| 1. |
- Addelyan Rasi, Hamideh, 1975-
(författare)
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Empowering Women in the Middle East by Psychosocial Interventions : Can provision of learning spaces in individual and group sessions and teaching of coping strategies improve women’s quality of life?
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: This study set out to construct a conceptual framework that can be used in social work with women in the Middle East and other settings where women have limited access to resources, which, as a result, limits their decision-making capacity. The framework has both an empirical and a theoretical base. The empirical base comprises data from two intervention projects among Iranian women: single mothers and newly married women. The theoretical base is drawn from relevant psychological and social work theories and is harmonized with the empirical data. Psychosocial intervention projects, based on learning spaces for coping strategies, were organized to assess if Iranian women could use a problemsolving model (i.e. focused on cognition and emotion simultaneously) to effectively and independently meet challenges in their own lives and improve their quality of life.Methods: Descriptive qualitative and quasi-experimental quantitative methods were used for data collection and analysis. Forty-four single mothers and newly married women from social welfare services were allocated to nonrandomized intervention and comparison groups. The intervention groups were invited to participate in a 7-month psychosocial intervention; the comparison groups were provided with treatment as usual by the social welfare services. The WHOQOL-BREF instrument was used to measure quality of life, comparing each intervention groups’ scores before and after the intervention and with respective comparison groups. In addition, content analysis and constant comparative analysis were performed on the qualitative data collected from the participants before, during and after the intervention.Results: The results of the quasi-experimental study show significant and large effect sizes among the women exposed to the intervention. Small and not statistically significant effect sizes were observed in the women provided with traditional social welfare services. Accordingly, teaching coping strategies can be a means to improve the quality of life of women in societies where gender discrimination is prevalent. The qualitative findings from the Iranian projects illustrate a process of change —socio-cognitive empowerment— with regard to thinking, feeling and acting among women during and after the intervention. The women developed a number of mental capacities essential to coping and life management. All women used the model effectively, and consequently, made more deliberate decisions to improve their life situations.Conclusion: The practical lessons from the Iranian projects highlight the possibilities of empowering women through fostering mindfulness and deliberate decision making as well as achieving consciousness. This study provides provisional evidence that psychosocial intervention projects, based on learning spaces for coping strategies, can help many clients to achieve their goals and improve their quality of life, and that this psychosocial intervention project can be a useful model for social work practice with women in the Middle East. The conceptual framework can help social workers to bridge the gap between theory and practice: that is, to draw from existing social work theories and, through the psychosocial intervention model, better apply this knowledge in their practical work with women in challenging social environments.
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| 2. |
- Ekberg, Joakim, 1976-
(författare)
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Online health promoting communities : Design, implementation and formative evaluation of an intervention
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden, obesity among children has not yet reached the epidemic proportions reported from other parts of the world. However, among adolescents, being overweight and self-consciousness regarding body shape, diet and exercise influence social, psychological and physical health. Obese children may be in need of secondary prevention because of adverse effects related to obesity, but it is less obvious exactly what to prevent in the rest of the population. General interventions to prevent overweight and obesity are problematic because of the lack of associations for general application; there is a need for personalized community-based health promotion. Online interventions are especially suitable considering the amount of time adolescents spend online.This thesis takes a design approach to interventions and describes the design of an online health promoting community as a path to health promotion among adolescents. The first two studies use data from the first 15 years of a 1991 cohort living in Östergötland to determine the predictability of obesity from childhood body mass index and to investigate interventions and available evidence to suggest appropriate interventions. The next two studies use these findings to design and formatively evaluate a health promotion intervention.In Study I we found reasons for offering population-based interventions systematically from 5 years of age. It would be worthwhile identifying at an early age those relatively few children with substantially increased risk of maintaining obesity in adulthood and offering them interventions; but interventions must be avoided when they are not necessary. The projections in Study II indicate that more specified interventions would benefit adolescents without increasing the costs. In Study III, we found than an online health promoting community can be designed simply at relatively low cost and can be negotiated to satisfy both the needs of the user community and public health goals and service capabilities. In Study IV, a checklist for pre-launch evaluation of online health promoting communities was developed and the most important result was the delicate balance between community autonomy and quality control. Future studies addressing health outcome constructs for use in online health promoting community evaluations are warranted.
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| 3. |
- Grahn Kronhed, Ann-Charlotte, 1954-
(författare)
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Community-based osteoporosis prevention: Physical activity in relation to bone density, fall prevention, and the effect of training programmes : The Vadstena Osteoporosis Prevention Project
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is based on studies of the ten-year community-based intervention programme entitled, the Vadstena Osteoporosis Prevention Project (VOPP). The specific aims of the research were to describe the effects of physical activity and training programmes on bone mass and balance performance in adults, to determine whether a fall risk prevention programme could motivate personal actions among the elderly, to ascertain whether the intervention programme could reduce the incidence of forearm and hip fractures.Two studies addressed training programmes for middle-aged and old people. First, VOPP participants who were aged 40–70 years and had low forearm bone mineral density (BMD) values were invited to take part in a one-year weight-bearing training study. Thirty of those individuals were included in the investigation. Additional bone mass measurements were performed at the hip and the lumbar spine, and balance and aerobic capacity were also tested. The training programme was performed twice a week (I). In the second study, healthy persons aged 70–75 years were invited to participate in a balance-training study. Fifteen persons joined an exercise group, and another fifteen were controls. The training programme comprised specific balance exercises and was carried out twice a week for nine weeks (II). The association between forearm BMD values and several lifestyle factors was explored in random samples of the population aged 20–72 years (n=880) in a cross-sectional study (III). Another study explored the association between calcaneal stiffness, forearm BMD, and lifestyle factors amongst participants aged 20–79 years (n=956) at the final registration of the VOPP (V). Effects of the VOPP interventions directed at environmental risk factors for falls and the promotion of physical activity were examined in people aged ≥ 65 years (IV). The incidence of forearm and hip fractures was studied amongst middle-aged and elderly individuals in the intervention and the control communities during the study period 1987–2001 (VI).The exercise group (n=15) in the weight-bearing training study showed increases in BMD at the greater trochanter (p<0.01), one-leg stance balance with the eyes closed and coordination tests (p<0.05), and aerobic capacity (p<0.05). No significant difference was found when the groups were compared concerning changes in the different tests during the intervention period (I). In the balance-training study, the exercise group showed post-training improvement in the following tests: standing on the right leg with eyes closed (p<0.01), standing on the right leg (p<0.01) and on the left leg (p<0.05) while turning the head, and walking 30 metres (p<0.01). There were significant differences between the groups in these tests when changes were compared at the post-intervention test (II). Age (p<0.0001) and body mass index (p≤.0001) were associated with forearm BMD in both sexes. Reported moderate physical activity levels in men were positively associated with forearm BMD (p<0.05) (III). In both sexes, reported moderate (p<0.05) and high (women p<0.05 and men p<0.001) physical activity levels were positively associated with calcaneal stiffness. The correlation coefficient between forearm BMD and calcaneal stiffness was 0.58 in women and 0.34 in men (V). Persons aged ≥ 65 years at the follow-up in 1994 reported more use of shoe/cane spikesand moderate physical activity levels compared to controls (IV). There was no change in the general incidence of forearm and hip fractures between the communities for the study period. However, there was a tendency towards decreasing incidence of forearm and trochanteric hip fracture in both sexes during the late intervention period in the intervention community (VI).A community-based intervention programme aimed at reducing the incidence of osteoporotic fractures must be regarded as a long-term project and should preferably be monitored over an extended post-intervention period.
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| 4. |
- Jacobsson, Jenny
(författare)
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Towards systematic prevention of athletics injuries : Use of clinical epidemiology for evidence-based injury prevention
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this thesis were to outline the design protocol for a prospective clinical epidemiological study of injuries among athletics athletes; study the 1-year prevalence, the point prevalence and incidence of injuries in total cohorts of Swedish elite adult and talented youth athletics athletes; pinpoint the risk indicators and factors for different injury types/patterns in athletics.In paper I, an argument-based method to investigate complex design problems was used to structure the collection and analysis of data. A requirement analysis showed that a central requirement of an injury surveillance protocol for elite athletics should allow for detailed epidemiological analyses of overuse injuries, requiring self-reported data from athletes. The resulting study protocol was centred on a web-based weekly athlete e-diary enabling continuous collection of individual-level data on exposure and injuries.In paper II, the prevalence of injuries was examined and 278 athletes (87%) of the enrolled study population submitted their assessments via the web survey. The overall 1-year retrospective injury prevalence was 42.8% (95% CI 36.9–49.0%). The point prevalence of ongoing injury was 35.4% (95% CI 29.7–41.4%). The 1-year injury prevalence showed a tendency to vary with regard to gender and age (p = 0.11). The diagnostic group that displayed the highest 1-year prevalence (20.9%, 95% CI 16.2–22.2%) and point prevalence (23.2%, 95% CI 18.4–28.7%) of injury was inflammation and pain with gradual onset.In paper III, during the 52-week period, 292 athletes (91% of the study population) submitted weekly reports reporting a cumulative injury incidence of 3.57 injuries per 1000 hours of exposure to athletics. Most injuries (73%) were reported from training. There was a statistically significant difference with regard to gender and age in the proportion of athletes who avoided injury (P=0.043). Differences between event groups could not be statistically demonstrated (P=0.937). Ninety-six percent of the reported injuries were nontraumatic (associated with overuse). About every second injury (51%) was severe, causing a period of absence from normal training exceeding 3 weeks. Seventy-seven percent of the injuries occurred in lower extremities.In paper IV, 199 (68%) athletes reported an injury during the study year. The median time to first injury was 101 days (95% confidence interval (CI) 75–127). Univariate log-rank tests revealed risk differences with regard to athlete category (p = 0.046), serious injury (>3 weeks time loss) during the previous season (p = 0.039) and training load rank index (TLRI) (p = 0.019). Athletes in the third and fourth TLRI quartile had almost a twofold increased risk of injury compared to the first quartile. Youth male athletes with a previous serious injury had more than a fourfold increased risk of injury compared with youth females with no previous injury.
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| 5. |
- Kullberg, Agneta, 1955-
(författare)
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My Home is my Castle : Residential Well being and Perceived Safety in Different Types of Housing Areas in Sweden
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Safety in the housing environment is a basic human need and may be a prerequisite for health but studies from the perspective of the residents are limited in the literature. Although historically public health research has recognized the housing environment as an important determinant of health, there is a need for more research on how housing conditions influence residential well-being.Aim: The overall aim of this thesis was to examine factors and conditions associated with residential well-being and perceived safety in different types of housing areas and to compare safety promotion intervention designs based on residents self-expressed safety needs with corresponding designs developed by local government professionals.Materials and methods: A postal survey (response rate 56%, n=2476) and 11 focus groups (57 participants) were conducted among the residents in 3 small-scale housing areas with detached houses and 3 housing areas with blocks of flats in a Swedish municipality. The areas were geographically contiguous as each of the small-scale areas bordered on an area with blocks of flats. The study municipality is a designated member of WHO Safe Community network that have signed up to work in line with the indicators developed by WHO Collaborating Centre on Community Safety Promotion. Narrative data from a postal questionnaire were used to analyze the lay perspective and identify features perceived to be necessary to feel safe by residents in areas with blocks of flats and small-scale housing areas. Quantitative data were used to examine correlates of local safety-related concerns through a factor analysis. Logistic regression analysis examined associations between high-level scores of the safetyrelated dimensions found and area-level crime rate and being a victim of crime, area reputation, gender, age, education, country of birth, household civil status and type of housing. To examine how self-assessed area reputation is associated with social trust and residential well-being, a multilevel logistic regression analysis was performed using quantitative data, controlling for the random effect of neighbourhood- and individual-level socio-demographic factors. Data from focus group interviews were analyzed to identify mechanisms of how neighbourhood reputation was established. The quality function deployment (QFD) technique was used in a case study to integrate residents’ demands into the design of safety promotion interventions in housing areas. The resulting design was then compared with the safety intervention programme designed by professionals at the municipality administrative office. The results from this comparison were then investigated to identify improvements for the indicators for Safe Homes in the Safe Community programme.Results: The residents’ narratives showed that 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 small-scale housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. The crime rates were lower and safety-related concerns were less in small-scale housing areas. Three composite dimensions (CD) of perceived residential safety were identified: structural indicators of social disorder (CD 1); contact with disorderly behaviour (CD 2); and existential insecurity (CD 3). Area-level crime rates and individual-level variables were associated with dimensions (CD 1) and (CD 3), but only individuallevel variables were associated with dimension (CD 2). The level of residential well-being and social trust was higher in small-scale areas. The housing area reputation was found to be strongly associated with safety-related concerns, residential well-being and social trust. The area reputation also seemed to be a determinant of position in the local social structure; residents were found to position themselves in a rank order. The QFD analysis showed that the initiation and maintenance of social integrative processes in housing areas were the most highly prioritized interventions among the residents, but the analysis did not highlight the safety needs of several vulnerable groups. The Safe Community programme designed by professionals did not address the social integrative processes, but did cover the vulnerable groups.Conclusions: Area reputation is an important and probably underestimated dimension in the development of residential well-being and perceived safety. The QFD technique can be added to the methodological toolbox for residential safety promotion. The technique is particular suitable for providing a quality orientation from the lay perspective on safety promotion in local residential areas. The current Safe Homes concept in the Safe Community programme would benefit from being widened to Safe Housing.
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| 6. |
- Nilsen, Per, 1960-
(författare)
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Opening the Black Box of Community-Based Injury Prevention Programmes : Towards Improved Understanding of Factors that Influence Programme Effectiveness
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite wide application of community-based programmes to prevent injuries and promote health over the last 25 years, there is a paucity of evaluations from which to obtain evidence regarding the effectiveness and critical factors contributing to achieving effectiveness of these programmes. Research on community-based injury prevention programmes thus far has been driven by the question “does it work?” However, merely establishing whether a programme works or not provides insufficient information to generate new knowledge about these programmes. Many programme evaluations have been characterised as “black box” evaluations, with inadequate information about the intervening and contextual factors that mediate the relationship between the programme and its effects. Opening the black box is essential to developing the best evidence in relation to community-based programmes.Keeping the question “does it work?” in mind as a departure point, the seven studies of this thesis address different aspects of the questions “why does it work?” and “how does it work?” The aim is to aid in the understanding of factors that influence the operation and effectiveness of community-based injury prevention programmes.The findings from the studies support a number of conclusions with regard to the three research questions posed. There is limited evidence for the effectiveness of communitybased injury prevention programmes. Some of the problems of providing convincing evidence are due to the methodological difficulties of evaluating these programs.Contextual conditions and the amount of financial resources available to a programme are key factors associated with the effectiveness of community-based injury prevention programmes. There is inconclusive evidence regarding the importance of some of the socalled success factors described in the scientific literature for achieving effectiveness. While many programmes have access to locally collected injury data, they devote limited time to the analysis of this ssembled data. When selecting interventions, many programmes rely upon tuitive and subjective methods, e.g. discussions in networks, feedback from the general public, and experiences gained in their own work. This style of decision making is “experience-based” rather than evidence-based.The theoretical underpinning of the community-based approach has certain shortcomings, which could explain some of the difficulties in demonstrating effectiveness seen with many of these programmes. Programmes overwhelmingly define geographical units as communities. However, these entities can be highly heterogeneous and characterised by a weak sense of community, which can yield insufficient community member participation and intersectoral collaboration, as well as inadequate reach for many programmes. At the same time, none of the most plausible assumptions of the community-based approach appears to be fully or widely applied in programme practice. The implication is that many community-based programmes do not function at an optimum level.
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| 7. |
- Olsen Faresjö, Åshild
(författare)
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Irritable bowel syndrome diagnosed in primary care : Occurrence, treatment and impact on everyday life
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: IBS is the most common functional gastrointestinal disorders and affects approximately 10-20 % of the general population and is widespread in all societies and socio-economic groups. Although the disorder does not have a life-threatening course, it still seriously affects the patients in their everyday life.Aim: The general aims of this thesis were to estimate the occurrence of irritable bowel syndrome in the general population and to achieve a better understanding of present treatment of this disorder and impact on every-day life in those suffering from IBS.Material and methods: The LIPS study comprises two parts. Part I was a retrospective register study where the data collection was based on computerised medical records at three selected Primary Health Care centres in a defined region. Part II was a population based case-control study. The identified IBS cases from part I constitute the cases, while their control groups were randomly selected from the population census register in the same area as the cases. Data in part II were collected by means of a postal questionnaire to cases and controls. The study was conducted in Linköping, a city located in the south-east of Sweden with 135 000 inhabitants.Results: The female IBS patients reported lower influence on planning their work and working hours as well as fewer opportunities to learn new things at their work compared to their controls, even after adjustments in multiple logistic regressions for potential confounders like; mood, sleeping problems and perceived health. The female IBS patients had considerably lower HRQOL in all dimensions compared to their controls, even when compared to male patients. Younger female IBS cases (18-44 years) reported lower mental health on the SF-36 scale than the older IBS female cases (p=0.015). In the multivariate analysis these variables, lack of influence on planning the work, family history of IBS, anxiety and sleeping disturbance displayed an association with being diagnosed with IBS in women. In men, lack of influence on working pace, family history of IBS was associated with an IBS diagnosis.The consultation incidence of IBS in part I was 3.4 (95% CI 3.20-3.70) per 1000 person-years for all IBS cases, among females; the incidence rate was 4.6 per 1000 person-years (95% CI 4.16-4.97) and males; 2.3 per 1000 person-years (95% CI 2.01-2.59). The dominating pharmacological treatment prescribed for abdominal complaints were fibre and bulking laxatives agents as well as acid suppressive drugs. These variables had an independent impact on the probability of a follow-up consultation; diagnosed co-morbidity besides the IBS diagnosis, rectoscopy ordered and laboratory tests ordered.Conclusions: IBS patients identified in primary care are significantly affected in their working-life compared to individuals in the general population. Especially female IBS-patients report lower decision latitude at work and they also appear to have a particularly impaired psychosocial functioning in their every day life and impaired HRQOL. Factors associated with IBS diagnosis among females are anxiety as well as family history of IBS and lack of co-determination at work.The incidence rate of IBS was 3.4 per 1000 person-years which increased with age and with an overrepresentation of females. IBS patients did not appear to be heavy utilisers of primary care and those who attended were treated by their GP without further consultation. The strongest predictors for having a follow-up consultation were diagnosed co-morbidity, rectoscopy and laboratory tests ordered
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| 8. |
- Spreco, Armin
(författare)
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Epidemiological and statistical basis for detection and prediction of influenza epidemics
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A large number of emerging infectious diseases (including influenza epidemics) has been identified during the last century. The emergence and re-emergence of infectious diseases have a negative impact on global health. Influenza epidemics alone cause between 3 and 5 million cases of severe illness annually, and between 250,000 and 500,000 deaths. In addition to the human suffering, influenza epidemics also impose heavy demands on the health care system. For example, hospitals and intensive care units have limited excess capacity during infectious diseases epidemics. Therefore, it is important that increased influenza activity is noticed early at local levels to allow time to adjust primary care and hospital resources that are already under pressure. Algorithms for the detection and prediction of influenza epidemics are essential components to achieve this.Although a large number of studies have reported algorithms for detection or prediction of influenza epidemics, outputs that fulfil standard criteria for operational readiness are seldom produced. Furthermore, in the light of the rapidly growing availability of “Big Data” from both diagnostic and prediagnostic (syndromic) data sources in health care and public health settings, a new generation of epidemiologic and statistical methods, using several data sources, is desired for reliable analyses and modeling.The rationale for this thesis was to inform the planning of local response measures and adjustments to health care capacity during influenza epidemics. The overall aim was to develop a method for detection and prediction of influenza epidemics. Before developing the method, three preparatory studies were performed. In the first of these studies, the associations (in terms of correlation) between diagnostic and pre-diagnostic data sources were examined, with the aim of investigating the potential of these sources for use in influenza surveillance systems. In the second study, a literature study of detection and prediction algorithms used in the field of influenza surveillance was performed. In the third study, the algorithms found in the previous study were compared in a prospective evaluation study. In the fourth study, a method for nowcasting of influenza activity was developed using electronically available data for real-time surveillance in local settings followed by retrospective application on the same data. This method includes three functions: detection of the start of the epidemic at the local level and predictions of the peak timing and the peak intensity. In the fifth and final study, the nowcasting method was evaluated by prospective application on authentic data from Östergötland County, Sweden.In the first study, correlations with large effect sizes between diagnostic and pre-diagnostic data were found, indicating that pre-diagnostic data sources have potential for use in influenza surveillance systems. However, it was concluded that further longitudinal research incorporating prospective evaluations is required before these sources can be used for this purpose. In the second study, a meta-narrative review approach was used in which two narratives for reporting prospective evaluation of influenza detection and prediction algorithms were identified: the biodefence informatics narrative and the health policy research narrative. As a result of the promising performances of one detection algorithm and one prediction algorithm in the third study, it was concluded that both further evaluation research and research on methods for nowcasting of influenza activity were warranted. In the fourth study, the performance of the nowcasting method was promising when applied on retrospective data but it was concluded that thorough prospective evaluations are necessary before recommending the method for broader use. In the fifth study, the performance of the nowcasting method was promising when prospectively applied on authentic data, implying that the method has potential for routine use. In future studies, the validity of the nowcasting method must be investigated by application and further evaluation in multiple local settings, including large urbanizations.
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| 9. |
- Timpka, Toomas, 1957-
(författare)
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Design of computer-based decision support for general practitioners
- 1989
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Most computer-based decision support systems (DSSs) in medicine have been developed in hospital settings, intended for use in hospitals. In this study, a DSS for general practitioners (GPs) in primary care is designed, taking into consideration that primary care is the first level in a health care organization. Female genitourinary (GU) infections is chosen as prototype area for the study of decisionmaking. There are three primary data sources used for this study: 1. Decision protocols were obtained from 11 GPs after 139 GU consultations. A decision certainty estimate and an estimate by the GP of the patient's desire to go through GU work-up was included. 2. A nine-physician panel evaluated 63 of these protocols. Individually, the panel completed a similar decision protncol without access to the GP's decisions. 3. Questionnaires were responded to by 186 primary care physicians regarding information needs and attitudes towards computer support. The critical incident technique is used to identify information dilemmas. Discriminant analysis is used to identify dati items used by the GPs to differentiate between decision alternatives. The kappa coefficient is used as measure of inter-physician decision variability in the panel. From a theoretical review, a model is establisbed,of which knowledge types the GP uses and the forms in which this knowledge is used in daily practice:Not all types of knowledge relevant to the GP are available in forms amenable to computer manipulation. Doctor-patient communication skills are, for instance, tacit and acquired through professional experience. The main empirical results of this study are that: I. The GPs rely heavily on laboratory data in their decisions. However, they fail to use negative evidence. Orthogonal patient desire is a major source of uncertainty. 2. The urethritis diagnosis is used inconsistently. 3. There are considerable differences between individual physicians in their use of medical concepts. In one case out of four, no consensus diagnosis is available at all. 4. Dilemmas in general inte'rnal medicine are the most prevalent medicaldilemmas for the GP, and support for drug prescription and access to full-text databases are the computer applications most desired. A design of the DSS is described, which consists of five integrated components: a hypertext module, a critiquing program for support of drug prescriptions, diagnosis support of reconsider type, an interface to computer-based library and communication resources, and a central database. The design is implemented in experimental form. Organizational changes to facilitate decision-making and a theoretical model of the GP's information use arc discussed.
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| 10. |
- Wilhelmsson, Margaretha, 1948-
(författare)
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Developing Interprofessional Competence : Theoretical and Empirical Contributions
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Different professions meet and work together in teams every day in health and social care. In order to idenUiy and deliver the best quality of care for the patient, the teamworkers need to be both professionally and interprofessionally competent. How can higher education prepare teamworkers to be both professionillly and interprofcssionally competent? This thesis seeks to contribute theoretically and empirically to this issuc. A starting point for interprofessional education (WE) worldwide was when WHO presented a document entitled "Leaming Together to Work Together for Bdter Health". The basic idea in this strateg)' was that it is favourable for undergraduilte students and the development of their own professionill identity to experience other professions in health and sodal sectors as earlyas during their undcrgraduate studies. Inherent in this scheme is that the various professions will work together in practice. Thc overall winner in this new thinking about education and professionai prLlctice would be the patient. One of the Hrst systematic attempts to organize IPE academically was initiated in 1986 at the Faculty of Health Sciences (FHS) at Linköping University in Sweden. The "Linköping Model" has now yielded 25 yeilrs of practical experience and development of IPE curricula.Aims: The overall aims of this thesis we.re to define, describe and measure effects and outcomes of interprofessional education/learning.Methods: In the research papers theoretical, aualitative and quantitative methods have been used.Results: The newly registered medical doctors educated at the FHS at Linköping University and exposed to WE and PBL reported more confidence (p < 0.0001) that their lIndergraduate studies had given them interprofessional skilIs and abilities to collaborate with other professions than medical students from all other medical faculties in Sweden. Nurses who hild been exposed to interprofessional curricula during their undergraduate education ilt FHS reported to greater extent (p = 0.003) that they were prepared to work as a nurse. Furthermore, they also reported to a greater extent (p < 0.0001) that their undergraduate education hild prepared them to work with other healt care professions. Other findings in this thesis wcre that female tudents in generill and nursing students had a more positive view of interprofessional learning and were more open-minded about collaboration with other professions. Only to a minor extent did exposure to a more extensive interprofessional curriculum promote a positive attitude towards teamwork.Conclusions: A major challenge to modern health care is the need for more interprofessional teamwork to improve the safety and quality of patient-centred care. This thesis indicates some directions for more successful interprofessional education.
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