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- Ekerstad, Niklas, et al.
(författare)
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Elderly people with multi-morbidity and acute coronary syndrome: Doctors' views on decision-making
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:3, s. 325-331
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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, problems exist in areas where the evidence base is weak, e.g. elderly patients with heart disease and multiple co-morbidities. Objective: Our aim is to evaluate the views of Swedish cardiologists on decision-making for elderly people with multiple co-morbidities and acute coronary syndrome without ST-elevation (NSTE ACS), and to generate some hypotheses for testing. Methods: A confidential questionnaire study was conducted to assess the views of cardiologists/internists (n = 370). The response rate was 69%. Responses were analyzed with frequencies and descriptive statistics. When appropriate, differences in proportions were assessed by a chi-square test. A content analysis was used to process the answers to the open-ended questions. Results: 81% of the respondents reported extensive use of national quidelines for care of heart disease in their clinical decision-making. However, when making decisions for multiple-diseased elderly patients, the individual physician's own clinical experience and the patient's views of treatment choice were used to an evidently greater extent than national guidelines. Approximately 50% estimated that they treated multiple-diseased elderly patients with NSTE ACS every day. Preferred measures for improving decision-making were: (a) carrying out treatment studies including elderly patients with multiple co-morbidities, and (b) preparing specific national guidelines for multiple-diseased elderly patients. Conclusions: In the future, national guidelines for heart disease should be adapted in order to be applicable for elderly patients with multiple co-morbidities.
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- Faresjö, Tomas, et al.
(författare)
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Educational level is a crucial factor for good perceived health in the local community
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 38:6, s. 605-610
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Educational level is a strong determinant of perceived health, and also an important component in the socioeconomic concept. The aim of this study was to analyze a number of social conditions and lifestyle factors that might explain differences in self-reported health between the populations in two different social environments, one white-collar city and one blue-collar city. These "twin cities" are served by the same healthcare organisation, but differ in terms of social history and current social structure. Methods: The material consisted of responses to a community-based survey of individuals aged between 20 and 64 years, with an overall response rate of 49%. Differences in self-reported health status were tested with chi-square tests and regression analysis. Results: We found significant differences in perceived health between the two populations. These differences in self-reported health could not be explained by differences in demographic factors, lifestyles, or living conditions. However, when the educational level of the respondents was taken into account, the differences in perceived health diminished. Conclusions: Public health in local communities tends to reflect the social history and social heritage of the population. In this study, we found that educational level appears to be a vital factor for good perceived health of the individual in a community.
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- Lindmark, Ulrika, et al.
(författare)
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The distribution of ‘‘sense of coherence’’ among Swedish adults : A quantitative cross-sectional population study
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antonovskys concept of "sense of coherence (SOC) has been shown to be related to health. The aim of this study was to describe the distribution of SOC scores and their components in an adult Swedish population aged 20-80 years. Methods: A random sample of 910 individuals from Jonkoping, Sweden, aged 20, 30, 40, 50, 60, 70 and 80 years, of which 589 agreed to participate in an oral health examination. The participants answered Antonovskys 13-item version of "the life orientation questionnaire scale. The response to the items and the distribution of the three components of comprehensibility, manageability and meaningfulness were analyzed for different age groups and genders using mean values and standard deviations, Students t-test and ANOVA. Results: A total of 526 individuals, 263 men and 263 women, answered all 13 questions and constituted the final material for the study (response rate 89%). The individual SOC score increased with age. The 20 year olds had a statistically significantly lower SOC score compared with the other age groups and 55% of them had a low SOC (andlt;= 66 points) compared with 17% of the 80 year olds. Men in the 60 and 70 year age groups had a statistically significantly higher SOC score compared with women of the same age. Conclusions: The individual distribution of SOC varied with age and gender. Twenty year olds had a significantly lower SOC score compared with elderly age groups. Elderly men had a statistically significantly higher SOC score compared with women of the same age.
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- Nordyke, Katrina, et al.
(författare)
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How do children experience participating in a coeliac disease screening? A qualitative study based on childrens written narratives
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 38:4, s. 351-358
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore how 12-year-old Swedish children experienced being involved in a coeliac disease (CD) screening. Methods: A qualitative approach was used to analyse short narratives written by children who had taken part in a school-based CD screening. Narratives were written after blood sampling, but prior to learning of the test results. Through an oscillation between the texts, codes, subcategories and four categories, a theme was generated describing the childrens experience. Results: The theme "A Journey towards Confidence" captures the overall experience of the screening. It illustrates that, although some children faced fear or anxiety, overall they had or were provided tools allowing them to cope well and experience a journey towards confidence. The categories describe conditions that contributed to the experience. The first, being involved, reflects the importance of involvement in receiving information and deciding to participate. Being a "good citizen" refers to feeling a duty to help and a trust to be treated fairly. Being able to cope with the screening was influenced by the childrens ability to manage sensations and support received. The last category, being able to balance risk, illustrates that the children were able to balance the risks of screening when they had a realistic understanding of the disease and their vulnerability and had tamed their anxiety. Conclusions: This study increases the understanding of how 12-year-old Swedish children experienced participating in a CD screening and describes conditions important for a positive experience. We show that, although some children faced anxiety, they had, or were provided with, tools allowing them to cope well and gain confidence.
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