| 1. |
- Abelsson, Tobias, et al.
(författare)
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The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context
- 2024
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Ingår i: BMC PRIMARY CARE. - 2731-4553. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrimary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals' experiences of and attitudes towards working in accordance with EBP in primary care.MethodsThe study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).ResultsThe EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: "The dilemma of the split between theory and reality". Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.ConclusionsAlthough the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.
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| 2. |
- Mårtensson, Lena, 1953, et al.
(författare)
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Long-term influences of a biopsychosocial rehabilitation programme for chronic pain patients.
- 2004
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Ingår i: Musculoskeletal care. - : Wiley. - 1478-2189 .- 1557-0681. ; 2, s. 152-64
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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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| 3. |
- Rask, Mikael, 1958-, et al.
(författare)
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Validity and reliability of a Swedish version of the Relationship Assessment Scale (RAS) : a pilot study
- 2010
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Ingår i: Canadian journal of cardiovascular nursing. - Ottawa : Canadian Council of Cardiovascular Nurses. - 0843-6096. ; 20:1, s. 16-21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.
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| 4. |
- Skärsäter, Ingela, 1952, et al.
(författare)
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Functional status and quality of life in patients with first-episode major depression
- 2006
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - West Sussex, UK : Wiley. - 1351-0126 .- 1365-2850. ; 13:2, s. 205-213
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse the level of severity of major depression and its relation to functioning and health-related quality of life over time in patients treated for their first episode of major depression. Thirty-three adult patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression were included in the study. Semi-structured interviews and self-assessment questionnaires were used at baseline and at 6-monthly intervals in a 2-year follow-up, in order to measure the level of severity of depression, functioning and quality of life. The results showed that the first episode of major depression was rated as severe in 43% of cases. Multiple domains of functioning as well as quality of life were strongly affected in patients at baseline, although the level of functioning increased significantly over the study period, as did quality of life, but not concurrently with the decrease in the level of severity of the depression. Psychosocial functioning is an important outcome measure related to major depression, which underlines the importance of separate evaluations initiated and conducted by mental health nurses in order to determine whether or not patients have actually achieved a state of health. © 2006 Blackwell Publishing Ltd.
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| 5. |
- Abelsson, Tobias, et al.
(författare)
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Evidence-based practice in primary healthcare from the managerial point of view - a national survey
- 2021
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The vast availability of and demand for evidence in modern primary healthcare force clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary healthcare managers play a key role in implementing these governing documents. Thus, the aim of this article is to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary healthcare managers. Methods The study is based on a national survey of primary healthcare managers, consisting of 186 respondents, recruited nationally from Sweden. The data was analysed using empirically constructed concepts and validated using factor analysis. A chi-square test was utilized to determine the statistical significance of comparisons. Associations between variables were calculated using Spearman's correlation coefficients. All tests were two-sided, and the significance level was set to 0.05. Results A majority (97 %) of managers stated that guidelines and policy documents impacted primary healthcare; 84 % of managers observed a direct effect on daily practices. Most of the managers (70 %) stated that some adaptation was needed when new evidence was introduced. The managers emphasized the importance of keeping themselves updated and open to new information about work routines (96 %). Conclusions The study illustrates a nearly unanimous response about the influence of clinical evidence on daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date is viewed as a direct result of this effect on daily practice. An information-dense organization such as a primary healthcare organization would have much to gain from increased cooperation with regional information resources such as clinical libraries.
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| 6. |
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| 7. |
- Arvidsson, Barbro, et al.
(författare)
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Effects of process-oriented group supervision as reported by nursing students : a pilot study
- 2008
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Ingår i: Vård i Norden. - Köpenhamn : SSN [Sjuksköterskornas samarbete i Norden]. - 0107-4083 .- 1890-4238. ; 28:1, s. 26-29
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Tidskriftsartikel (refereegranskat)abstract
- One method to ensure that nursing students are better prepared for their future professional role can be to offer them process-oriented group supervision. The aim of this prospective, longitudinal pilot study was to evaluate the effects of a process-oriented group supervision programme (PGSP) comprising educational, supportive and developmental areas based on reports by nursing students undergoing a 3-year nursing education. The students (N=61) evaluated their experiences of the PGSP by means of a questionnaire, which they filled in after each study year. An independent t-test was conducted to compare the educational, supportive, and developmental areas after the first (2002), second (2003) and third year (2004) as well as over the whole 3-year study period. The result showed no significant difference in scores in the educational area. However, there was a significant increase in the supportive area (p=.03) over the 3-year period, which was especially noticeable during the first year (p=.013). There was also an increase in the developmental area over the 3-year period (p=.021) as well as during the first year (p=.024). Thus, PGSP seems to develop nursing students in their professional identity and personal growth. However, as this was a pilot study, a research implication is to perform a large-scale study over a longer period of time.
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| 8. |
- Arvidsson, Barbro, et al.
(författare)
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The development of a questionnaire for evaluating process-oriented group supervision during nursing education
- 2008
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Ingår i: Nurse Education in Practice. - Amsterdam : Elsevier. - 1471-5953 .- 1873-5223. ; 8:2, s. 88-93
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Tidskriftsartikel (refereegranskat)abstract
- The benefits of process-oriented group supervision are difficult to evaluate, as the validity and reliability of the existing instruments have been questioned. The aim was to develop and test the psychometric properties of a questionnaire in order to evaluate the effects of process-oriented group supervision on nursing students during their three-year nursing education. A 55-item Process-oriented Group Supervision Questionnaire (PGSQ) with a developmental design was formulated on the basis of a literature review and the expectations of nursing students who participated in a three-year nursing education programme (N = 176). Construct validity and internal consistency reliability were tested at the end of each study year: year 1 (T1), year 2 (T2), and year 3 (T3) by means of exploratory factor analysis and Cronbach’s coefficient. An adequate explorative factor analysis (principal component analysis, varimax rotation) with an Eigenvalue >1.0 and factor loadings >0.40, reduced the questionnaire to 18 items comprising three factors labelled educative, supportive and developmental, which explained 60.2% at T1, 71.8% at T2, and 69.3% at T3 of the total cumulative variance. The corresponding Cronbach’s coefficient figures were 0.89 (T1), 0.94 (T2) and 0.93 (T3). The 18-item PGSQ is considered to be a short and useful tool due to its satisfactory validity and reliability figures.
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| 9. |
- Baigi, Amir, 1953
(författare)
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Life expectancy in the province of Halland, Sweden. A historic to modern, socio-epidemiological perspective with focus on cardiovascular diseases
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction One of the most concrete expressions of mortality in a population is the so-called life expectancy, i.e. a figure that indicates the average life span of an individual under the prevailing conditions. The life expectancy of a population is considered as a generic measure of public health. The province of Halland is situated in the Southwestern part of Sweden and has today a population of approximately 270 000 inhabitants. The province has retained its agrarian character, more so than the country as a whole. Today, the population of Halland has a life expectancy of 79.37 years, which is the highest in Sweden.The aim of the thesis was to study life expectancy and causes of death, in particular cardiovascular diseases in the province of Halland, compared to Sweden as a whole, for the purpose of identifying, from a socio-epidemiological perspective, important factors contributing to life expectancy during the 20th century.Material and Method Data on population, death rates and causes of death in Halland and Sweden between 1911 and 1950 were processed in a computer program specially designed for the purpose of studying life expectancy and causes of death from a historical perspective. From a modern perspective, mortality from cardiovascular diseases in both Halland and Sweden between 1980-1990 was investigated by means of a prospective design, the aim being to establish whether or not any association with socio-economic status exists. In addition, the incidence of acute myocardial infarction in the period 1980-1992 as well as chest pain in 1997 was studied with socio-economic status as a background variable. Poisson distribution, Poisson regression and logistic regression with 95% CI and p-value were employed.Results Since 1911, Halland has shown a longer life expectancy when compared to Sweden as a whole. From a historical perspective, this difference could be explained by lower infant mortality in combination with lower mortality from infectious diseases while, from a modern perspective, the explanations are lower mortality from cardiovascular diseases in general and ischaemic heart disease in particular. The favourable conditions in Halland can most likely be explained by the socio-structural differences in past times and individual differences in the present day.Conclusion The favourable health situation in Halland is based on a combination of a high standard of living and the associated rich nutritional intake resulting from the agricultural development of the province, in addition to the agrarian environment and the relatively homogeneous social structure.
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| 10. |
- Baigi, Amir, 1953, et al.
(författare)
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Non-attendees' attitudes to the design of a cardiac rehabilitation programme focused on information of risk factors and professional involvement
- 2009
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 8:1, s. 62-66
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Tidskriftsartikel (refereegranskat)abstract
- Background: Enhancing the accuracy of the content of cardiac rehabilitation programmes (CRPs) and providing the mediators preferred by patients can increase attendance rates in line with secondary prevention goals. The aim of this study was therefore to explore non-attendees' attitudes to the design of a CRP focused on information of risk factors and professional involvement. Method: Consecutive patients with coronary heart disease (n = 100) who declined to participate in a CRP answered a questionnaire focusing on patients' attitudes to risk factors and cardiac rehabilitation. Results: Non-attendees considered that information of hypertension and information of sedentary lifestyle constituted the most important content of a CRP. Physicians, nurses and social workers were considered the most suitable professional categories. Females preferred nurses when discussing smoking issues while males preferred physicians. More males compared to females preferred occupational therapists for dealing with stress, physicians for depression and social workers for social isolation. Conclusions: Non-attendees' attitudes are similar to those of attendees and quite traditional in that they favour physician or nurse-led activities. There is a difference in attitude between male and female.
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