| 31. |
- Irestig, R, et al.
(författare)
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How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:3, s. 225-231
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To elucidate the perceived treatment that the homeless have received from the healthcare and other societal organisations and to present homeless persons’ trust in the healthcare system and suggestions of necessary changes for improving it. Methods: Homeless individuals in special houses and institutions in the County of Stockholm were asked to answer a short version of a public health survey, including added questions about how they experienced the healthcare providers’ attitudes towards them and how much trust they had in the healthcare system. A total of 155 homeless persons (123 male and 32 female) were interviewed. Results: Three-quarters of the participants stated that they had fairly or very high trust in healthcare services and also felt that they had been fairly or very well treated. Fewer females than males reported being treated well and they declared a lower degree of trust in the healthcare system. The homeless suggest that extra resources be set aside to organise their healthcare, including a higher level of knowledge of the medical problems prevailing in the group. Those who felt badly treated also asked for less neglect and disrespect from the healthcare staff. Conclusions: Even though a majority experience that they are being well treated within the healthcare system, the study also indicated disadvantages in the treatment of homeless persons in Sweden. The study also reveals an imbalance between the official ethical framework in Sweden and of the specific moral of some individual healthcare providers. One way to facilitate their entry into the healthcare system might be to create special surgeries for the homeless.
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| 32. |
- Johansson, Gunnar, 1956-
(författare)
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Overweight and obesity in Sweden : A five year follow-up, 2004-2008
- 2010
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Ingår i: Scandinavian Journal of Public Health. - Oslo : Scandinavian University Press. - 1403-4948 .- 1651-1905. ; 38:8, s. 803-809
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The number of overweight and obese persons increased through the 1980s and 1990s in Sweden, for instance for men from 35% in 1980 to 52% in 2007. This study investigated whether this trend continued over the past 5 years, including trends for diet and physical activity.MATERIALS AND METHODS:The sampling frame in these surveys was established from the Swedish National Registry where all people registered in Sweden between 18 and 84 years in 2004 and 16-84 years in 2005-08 were included.RESULTS:There were no changes in the number of overweight (approximately 42% for men and 27% for women) and obese (approximately 11% for both men and women) persons between 2004 and 2008. Approximately 65% of the men and 64% of the women were physically active for an average of 30 minutes per day in 2008. Thirteen percent of women and 5% of men reported consuming at least five servings of fruit and vegetables per day during the 5-year period.CONCLUSIONS:Sweden seems to have reached a steady state regarding overweight and obesity. It would probably be fruitful to further discuss life-style issues, such as diet and physical activity, in the Swedish healthcare system and how to deal with the social gradient.
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| 33. |
- Johansson, Pia, et al.
(författare)
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Financing intersectoral health promotion programmes : some reasons why collaborators are collaborating as indicated by cost-effectiveness analyses
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Intersectoral collaboration is an important part of many health promotion programmes. The reasons for the local organisations to collaborate, i.e. to finance programmes, are presumably based on benefits they derive from the collaboration. The aim of this study is to discuss whether subsector financial analyses based on data from cost-effectiveness analyses reflect incentives of collaborating organisations in two intersectoral health promotion programmes. Methods: Within economics, financial incentives are important reasons for actions. The financial incentives of collaborators are exemplified with two subsector financial analyses containing avoided disease-related costs as estimated in two cost-effectiveness analyses, on an elderly safety promotion programme (Safe Seniors in Sundbyberg) and on a diabetes prevention programme (Stockholm Diabetes Prevention Program, SDPP) from Stockholm, Sweden. Results: The subsector financial analyses indicate that there are financial incentives for the key local community organisation, i.e. the local authority, to collaborate in one of the programmes but not the other. There are no financial benefits for other important community organisations, such as non-governmental organisations. Conclusions: The reasons for collaborating organisations to collaborate within intersectoral health promotion programmes extend beyond financial benefits from averted disease. Thus, the reported subsector financial analyses are only partial reflections of the incentives of collaborators, but they might be used as a starting point for discussions on cost sharing among potential intersectoral collaborators.
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| 34. |
- Koponen, AM, et al.
(författare)
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Job involvement of primary healthcare employees: does a service provision model play a role?
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:3, s. 266-274
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. Methods: A panel mail survey 2000—02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Results: Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Conclusion: Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.
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| 35. |
- Kristenson, Margareta, et al.
(författare)
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Socioeconomic differences in outpatient healthcare utilisation are mainly seen for musculoskeletal problems in groups with poor self-rated health
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications (UK and US). - 1403-4948 .- 1651-1905. ; 39:8, s. 805-812
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess whether there are socioeconomic (SES) differences in outpatient visits within groups of comparable morbidity (medical disease and self-rated health) and whether psychosocial factors can explain these differences. Methods: Baseline data for SES, presence of disease, self-rated health (SRH), and psychosocial factors were collected during 2003-04 from 923 men and women aged 45-69 years in southeast Sweden. Outcome data were all registered outpatient healthcare visits to physicians during 2004-08. Cumulative incidences and standardised rate ratios (SSR) were calculated for strata of comparable morbidity for all visits, for visits due to cardiovascular disorders (CVD)/diabetes and for musculoskeletal problems. Results: Low SES was associated with more outpatient visits due to musculoskeletal problems (SRR for education 1.52, 95% CI 1.35-1.73; for occupation 1.40, 95% CI 1.26-1.56) and accentuated in groups with poor SRH. The SES effect was significant for visits to primary care and to hospitals, for men and women, and independent of present disease, SRH, and psychosocial factors. Low SES was significantly associated with more total outpatient visits at primary healthcare centres. In contrast, for outpatient visits due to CVD/diabetes, high SES was related to more visits to hospitals among people with good SRH at baseline. Conclusions: We found a consistent pattern for outpatient visits related to musculoskeletal problems where people with low SES counted more visits and this was most prominent in groups of poor SRH. The results demonstrate the need to apply different morbidity measures when studying inequalities in healthcare utilisation.
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| 36. |
- Kulla, Gunilla, et al.
(författare)
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Differences in self-rated health among older immigrants : A comparison between older Finland-Swedes and Finns in Sweden
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : Sage Journals. - 1403-4948 .- 1651-1905. ; 38:1, s. 25-31
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Research has shown a tendency among immigrants and ethnic minorities to have a lower health status compared with the majority population. This applies to Finnish immigrants in Sweden. This group, however, also consists of persons who belong to a small ethnic minority in Finland, the Finland-Swedes, who speak Swedish as their mother tongue. In Finland, this minority has been shown to have better health and longer lives than the majority of Finnish-speaking people. Most of the previous research has studied the objective health of immigrants and minorities, while less is known about their subjective health. The aim of this study was to describe and compare self-rated health in older Finland-Swedes and Finns living as immigrants in Sweden. Methods: The study was carried out as a sample-based cross-sectional study. Data was collected by a postal structured questionnaire. The response rate among the Finland-Swedes was 47% (n = 169) and among the Finns was 54% (n = 643). Data was analyzed descriptively and tested with Pearson’s chi-square test. Results: The results showed significant differences between the language groups in self-rated health, age of retirement and causes for retirement. The Finland-Swede immigrants rated their health as better than the Finnish-speaking ones. They had retired at an older age and less frequently because of health problems. Conclusions: The results indicate that there may be significant differences in health, at least in subjective health, between immigrant groups. Due to the low response rate, the results cannot be generalized.
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| 37. |
- Kullberg, Agneta, 1955-, et al.
(författare)
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Residents’ perspectives on safety support needs in different types of housing areas
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage. - 1403-4948 .- 1651-1905. ; 39:6, s. 590-597
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Tidskriftsartikel (refereegranskat)abstract
- Background: Knowledge about conditions that are understood to support safety is important for planning residential safety promotion in interactions with residents. How residents themselves perceive and reason about their own safety needs has seldom been investigated in Scandinavia. Aim: To identify factors perceived to be necessary to feel safe by residents in areas with blocks of flats and detached houses. Methods: Residents in a Swedish municipality were asked an open-ended question on the research topic by a mail survey; 787 residents provided narrative data that were fed into a summative qualitative and quantitative content analysis. Results: A stable social structure in the housing area was perceived to be the central factor in a safety-supportive residential environment. Whereas maintenance of good and reassuring relations was emphasized in detached housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. This finding emphasizes the need to reduce the differential exposure to safety-related factors in the living environment. Conclusions: The results of our study encourage the continued use of a setting-orientated safety promotion approach in which residents and other stakeholders are involved. The policy recommendation that can be drawn from the study is that both the subjective and objective dimensions of safety should be identified and considered when developing local safety promotion interventions in community contexts.
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| 38. |
- Laamanen, R, et al.
(författare)
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Does patients' choice of health centre doctor depend on the organization? A comparative study of four municipalities with different forms of service provision in Finland
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:7, s. 715-723
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the study was to examine the use of physician services and the willingness to choose an health centre (HC) doctor rather than an alternative (i.e. private, occupational healthcare, other doctor) by the working age population in four municipalities in Finland. In a Southern municipality primary health care was contracted out to a non-profit organization whereas Eastern, Western and South-Western municipalities mainly provided services themselves. Methods: A mail survey of a random sample of the 15—64-age population was conducted in 2002 (n = 2,000, response rate 62%). Data were analyzed using descriptive statistics as well as bi- and multivariate logistic regression analyses. Results: Of the respondents, 69% had visited an HC doctor during the past year, and of these, more than 40% had also visited another doctor outside the HC. The willingness to choose an HC doctor varied from 40% to 54% and was highest in the Southern municipality. When significantly associated variables — age, working status, perceived stress in life situation, access to an appointment, perceived interpersonal quality, and visits to doctors — were controlled for, the willingness to choose an HC doctor was, compared with the Southern municipality, less popular only in the Western municipality. Conclusions: The tendency to choose an HC doctor rather than an alternative was quite low, probably reflecting lack of attractiveness of HC to patients. However, contracting out service production did not additionally decrease patients’ willingness to choose an HC doctor. More attention should be paid to improving access, interpersonal quality and continuity of care.
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| 39. |
- Landstedt, Evelina, 1978-, et al.
(författare)
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Deliberate self-harm and associated factors in 17-year-old Swedish students
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 17-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Deliberate self-harm (DSH) in young people is an important public health issue. To prevent DSH, more knowledge is needed about its prevalence and associated contextual factors in community samples of adolescents. Aims: To determine the prevalence of deliberate self-harm in 17-year-old Swedish students and to explore the association of demographic variables, psychological distress, experiences of violence, and school-related factors with DSH. Methods: Data were derived from a cross-sectional study in which 17-year-old students completed questionnaires during school hours (n=1,663; 78.3%). The variables used in this analysis are as follows: deliberate self-harm, demographic variables, psychological distress, experiences of violence, and school-related factors. Data were analysed using chi-squared statistics and logistic regression. Results: The lifetime prevalence of DSH was 17%, and it was more common among girls (23.3%) than boys (10.5%). There were considerable socioeconomic differences in reports of DSH. Psychological distress was strongly associated with DSH in both boys and girls, as were experiences of bullying, sexual harassment, physical violence and sexual assault. Social support, safety and academic factors in school were related to reports of DSH in both girls and boys. There were some gender differences with respect to which factors were associated with DSH. Conclusions: Deliberate self-harm is common and more frequently reported by girls than boys. Psychological distress, experiences of different types of violence, and school-related factors (academic, social and safety-related), should be considered risk factors for DSH in young people. Findings can be applied to health-promotion policy and interventions in various contexts, for example schools.
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| 40. |
- Larsson, Jerry, et al.
(författare)
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Sick leave after traumatic brain injury. The person or the diagnosis - Which has greater impact?
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 541-547
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe if and when a sample of traumatic brain injury (TBI) patients could finish their time of sick leave during a 4-year follow up and to explore which factors that influenced the time for sick leave. Materials and methods: All persons, 1999—2002, between 18 and 64 years of age (250 in total), admitted to the emergency room and diagnosed according to ICD 10 as S062 and S063, were included. Demographic data were gathered from medical charts and data concerning sick leave 1 year before trauma and 4 years after trauma, were collected from the Swedish social insurance system. To explore predictors of sick leave, two logistic regressions were performed. Results: The sample (mean age 39.68) consisted of 78% men. More than half of the accidents were due to fall. In the sample, 28 % was on sick leave on the day of trauma and 96 % of these were still on sick leave 4 years after trauma, compared with 39 % in the group not on sick leave on the day of TBI. Sick leave at the day for trauma was found to be a predictor for sick leave 4 years after trauma for the whole group (p = 0.000) together with Glasgow Coma Scale (GCS) (p = 0.002) and length of stay (p = 0.049). In the logistic regression with only the group not on sick leave, the only significant variable was GCS (p = 0.003). Conclusion: The findings support the necessity to consider premorbid and social factors in the TBI rehabilitation.
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