| 1. |
- Aglen, B., et al.
(författare)
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Self-help and self-help groups for people with long-lasting health problems or mental health difficulties in a Nordic context : A review
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 813-822
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Forskningsöversikt (refereegranskat)abstract
- Aim: The aim of this review is to provide systematic knowledge of research from Nordic countries about the meaning of self-help and self-help groups when these are used as a concept or method addressing issues related to long-lasting health problems or mental health difficulties. Methods: Included were studies conducted in the Nordic countries that were published between January 1999 and September 2009. These studies investigated self-help and self-help groups addressing issues related to long-lasting health problems. Results: A total of 83 publications met the inclusion criteria. Four major characteristics of self-help were found to be present in the publications: self-help as an intrapsychological process, self-help as an interpsychological or group process, self-help as a coping, individual learning or empowerment process, and self-help as an alternative or complement to medical treatment. Of the 83 studies, 72 publications used a professional treatment perspective for studying self-help and 11 publications used a perspective derived from alternative or complementary therapies. Conclusions: The review shows that most of the research on self-help and self-help groups for people with long-lasting health problems or disability is conducted with an interest to improve the professional healthcare system. That is, the health-promotion strategy is mainly considered in the framework of treatment or care settings. This means that self-help in this context does not challenge the dominant biomedical health model. © 2011 the Nordic Societies of Public Health.
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| 2. |
- Beijer, U, et al.
(författare)
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Mortality and causes of death among homeless women and men in Stockholm
- 2011
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:2, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To study the mortality and causes of death among homeless men and women in relation to the risk indicators, previous treatment for alcohol and drug abuse, previous treatment for mental disorders and non-Swedish citizenship. Methods: The mortality was studied in a cohort comprising 1,757 men and 526 women compared with the general population and persons with inpatient treatment for alcohol- and drug-related disorders. The follow-up period was from 1995 to 1997 until the end of 2005. The causes of death were analyzed. Results: 421 deaths occurred during the follow-up period. The relative risk of death was 3.1, with no difference in mortality between homeless men and homeless women. Previous treatment for alcohol and drug abuse disorders was related to excess mortality and previous treatment for mental disease to lower mortality. Homeless people with inpatient treatment for alcohol or drug use disorders had no higher mortality than the general population in Stockholm with a similar history. There was a dominance of alcohol- and drug-related causes of death. Discussion: Compared with previous studies of homeless people in Stockholm the excess mortality among men found in this study is of the same magnitude. Mortality among women is lower. The mortality rate in homeless people with previous treatment for an alcohol and illicit drug use disorder did not differ from those treated for these disorders in the general population. Conclusions: The most important finding is that excess mortality among homeless men and women in Stockholm is entirely related to alcohol and drug abuse.
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| 3. |
- Bryngelson, Anna, et al.
(författare)
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The relationship between gender segregation in the workplace and long-term sickness absence in Sweden
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:6, s. 618-626
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the study is to investigate whether the gender composition in workplaces is related to long-term sickness absence (LSA). We start off with Kanter’s theory on ‘‘tokenism,’’ suggesting an increased risk of stress among minority groups (tokens), which, in turn, might increase the risk of ill health and LSA. Methods: The dataset consists of information obtained from the Swedish level of Living Survey (LNU) and the Swedish Establishment Survey (APU), linked to register-based data from the Swedish Social Insurance Agency. The longitudinal data is representative for the Swedish population and consists of 496 women and 566 men, aged 20—55 at baseline. Our study group consisted of employed persons in 1991 and we analyze, by means of piecewise constant intensity regressions, the first entry into LSA with a follow-up period of nine years. Results: Compared with women in gender-integrated workplaces, women’s risk of LSA is most elevated at both extremely male-dominated (0—20% females) and extremely female-dominated workplaces (80—100% females), although the result among women in the most male-dominated group did not reach statistical significance at the 5% level. Men’s risk seems less varied by gender composition. Conclusions: The present study suggests that the gender composition in the workplace has an impact on the risk of LSA, especially among women. Our findings lend no support for Kanter’s theory on the effects of being a token. Most likely, women’s and men’s different status positions have an impact on the different associations found.
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| 4. |
- Carlsson, Anna, et al.
(författare)
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Precautions taken by mothers to prevent burn and scald injuries to young children at home : An intervention study
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:5, s. 471-478
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to investigate to what extent individual-based extended information given to mothers from city parts of low education can improve precautions taken by them to prevent burn and scald injuries involving young children in the home and further to compare the results with a group of mothers who had not received extended information. METHODS: This intervention study, with a comparison group, has a quasi-experimental design. Individual-based information, with an empowerment approach, was given to a group of mothers living in two separate areas of a city in southern Sweden with a low level of education. In total, 99 mothers of children under the age of 7 months participated. The mothers were selected through the local child healthcare authorities. Observations were made and bivariate analyses were established. RESULTS: The results showed that the intervention had a significant impact on improving the precautions the participating mothers introduced to protect their children against burn and scald injuries in the home and further, in relation to a comparison group. CONCLUSIONS: Through empowerment, workshops, and home visits aimed to increase their consciousness and knowledge, the participating mothers' precautions taken against child injuries in the home improved. It is of great importance that a framework for considering the problem of burn and scald injuries to children is presented from a preventive perspective which, in combination with evidence-based interventions, may enable the creation of injury prevention programmes for implementation by the community health care.
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| 5. |
- Celeste, Roger Keller, et al.
(författare)
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Trends in socioeconomic disparities in the utilization of dental care in Brazil and Sweden
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:6, s. 640-648
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe trends in socioeconomic disparities in utilization of dental care. Methods: We obtained cross-sectional data from Sweden in the period 1968-2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression. Results: In Brazil, there was a decline in use of dental care among the 15-19 year olds in the period 1986-2002, but not among the 35-44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01). Conclusions: The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.
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| 6. |
- Ekerstad, Niklas, 1969-, et al.
(författare)
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A Tentative Consensus-Based Model for Priority Setting : An Example from Elderly Patients with Myocardial Infarction and Multi-morbidity
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage. - 1403-4948 .- 1651-1905. ; 39:4, s. 345-353
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Tidskriftsartikel (refereegranskat)abstract
- Background: In most Western countries the growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines into focus. However, such guidelines are difficult to use when the evidence base is weak. Priority setting for frail elderly patients with heart disease illustrates this problem. We have outlined a tentative model for priority setting regarding frail elderly heart patients. The model takes cardiovascular risk, frailty, and comorbidity into account. Objective: Our aim is to validate the model’s components. We want to evaluate the inter-rater reliability of the study experts’ rankings regarding each of the model’s categories. Methods: A confidential questionnaire study consisting of 15 authentic and validated cases was conducted to assess the views of purposefully selected cardiology experts (n = 58). They were asked to rank the cases regarding the need for coronary angiography using their individual clinical experience. The response rate was 71%. Responses were analysed with frequencies and descriptive statistics. The inter-rater reliability regarding the experts’ rankings of the cases was estimated via an intra-class correlation test (ICC). Results: The cardiologists considered the clinical cases to be realistic. The intra-class correlation (two-way random, consistency, average measure) was 0.978 (95% CI 0.958–0.991), which denotes a very good inter-rater reliability on the group level. The model’s components were considered relevant regarding complex cases of non-ST elevation myocardial infarction. Comorbidity was considered to be the most relevant component, frailty the second most relevant, followed by cardiovascular risk. Conclusions: A framework taking comorbidity, frailty, and cardiovascular risk into account could constitute a foundation for consensus-based guidelines for frail elderly heart patients. From a priority setting perspective, it is reasonable to believe that the framework is applicable to other groups of elderly patients with acute disease and complex needs.
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| 7. |
- Eriksson, Monica, 1952-, et al.
(författare)
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From health education to healthy learning : Implementing salutogenesis in educational science
- 2011
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Ingår i: Scandinavian Journal of Public Health. - London : Taylor & Francis. - 1403-4948 .- 1651-1905. ; 39:Suppl 6, s. 85-92
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim is to scrutinise the concept of health education (HE) and to broaden the concept of health literacy (HL) towardsa lifelong healthy learning concept. HL is a broader concept than HE. This paper dissects both the health and the education concepts, and puts them into the value system of health promotion (HP) of the Ottawa Charter (OC) using the core principles and values of HP, HL, and action competence (AC) in the light of the salutogenesis (SAL). Conceptually the salutogenic model focuses on the direction towards the healthy end of the health continuum. The salutogenic theory, based on resources and comprehensibility, manageability, and meaningfulness, can be integrated into a learning model. People are seen as active and participating subjects shaping their lives through their AC. Method:a combination of an analysis of the values andintentions of health promotion according to the OC combined with the existing evidence on the salutogenic approach to health, stemming from a systematic research synthesis 1992–2003 and an ongoing analysis 2004–2009 by the authors. In addition, the views from a discussion with the participants of a session in the NHPR Conference 2009 are integrated. Results: The similarities and differences between the salutogenesis, theOCand healthy learning were shown in a graph. Integrating the salutogenesis in educational sciences further expands the concepts of HE and HL into healthy learning. Conclusions: Theresults of the discussions will further develop and strengthen the concept of healthy learning. Abstract Aim: The aim is to scrutinise the concept of health education (HE) and to broaden the concept of health literacy (HL) towards a lifelong healthy learning concept. HL is a broader concept than HE. This paper dissects both the health and the education concepts, and puts them into the value system of health promotion (HP) of the Ottawa Charter (OC) using the core principles and values of HP, HL, and action competence (AC) in the light of the salutogenesis (SAL). Conceptually the salutogenic model focuses on the direction towards the healthy end of the health continuum. The salutogenic theory, based on resources and comprehensibility, manageability, and meaningfulness, can be integrated into a learning model. People are seen as active and participating subjects shaping their lives through their AC. Method: a combination of an analysis of the values and intentions of health promotion according to the OC combined with the existing evidence on the salutogenic approach to health, stemming from a systematic research synthesis 1992–2003 and an ongoing analysis 2004–2009 by the authors. In addition, the views from a discussion with the participants of a session in the NHPR Conference 2009 are integrated. Results: The similarities and differences between the salutogenesis, theOCand healthy learning were shown in a graph. Integrating the salutogenesis in educational sciences further expands the concepts of HE and HL into healthy learning. Conclusions : The results of the discussions will further develop and strengthen the concept of healthy learning.
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| 8. |
- Eurenius, Eva, et al.
(författare)
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Maternal and paternal self-rated health and BMI in relation to lifestyle in early pregnancy: The Salut Programme in Sweden
- 2011
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Ingår i: Scandinavian Journal of Public Health. - Stockholm : Taylor & Francis. - 1403-4948 .- 1651-1905. ; 39:7, s. 730-741
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study’s aim was to increase knowledge about maternal and paternal self-rated health and body mass index in relation to lifestyle during early pregnancy. Methods: Study subjects were expectant parents visiting antenatal care (2006—07) as part of the Salut Programme in northern Sweden. During early pregnancy, 468 females and 413 male partners completed questionnaires. The questions addressed sociodemography, self-rated general health, weight and height, satisfaction with weight, and lifestyle, such as dietary habits, physical activity, sleeping pattern, and alcohol, tobacco, and drug use. Results: Most rated their general health as good, very good, or excellent, although women less often than men (88% and 93%). The sex difference was more prominent when restricting the comparison to self-rated health being very good or excellent - 49% of the women compared to 61% of the men. Being overweight or obese was common (53% of the men and 30% of the women). Few participants fulfilled the national recommendations with respect to a health-enhancing lifestyle; this was somewhat more common for women than men. Expectant parents with normal body mass index and vigorous physical activity were more likely to have very good or excellent self-rated health. Conclusions: Most expectant parents perceived their general health as good, although this perception was less for women than men. Being overweight and having a non-health-enhancing lifestyle were more common for men than women. Thus, there is need for more powerful health-promoting interventions for expectant parents.
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| 9. |
- Farsi Razavi, Monireh, et al.
(författare)
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Experiences of the Swedish healthcare system: An interview study with refugees in need of long-term health care
- 2011
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 39:3, s. 319-325
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Tidskriftsartikel (refereegranskat)abstract
- Background: Refugees needing long-term health care must adapt to new healthcare systems. The aim of this study was to examine the viewpoints of nine refugees in a county in Sweden, with a known chronic disease or functional impairment requiring long-term medical care, on their contacts with care providers regarding treatment and personal needs. Methods: Semi-structured interviews with nine individuals and/or their next of kin. Inductive content analysis was used to identify experiences. Results: "Care organisations/resources" and "professional competence" were the categories extracted. Participants felt cared for due to accessibility to and regular appointments with the same care provider. Visiting different clinics contributed to a negative experience and lack of trust. The staffs interest in participants lives and health contributed to a sense of professionalism. Most participants said the problems experienced were not related to their backgrounds as refugees. Many patients did not fully understand which clinic they were attending or the purpose of the care that the specific clinic provided. Some lacked knowledge of their disease. Conclusions: Health care was perceived as equal to other Swedish citizens and problems experienced were not explained by refugee backgrounds. Lack of information from care providers and being sent to various levels of care created feelings of a lack of overall medical responsibility.
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| 10. |
- Fors, Stefan, et al.
(författare)
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Live long and prosper? Childhood living conditions, marital status, social class in adulthood and mortality during mid-life : A cohort study
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:2, s. 179-186
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the present study was to investigate the impact of childhood living conditions, marital status, and social class in adulthood on the risk of mortality during mid-life. Two questions were addressed: Is there an effect of childhood living conditions on mortality risk during mid-life and if so, is the effect mediated or modified by social class and/or marital status in adulthood? Methods: A nationally representative, Swedish, level of living survey from 1968 was used as baseline. The study included those aged 25—69 at baseline (n = 4082). Social conditions in childhood and adulthood were assessed using self-reports. These individuals were then followed for 39 years using registry data on mortality. Results: The results showed associations between childhood living conditions, marital status, social class in adulthood and mortality during mid life. Social class and familial conditions during childhood as well as marital status and social class in adulthood all contributed to the risk of mortality during mid-life. Individuals whose father’s were manual workers, who grew up in broken homes, who were unmarried, and/or were manual workers in adulthood had an increased risk of mortality during mid life. The effects of childhood conditions were, in part, both mediated and modified by social class in adulthood. Conclusions: The findings of this study suggest that there are structural, social conditions experienced at different stages of the life course that affect the risk of mortality during mid-life.
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