| 1. |
- Hallberg, Lillemor R-M, 1942, et al.
(författare)
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Facing a moral dilemma--introducing a dental care insurance within the public dental service.
- 2012
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Ingår i: Swedish dental journal. - : Swedish dental journal. - 0347-9994. ; 36:3, s. 149-56
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Tidskriftsartikel (refereegranskat)abstract
- Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.
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| 2. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Trends in treatment with antipsychotic medication in relation to national directives, in people with dementia : a review of the Swedish context
- 2017
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Ingår i: BMC Psychiatry. - London : BioMed Central. - 1471-244X. ; 17, s. 1-9
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Forskningsöversikt (refereegranskat)abstract
- Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in nursing homes as reported in the most recent empirical studies on the topic, and to relate these trends to directives from the national authorities. Methods: The study included two scoping review studies based on searches of electronic databases as well as the Swedish directives in the field. Results: During the past decade, directives have been developed for antipsychotic medication in Sweden. These directives were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and in those with moderate cognitive impairment and living in nursing homes for people with dementia. A decreasing trend in antipsychotic use has been seen over the last 15 years. Conclusions: Directives from the authorities in Sweden may have had an impact on treatment with antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while treatment with combinations of psychotropic medications is common. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
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| 3. |
- Pihl, Emma, et al.
(författare)
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Exercise in elderly patients with chronic heart failure in primary care : Effects on physical capacity and health-related quality of life
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - London : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:3, s. 150-158
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). AIM: The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.METHODS: An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12 months.RESULTS: Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. CONCLUSION: This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population. ©Sage Publications
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| 4. |
- Milos Nymberg, Veronica, et al.
(författare)
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HEAD-MIP–(HEAlth Dialogues for patients with Mental Illness in Primary care)—a feasibility study
- 2023
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Ingår i: Pilot and Feasibility Studies. - London : BioMed Central (BMC). - 2055-5784. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, which is partly related to unhealthy lifestyle habits. To individualise lifestyle counselling in primary care, the Swedish-developed Health Dialogue (HD) can be used as an educative tool at recurrent measurement points with the goal to improve non-healthy lifestyle habits. HD has not been aimed specifically at patients with mental illness, and the effect of a systematic approach with repeated HDs in patients with mental illness in primary care has not been previously studied. The aim of this pilot study was to assess the feasibility of the study design for a larger-scale cohort study using repeated HDs focused on the improvement of lifestyle habits in patients seeking primary care due to anxiety, depression, sleeping problems or stress-related symptoms. Methods: Patients were recruited after a visit to a Primary Health Care Center due to mental illness between October 2019 until November 2021 and received a Health Dialogue, including an assessment of cardiovascular risk factors through a Health Curve. Specific feasibility objectives measured were dropout rate, time to follow-up, and risk improvement rate for different lifestyle changes. Results: A total of 64 patients were recruited and 29 (45%) attended a second HD, with a mean follow-up time of 15 months. All participants had at least one elevated cardiovascular risk level on the Health Curve for the assessed lifestyles. Risk level improvement rate was good except for tobacco use. Conclusion: Despite a higher dropout rate than expected, we suggest that the proposed methodology for a full cohort study within general practice of patients with mental illness in primary care is both acceptable to practice and feasible. © 2023, BioMed Central Ltd., part of Springer Nature.
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| 5. |
- Emilson, Christina, et al.
(författare)
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Physical therapists' assessments, analyses and use of behavior change techniques in initial consultations on musculoskeletal pain : direct observations in primary health care
- 2016
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Ingår i: BMC Musculoskeletal Disorders. - London : BIOMED CENTRAL LTD. - 1471-2474. ; 23, s. S187-S187
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Tidskriftsartikel (refereegranskat)abstract
- Background: Behavioral medicine (BM) treatment is recommended to be implemented for pain management in physical therapy. Its implementation requires physical therapists (PTs), who are skilled at performing functional behavioral analyses based on physical, psychological and behavioral assessments. The purpose of the current study was to explore and describe PTs' assessments, analyses and their use of behavioral change techniques (BCTs) in initial consultations with patients who seek primary health care due to musculoskeletal pain. Methods: A descriptive and explorative research design was applied, using data from video recordings of 12 primary health care PTs. A deductive analysis was performed, based on a specific protocol with definitions of PTs' assessment of physical and psychological prognostic factors (red and yellow flags, respectively), analysis of the clinical problem, and use of BCTs. An additional inductive analysis was performed to identify and describe the variation in the PTs' clinical practice. Results: Red and yellow flags were assessed in a majority of the cases. Analyses were mainly based on biomedical assessments and none of the PTs performed functional behavioral analyses. All of the PTs used BCTs, mainly instruction and information, to facilitate physical activity and improved posture. The four most clinically relevant cases were selected to illustrate the variation in the PTs' clinical practice. The results are based on 12 experienced primary health care PTs in Sweden, limiting the generalizability to similar populations and settings. Conclusion: Red and yellow flags were assessed by PTs in the current study, but their interpretation and integration of the findings in analyses and treatment were incomplete, indicating a need of further strategies to implement behavioral medicine in Swedish primary health care physical therapy.
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| 6. |
- Axelsson, Åsa B., 1955, et al.
(författare)
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How bystanders perceive their cardiopulmonary resuscitation intervention : a qualitative study
- 2000
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Ingår i: Resuscitation. - Amsterdam : Elsevier. - 0300-9572 .- 1873-1570. ; 47:1, s. 71-81
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Tidskriftsartikel (refereegranskat)abstract
- The importance of bystander cardiopulmonary resuscitation (CPR) prior to arrival of the emergency medical service is well documented. In Sweden, CPR is initiated prior to emergency medical services (EMS) arrival in about 30% of cardiac arrests out-of-hospital, a figure which should be improved urgently. To do so, it is of interest to know more about the bystanders' perceptions of their intervention. A qualitative method inspired by the phenomenographic approach was applied to 19 bystanders who had performed CPR. In the analysis, five main categories and 14 subcategories emerged. The main categories were: to have a sense of humanity, to have competence, to feel an obligation, to have courage and to feel exposed. Interviews described how humanity and concern for another human being were the foundation of their intervention. CPR training offers the possibility to give appropriate help in this emergency. If the aim of CPR training was extended beyond teaching the skill of CPR to include preparation of the rescuer for the intervention and his/her reactions, this might increase the number of people able to take action in the cardiac arrest situation.
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| 7. |
- Wendt, Eva, et al.
(författare)
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Trust and confirmation in a gynecologic examination situation : A critical incident technique analysis
- 2004
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Copenhagen : Blackwell. - 0001-6349 .- 1600-0412. ; 83, s. 1208-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gynecologic examination is a common measure in reproductive health care. Many women experience the examination as a more or less negative event, with shortcomings in the examiner's behavior. The aim of the study was to describe, in terms of critical incidences, women's experiences concerning the personnel's behavior in the situation of gynecologic examination. Methods. The informants were strategically chosen and consisted of 30 Swedish women between the ages of 18-82 years old. The data collection method was qualitative research interviews analyzed by critical incident technique. Results. The result consisted of 30 subcategories, five categories, and two main areas - trust and confirmation. The personnel enabled trust when they promoted participation, created confidence, and were supportive. The opposite behavior contributed to the lack of trust. Confirmation described behavior that confirmed, respectively, did not confirm the women. This was shown through the presence or lack of respect and engagement. Conclusion. The personnel's positive behavior enabled trust and confirmed the women as individuals, while negative behavior was decisive in an unfavorable way. A complexity of patterns of knowing in nursing was identified. Participation through information that contributed to trust was important and amounted to one fourth of the incidents in the material. Respect and engagement, which confirmed the women, facilitated a positive caring relationship. The examination situation can be improved through reflection of the personnel's own behavior and further research about women's own experiences.
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| 8. |
- Haglund, Emma, 1970-, et al.
(författare)
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Predictors of Presenteeism and Activity Impairment Outside Work in Patients with Spondyloarthritis
- 2015
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Ingår i: Journal of occupational rehabilitation. - New York, NY : Springer-Verlag New York. - 1053-0487 .- 1573-3688. ; 25:2, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Purposes To assess predictors of presenteeism (reduced productivity at work) and activity impairment outside work in patients with spondyloarthritis (SpA). Methods Multivariate logistic regression analysis was used to study predictors of presenteeism and activity impairment in 1,253 patients with SpA based on a 2.5 year follow-up questionnaire. The Work Productivity and Activity Impairment (WPAI) questionnaire was used as main outcome. Age, gender, lifestyle factors, subgroups, disease duration, and different patient reported outcome measures (PROMs) were studied as possible predictors. The association between presenteeism and WPAI activity impairment outside work was assessed. Results Out of 1,253 patients, 757 reported being in work and of these 720 responded to the WPAI questionnaire. The mean (confidence interval, CI) reported presenteeism was 25 % (23-27 %) and mean activity impairment 33 % (31-35 %) (0-100 %, 0 = no reduction). Significant predictors of presenteeism and activity impairment at follow-up (controlled for gender, age, spondyloarthritis subgroups and presenteeism at baseline) were presenteeism at baseline, poor quality of life, worse disease activity, decreased physical function, lower self-efficacy pain and symptom, higher scores of anxiety, depression, smoking and low education level, and for activity impairment also female sex. There was a strong association between presenteeism and activity impairment outside work (OR 16.7; 95 % CI 11.6-24.3; p < 0.001). Conclusions Presenteeism and activity impairment were not only predicted by presenteeism at baseline, but also by several PROMs commonly used in clinical rheumatology practice. Impaired activity outside work could indicate problems also at work suggesting why both areas need to be addressed in the clinical situation. © 2014, Springer Science+Business Media New York.
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| 9. |
- Sant'Anna, Anita, 1983-, et al.
(författare)
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Assessment of Gait Symmetry and Gait Normality Using Inertial Sensors : In-Lab and In-Situ Evaluation
- 2013
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Ingår i: Biomedical Engineering Systems and Technologies. - Heidelberg : Springer Berlin/Heidelberg. - 9783642382550 - 9783642382567 ; 357, s. 239-254
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Bokkapitel (refereegranskat)abstract
- Quantitative gait analysis is a powerful tool for the assessment of a number of physical and cognitive conditions. Unfortunately, the costs involved in providing in-lab 3D kinematic analysis to all patients is prohibitive. Inertial sensors such as accelerometers and gyroscopes may complement in-lab analysis by providing cheaper gait analysis systems that can be deployed anywhere. The present study investigates the use of inertial sensors to quantify gait symmetry and gait normality. The system was evaluated in-lab, against 3D kinematic measurements; and also in-situ, against clinical assessments of hip-replacement patients. Results show that the system not only correlates well with kinematic measurements but it also corroborates various quantitative and qualitative measures of recovery and health status of hip-replacement patients
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| 10. |
- Polymeri, Erini, et al.
(författare)
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Deep learning-based quantification of PET/CT prostate gland uptake : association with overall survival
- 2020
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Ingår i: Clinical Physiology and Functional Imaging. - Chichester : Blackwell Publishing. - 1475-0961 .- 1475-097X. ; 40:2, s. 106-113
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To validate a deep-learning (DL) algorithm for automated quantification of prostate cancer on positron emission tomography/computed tomography (PET/CT) and explore the potential of PET/CT measurements as prognostic biomarkers. Material and methods: Training of the DL-algorithm regarding prostate volume was performed on manually segmented CT images in 100 patients. Validation of the DL-algorithm was carried out in 45 patients with biopsy-proven hormone-naïve prostate cancer. The automated measurements of prostate volume were compared with manual measurements made independently by two observers. PET/CT measurements of tumour burden based on volume and SUV of abnormal voxels were calculated automatically. Voxels in the co-registered 18F-choline PET images above a standardized uptake value (SUV) of 2·65, and corresponding to the prostate as defined by the automated segmentation in the CT images, were defined as abnormal. Validation of abnormal voxels was performed by manual segmentation of radiotracer uptake. Agreement between algorithm and observers regarding prostate volume was analysed by Sørensen-Dice index (SDI). Associations between automatically based PET/CT biomarkers and age, prostate-specific antigen (PSA), Gleason score as well as overall survival were evaluated by a univariate Cox regression model. Results: The SDI between the automated and the manual volume segmentations was 0·78 and 0·79, respectively. Automated PET/CT measures reflecting total lesion uptake and the relation between volume of abnormal voxels and total prostate volume were significantly associated with overall survival (P = 0·02), whereas age, PSA, and Gleason score were not. Conclusion: Automated PET/CT biomarkers showed good agreement to manual measurements and were significantly associated with overall survival. © 2019 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine
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