| 21. |
- Lännerström, Linda, 1974-, et al.
(författare)
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Nurses' experiences of managing sick-listing issues in telephone advisory services at primary health care centres
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 857-863
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Over the last decade Swedish health care has focused on improving the management of sick-listing issues. At primary health care centres sick-listing is mainly dealt with by the patient’s physician but when patients have requests related to sick-listing and contact the telephone advisory service nurses will be involved. The aim of this study was to describe nurses’ experiences of managing sick-listing issues in telephone advisory services in a primary health care setting.Methods: The study was a qualitative focus group study. Data collection was conducted in three focus group conversations in a county in central Sweden in 2009. The conversations were recorded, transcribed and analyzed using qualitative content analysis. The study included fourteen nurses, purposively sampled as having current experience of telephone advisory services at primary health care centres.Findings:The management of sick-listing issues was described by the nurses as Nurses Actions which were affected by Enabling conditions and Obstructing conditions. The Nurses’ Actions included making an assessment for appropriate action, making an appointment and/or giving information and guidance to the patient and/or monitoring patient’s rights. Enabling conditions included documentation, routines, supportive co-operation and training in insurance medicine. The obstructing conditions were related to patients’ expectations, co-operation with other professionals, lack of training and the nurses’ professional role.Conclusion: The nurses experienced stress and difficulties related to being gatekeepers and related to the act of balancing different demands from patients, co-workers and the organisation. This in combination with the lack of training caused the nurses to state that they did not want responsibility for managing sick-listing issues. Sufficient documentation, education, routines, support of and discussions with other professionals at the primary health care centre could be ways of improving nurses’ and other professionals’ management of sick-listing issues.
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| 22. |
- Lännerström, Linda, 1974-, et al.
(författare)
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Possible causes of experiencing problems with sick leave questions in telephone nursing
- 2017
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; 122:4, s. 249-253
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Registered nurses at primary health care centres in Sweden receive about 20 million telephone calls annually. Questions related to sick leave occur regularly. Previous studies conclude that those calls often are perceived as problematic. The aim of this study was to explore factors associated with problems regarding sick leave questions in telephone nursing.METHODS: A questionnaire was distributed to all registered nurses (n = 185) working with telephone nursing in 26 Swedish primary health care centres, of whom 114 (61.6%) responded. Based on the results of a Spearman correlation analysis a logistic regression analysis was performed of significant exposure variables on outcome (perceived problems).RESULTS: Significant exposure variables were: experience of telephone nursing, age, being educated in social insurance medicine, and frequency of telephone calls with sick leave questions. Young age was associated with more problems than old age. Those having education in social insurance medicine reported fewer problems than those who had not, and so did those having few telephone calls with sick leave questions as compared with those who had many.CONCLUSIONS: Young age, lack of education in insurance medicine, and high frequency of sick leave questions increased the perceived problem level in telephone nursing.
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| 23. |
- Lännerström, Linda, 1974-, et al.
(författare)
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Registered nurses' work with sick leave questions by telephone in primary health care
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 26:5/6, s. 641-647
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES:To describe registered nurses' work with sick leave questions by telephone.BACKGROUND:In Sweden, when a sick person needs to request a sickness certification, it is common to contact the primary healthcare centre. The main access to primary health care is by telephone, with a registered nurse answering the care seeker's questions, triaging and helping care seekers to the right level of care. Registered nurses' work with sick leave questions has not been studied, except for two qualitative interview studies.DESIGN:A descriptive cross-sectional study.METHODS:A questionnaire with 120 questions was distributed to 185 registered nurses in one county in central Sweden. Descriptive statistics were used for analysis.RESULTS:Response rate was 62% (n = 114). Registered nurses (n = 105) in this study talked weekly to persons on, or at risk, for sick leave. A large part (n = 78) felt they had a role in the care of persons on sick leave, consisting of booking appointments as well as acting as a pilot, advisor, caretaker and coordinator. For 74 of 114 registered nurses, it was problematic to handle the phone calls weekly. Measures were 'often' booking appointments with physicians (n = 67) and 'seldom' providing information on social insurance rules ('never' n = 51). The registered nurses expressed a great need for more education.CONCLUSION:Registered nurses in this study reported having a role in the care of persons on sick leave when handling sick leave questions by telephone. The telephone calls were problematic to handle, and the registered nurses expressed a great need for education and training in social insurance medicine.RELEVANCE TO CLINICAL PRACTICE:There is a need to educate and train registered nurses in social insurance medicine to provide high-quality nursing for patients on or at risk for sick leave.
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| 24. |
- Lännerström, Linda, 1974-
(författare)
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Sick Leave Questions in Telephone Nursing : Perspectives of Persons on Sick Leave and Registered Nurses in Primary Health Care
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim and methods: To explore experiences of being on sick leave by interviewing 16 persons on sick leave and using a phenomenological approach. To explore registered nurses’ work in the care of persons on sick leave by performing three focus group discussions with registered nurses. To explore the effect and experiences of an educational intervention in social insurance medicine with registered nurses by studying the effect of a randomized controlled study with 100 registered nurses and by interviewing 12 registered nurses who participated in the intervention.Findings: The essential meaning of being on long-term sick leave was losing one’s independence. This loss was connected to mostly negative experiences of being absent from work, the social insurance rules, and experiences in encounters with many professionals.The registered nurses’ work in handling sick leave questions included assessing, dispositioning, supporting, and collaborating actions. They expressed lacking competence, had different understandings of their role, and experienced stress connected to contradictory demands in their roles as carers, co-workers, and distributors of organizational resources.The short educational intervention in social insurance medicine seemed to have had an effect, but due to the small study population, the effect was inconclusive. The process evaluation showed that the educational intervention was perceived to have contributed to registered nurses gaining role clarity in their work with sick leave questions. The registered nurses described increasing their knowledge and skills as well as taking on more of the traditional actions related to telephone nursing, for example giving more information and being more attentive, coaching, and encouraging towards patients.Conclusions: Being on long-term sick leave can be experienced negatively, and can be connected to several dimensions of life. Registered nurses at the studied primary health care centres had a role in the care of patients on sick leave, but had different understandings of their role that affected how they handled telephone calls with them. The educational intervention failed to show a conclusive effect due to the rather small study population. However, the registered nurses experienced that participating had enhanced their competence.
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| 25. |
- Lännerström, Linda, 1974-, et al.
(författare)
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The effect of a short educational intervention in social insurance medicine : A randomized controlled trial
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:2, s. 523-529
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Tidskriftsartikel (refereegranskat)abstract
- AimTo evaluate the effect of an educational intervention in social insurance medicine with Registered Nurses.DesignRandomized controlled trial.MethodsThe trial was performed in 20 primary healthcare centres in Central Sweden. The centres were randomly assigned as intervention or control. All Registered Nurses working with telephone nursing at the centres were invited (N = 114); out of these 100 agreed to participate and responded to a questionnaire at the beginning and end of the trial. Fourteen questions in the questionnaire dealt with professional background and were used as exposure variables and were analysed using nominal logistic regression.ResultsRegistered Nurses in the centres randomly assigned for the intervention experienced handling sick leave questions as less problematic after the intervention than those in the control group. This indicated that the intervention was associated with a positive effect. However, due to the rather small study population, the effect was inconclusive.
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| 26. |
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| 27. |
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| 28. |
- Mikaelsson, B, et al.
(författare)
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Varför ökar sjukfrånvaron?
- 1999
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 96:39, s. 4160-4162
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Tidskriftsartikel (refereegranskat)
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| 29. |
- Milos Nymberg, Veronica, et al.
(författare)
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Trends in Remote Health Care Consumption in Sweden : Comparison Before and During the First Wave of the COVID-19 Pandemic
- 2022
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Ingår i: JMIR Human Factors. - : JMIR Publications Inc.. - 2292-9495. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Remote assessment of respiratory tract infections (RTIs) has been a controversial topic during the fast development of private telemedicine providers in Swedish primary health care. The possibility to unburden the traditional care has been put against a questionable quality of care as well as risks of increased utilization and costs. The COVID-19 pandemic has contributed to a changed management of patient care to decrease viral spread, with an expected shift in contact types from in-person to remote ones. Objective: The main aim of this study was to compare health care consumption and type of contacts (in-person or remote) for RTIs before and during the COVID-19 pandemic. The second aim was to study whether the number of follow-up contacts after an index contact for RTIs changed during the study period, and whether the number of follow-up contacts differed if the index contact was in-person or remote. A third aim was to study whether the pattern of follow-up contacts differed depending on whether the index contact was with a traditional or a private telemedicine provider. Methods: The study design was an observational retrospective analysis with a description of all index contacts and follow-up contacts with physicians in primary care and emergency rooms in a Swedish region (Skane) for RTIs including patients of all ages and comparison for the same periods in 2018, 2019, and 2020. Results: Compared with 2018 and 2019, there were fewer index contacts for RTIs per 1000 inhabitants in 2020. By contrast, the number of follow-up contacts, both per 1000 inhabitants and per index contact, was higher in 2020. The composition of both index and follow-up contacts changed as the share of remote contacts, in particular for traditional care providers, increased. Conclusions: During the COVID-19 pandemic in 2020, fewer index contacts for RTIs but more follow-up contacts were conducted, compared with 2018-2019. The share of both index and follow-up contacts that were conducted remotely increased. Further studies are needed to study the reasons behind the increase in remote contacts, and if it will last after the pandemic, and more clinical guidelines for remote assessments of RTI are warranted.
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| 30. |
- Peterson, Gunnel, et al.
(författare)
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Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls : A case-control ultrasound study
- 2015
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Ingår i: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 20:2, s. 319-327
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R-2 = 0.14-0.70); to the tenth arm elevation (R-2 = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R-2 < 0.19) during the tenth compared to the first (R-2 < 0.44) arm elevation except for deformations in Lcap/Lco (R-2 = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group. (C) 2014 Elsevier Ltd. All rights reserved.
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