.
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4.
  • Haraldsson, K, et al. (författare)
  • The self-reported health condition of women after their participation in a stress management programme: a pilot study
  • 2005
  • Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 13:3, s. 224-230
  • Tidskriftsartikel (refereegranskat)abstract
    • From a public health perspective, it is important to develop effective measures to deal with stress which are based on the individual's participation, such as stress management provided in group sessions. Therefore, the aim of the present study was to compare and evaluate the self-reported health condition of women in terms of their general symptoms, stress and sense of coherence (SOC) after participation in a stress management programme. The intervention, which had a modified crossover design and involved 40 women divided into two groups (G1 and G2), comprised eight meetings, the content of which was both theoretical and practical, and included information about stress, stress management, massage and mental training. A questionnaire was filled in on three occasions: before and after the intervention (8 weeks later), and after another 8 weeks (16 weeks later). The questionnaire contained 60 items comprising background factors, general symptoms, stress and SOC. No significant differences existed between the groups at baseline. In favour of the intervention, significant differences were found between the groups with regard to fewer general symptoms (P = 0.035) as well as a tendency to stress reduction (P = 0.060). A comparison within groups showed that both groups had a significant reduction in symptoms after the intervention (G1, P = 0.002; and G2, P = 0.003) and in reduced stress (both P = 0.001). After a further 8 weeks, both groups still showed significantly fewer general symptoms and reduced stress, as well as significant improvements with regard to SOC (G1, P = 0.012; and G2, P = 0.026). These findings indicate that the combination of mental training and massage in this stress management programme had a positive influence on the women's health condition. The pilot study design could be used in a full-scale study with randomised groups.
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5.
  • Marklund, Bertil, 1945, et al. (författare)
  • Computer-supported telephone nurse triage: an evaluation of medical quality and costs.
  • 2007
  • Ingår i: Journal of nursing management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 15:2, s. 180-7
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To evaluate a telephone nurse triage model in terms of appropriateness of referrals to the appropriate level of care, patient's compliance with given advice and costs. BACKGROUND: A key concern in each telephonic consultation is to evaluate if appropriate. METHOD: An evaluative design in primary health care with consecutive patients (N = 362) calling telephone nurse triage between November 2002 and February 2003. RESULTS: The advice was considered adequate in 325 (97.6%) cases. The patients' compliance with self-care was 81.3%, to primary health care 91.1% and to Accident and Emergency department 100%. The nurses referred self-care cases (64.7%) and Accident and Emergency cases (29.6%) from a less adequate to an appropriate level of care. The cost saving per call leading to a recommendation of self-care was euro 70.3, to primary health care euro 24.3 and to Accident and Emergency department euro 22.2. CONCLUSIONS: The telephone nurse triage model showed adequate guidance for the patients concerning level of care and released resources for the benefit of both patients and the health care system.
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6.
  • Morténius, Helena, 1966, et al. (författare)
  • The utilization of knowledge of and interest in research and development among primary care staff by means of strategic communication - a staff cohort study
  • 2012
  • Ingår i: Journal of Evaluation in Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 18:4, s. 768-775
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective The obvious gap between evidence and practice in health care is unfavourable for patient care and requires the promotion of a scientific attitude among health care professionals. The aim of the present study was to determine the utilization of knowledge of and interest in research and development among primary care staff by means of a strategic communication process. Method A cohort consisting of primary care staff (n = 1276) was designed and strategic communication was utilized as a platform over a 7-year period. Quantitative and qualitative methods were taken in account. Results We found that 97% of the staff had gained knowledge of research and development, 60% of whom remained interested in the subject. The oral communication channel was the most powerful for creating research interest. Organizational culture was a barrier to interest in science. Conclusion The study demonstrates a significant increase in knowledge and interest among primary care staff as a result of a strategic communication process. Practice implications Strategic communication should lead to a more evenly distributed research commitment among all health care professionals, thus facilitating communication between them and patients in order to clarify, for example, the causes of disease.
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7.
  • Morténius, Helena, 1966, et al. (författare)
  • Utilisation of strategic communication to create willingness to change work practices among primary care staff: a long-term follow-up
  • 2012
  • Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 13:2, s. 130-141
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To evaluate the long-term utilisation of strategic communication as a factor of importance when changing work practices among primary care staff. Background: In many health care organisations, there is a gap between theory and practice. This gap hinders the provision of optimal evidence-based practice and, in the long term, is unfavourable for patient care. One way of overcoming this barrier is systematically structured communication between the scientific theoretical platform and clinical practice. Methods: This longitudinal evaluative study was conducted among a primary care staff cohort. Strategic communication was considered to be the intervention platform and included a network of ambassadors who acted as a component of the implementation. Measurements occurred 7 and 12 years after formation of the cohort. A questionnaire was used to obtain information from participants. In total, 846 employees (70%) agreed to take part in the study. After 12 years, the 352 individuals (60%) who had remained in the organisation were identified and followed up. Descriptive statistics and multivariate analysis were used to analyse the data. Findings: Continuous information contributed to significant improvements over time with respect to new ideas and the intention to change work practices. There was a statistically significant synergistic effect on the new way of thinking, that is, willingness to change work practices. During the final two years, the network of ambassadors had created a distinctive image for itself in the sense that primary care staff members were aware of it and its activities. This awareness was associated with a positive change with regard to new ways of thinking. More years of practice was inversely associated with willingness to change work practices. Strategic communication may lead to a scientific platform that promotes high-quality patient care by means of new methods and research findings.
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8.
  • Mårtensson, Lena, 1953, et al. (författare)
  • Evaluation of a Biopsychosocial Rehabilitation Programme in Primary Healthcare for Chronic Pain Patients
  • 1999
  • Ingår i: Scandinavian Journal of Occupational Therapy. - London : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 6, s. 157-165
  • Tidskriftsartikel (refereegranskat)abstract
    • The responsibility of primary healthcare for treatment and rehabilitation of chronic pain patients has increased in the last decade. Experiences of multidisciplinary, behavioural treatments in pain clinics have demonstrated positive effects. The aim of the study was to evaluate a biopsychosocial rehabilitation programme in primary healthcare for chronic pain patients. The study included 70 chronic pain patients, who participated in an intervention based on ego-strengthening psychotherapy, led by an occupational therapist and a physiotherapist. The study was performed by Visual Analogue Scale (VAS) and a questionnaire as well as statistically analysed. The results showed increased general well-being (p < 0.01) and ability of pain management (p < 0.001) together with decreased level of perceived complaints (p < 0.001). The intervention was also associated with positive changes in personality, physical and cognitive factors. The results suggest that the biopsychosocial rehabilitation programme is useful in primary healthcare. Further studies should be carried out into the effects of such a rehabilitation programme in controlled randomized designs
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9.
  • Mårtensson, Lena, 1953, et al. (författare)
  • Long-term influences of a biopsychosocial rehabilitation programme for chronic pain patients.
  • 2004
  • Ingår i: Musculoskeletal care. - : Wiley. - 1478-2189 .- 1557-0681. ; 2, s. 152-64
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Chronic pain leads to high costs in the form of compensation for absence from work due to illness, production loss and health care utilization. Multidisciplinary treatment programmes at pain clinics can result in return to work and a decrease in doctor visits. The aim of this study was to evaluate the long-term influences of a rehabilitation programme in primary health care for chronic pain patients with regard to doctor visits, frequency of sick-leave and level of disability. DESIGN: A longitudinal, intervention study design was used over a three-year period. METHODS: A biopsychosocial rehabilitation programme based on ego-strengthening psychotherapy was used. An occupational therapist and a physiotherapist led the intervention, which comprised two meetings per week for six weeks. The study was performed in a primary health care area in the southwest of Sweden with 54 chronic pain patients. RESULTS: The results showed a significant decrease in the number of doctor visits as well as sick-leave days. The level of absenteeism due to occupational disability changed significantly from being on sick leave to receiving a disability pension. CONCLUSIONS: The rehabilitation programme reduced patient attendance at health care facilities but did not increase the numbers of patients returning to work.
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10.
  • Nilsson, Sverker, 1958, et al. (författare)
  • Evaluation of a health promotion programme to prevent the misuse of androgenic anabolic steroids among Swedish adolescents
  • 2004
  • Ingår i: HEALTH PROMOTION INTERNATIONAL. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 19, s. 61-7
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to design an appearance programme in order to prevent the misuse of androgenic anabolic steroids among adolescents and to evaluate the adolescents' perception of this programme. The study was performed in all schools in a primary health care area on the south west coast of Sweden. The intervention targeted all 16- and 17-year-old males and females (n = 921). The intervention and evaluation were completed by 451 boys. The strategy of the appearance programme was to create awareness of and to discuss attitudes towards steroid hormones among these adolescents. Youth leaders and health workers, who discussed these subjects with adolescents over a period of 2 years, carried out the intervention programme. The perception of the programme was analysed anonymously using questionnaires. Effects on the total population of youths were assessed by two cross-sectional surveys. The intervention programme was well received by the adolescents. The misuse of androgenic anabolic steroids had a tendency to decrease after the appearance programme. We demonstrated a method for involving the community in an appearance programme to reduce misuse of anabolic steroids and showed that youth were sensitive to our discussions about appearance and attitudes. This study indicates that drug abuse among adolescents can be decreased by health promotion activities, such as group discussions. Controlled studies are needed before the results of this appearance programme can be generalized. Key words: adolescents; androgenic anabolics; appearance; intervention
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