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Sökning: L773:1403 4948 > (2010-2011) > Refereegranskat > Medicin och hälsovetenskap

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1.
  • Hansson, Anders, 1953-, et al. (författare)
  • Working together--primary care doctors' and nurses' attitudes to collaboration.
  • 2010
  • Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:1, s. 78-85
  • Tidskriftsartikel (refereegranskat)abstract
    • Multidisciplinary teamwork is recommended for various disorders and it has been suggested that it is a way to meet the new challenges and demands facing general practitioners (GPs) in modern society. Attempts to introduce the method in primary care have failed partly due to GPs' unwillingness to participate. The aim of this study was to measure attitudes towards collaboration among GPs and district nurses (DN) and to investigate whether there is a correlation between a positive attitude toward collaboration and high self-esteem in the professional role.
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2.
  • Fors, Stefan, et al. (författare)
  • Live long and prosper? Childhood living conditions, marital status, social class in adulthood and mortality during mid-life : A cohort study
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:2, s. 179-186
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The aim of the present study was to investigate the impact of childhood living conditions, marital status, and social class in adulthood on the risk of mortality during mid-life. Two questions were addressed: Is there an effect of childhood living conditions on mortality risk during mid-life and if so, is the effect mediated or modified by social class and/or marital status in adulthood? Methods: A nationally representative, Swedish, level of living survey from 1968 was used as baseline. The study included those aged 25—69 at baseline (n = 4082). Social conditions in childhood and adulthood were assessed using self-reports. These individuals were then followed for 39 years using registry data on mortality. Results: The results showed associations between childhood living conditions, marital status, social class in adulthood and mortality during mid life. Social class and familial conditions during childhood as well as marital status and social class in adulthood all contributed to the risk of mortality during mid-life. Individuals whose father’s were manual workers, who grew up in broken homes, who were unmarried, and/or were manual workers in adulthood had an increased risk of mortality during mid life. The effects of childhood conditions were, in part, both mediated and modified by social class in adulthood. Conclusions: The findings of this study suggest that there are structural, social conditions experienced at different stages of the life course that affect the risk of mortality during mid-life.
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3.
  • Ostberg, Anna-Lena, et al. (författare)
  • Group treatment of obesity in primary care practice : A qualitative study of patients' perspectives
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 98-105
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To explore patients' experiences of very low calorie diet (VLCD) and subsequent corset treatment of obesity in a primary care setting, and to explore their perceptions of factors influencing weight control. Methods: In western Sweden, five focus group sessions were carried out. The main themes for the discussions were the informants' perceptions of the treatment they had received and their experiences of living with obesity. The analysis was based on the Grounded Theory methodology. Results: The outcomes reflect obese individuals' struggle to handle the demands of their life situation and to recognize their own resources. The core category generated was labelled "Achieving a balance in life and adjusting one's identity". Three categories related to the process of weight reduction were identified: living with obesity, reducing weight and developing self-management. The group treatment with VLCD was positively perceived by the participants, but the corset treatment was considered to be of less value. Conclusions: Maintenance after weight reduction was demanding and the findings indicate a need for extended support. For some individuals the corset treatment could be a psychological support. Follow-up after weight reduction programmes should focus on long-term self-help strategies.
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4.
  • Werntoft, Elisabet, et al. (författare)
  • Lack of support structures in prioritization decision making concerning patients and resources : interviews with Swedish physicians
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 39:6, s. 627-633
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Methods: Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Results: Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: Prioritisation, easier in theory than in practice, and Increasing costs threaten the Swedish welfare model. Conclusions: The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.
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5.
  • André, Malin, et al. (författare)
  • Cohort differences in personality in middle-aged women during a 36-year period. Results from the Population Study of Women in Gothenburg
  • 2010
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 457-464
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To investigate secular trends in personality traits in adult female populations. METHODS: Two representative, population-based cohorts of women, 38 (n = 318) and 50 (n = 593) years of age participated in a health examination in 1968 and 2004 in Gothenburg, Sweden. The Eysenck Personality Inventory (EPI) and Cesarec-Marke Personality Schedule (CMPS) were used to measure personality traits. Socioeconomic and lifestyle variables (personal income, education, marital status, children at home, physical activity and smoking) were reported. RESULTS: In both age groups, secular comparisons in psychological profile subscales showed an increase in dominance, exhibition, aggression and achievement. Only small divergences were seen concerning affiliation, guilt feelings, nurturance and succorance. EPI showed a corresponding rise in extroversion. Social data showed a statistically significant increase in percentage of unmarried women, personal income levels, and higher educational achievement. While around 70% of women in 1968-69 had elementary school education only, around 90% had high school or university education in 2004-05. CONCLUSIONS: The results indicate major transitions in the adult Swedish female population in the direction of a more stereotypically ''male'' personality profile, but not at the expense of traditionally socially important female traits, which remained constant. These results are consistent with the hypothesis that society and the environment influence personality.
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6.
  • van den Bosch, Matilda, et al. (författare)
  • Nature-assisted therapy: Systematic review of controlled and observational studies
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 371-388
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Nature's potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. Methods: This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. Results: The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. Conclusions: This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.
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7.
  • Werntoft, Elisabet, et al. (författare)
  • Lack of support structures in prioritization decision making concerning patients and resources : interviews with Swedish physicians
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications Ltd. - 1403-4948 .- 1651-1905. ; 39:6, s. 627-633
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Methods: Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Results: Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: Prioritisation, easier in theory than in practice, and Increasing costs threaten the Swedish welfare model. Conclusions: The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.
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8.
  • Aglen, B., et al. (författare)
  • Self-help and self-help groups for people with long-lasting health problems or mental health difficulties in a Nordic context : A review
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:8, s. 813-822
  • Forskningsöversikt (refereegranskat)abstract
    • Aim: The aim of this review is to provide systematic knowledge of research from Nordic countries about the meaning of self-help and self-help groups when these are used as a concept or method addressing issues related to long-lasting health problems or mental health difficulties. Methods: Included were studies conducted in the Nordic countries that were published between January 1999 and September 2009. These studies investigated self-help and self-help groups addressing issues related to long-lasting health problems. Results: A total of 83 publications met the inclusion criteria. Four major characteristics of self-help were found to be present in the publications: self-help as an intrapsychological process, self-help as an interpsychological or group process, self-help as a coping, individual learning or empowerment process, and self-help as an alternative or complement to medical treatment. Of the 83 studies, 72 publications used a professional treatment perspective for studying self-help and 11 publications used a perspective derived from alternative or complementary therapies. Conclusions: The review shows that most of the research on self-help and self-help groups for people with long-lasting health problems or disability is conducted with an interest to improve the professional healthcare system. That is, the health-promotion strategy is mainly considered in the framework of treatment or care settings. This means that self-help in this context does not challenge the dominant biomedical health model. © 2011 the Nordic Societies of Public Health.
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9.
  • Deogan, Charlotte L., et al. (författare)
  • A cost-effectiveness analysis of the Chlamydia Monday A community-based intervention to decrease the prevalence of chlamydia in Sweden
  • 2010
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; 38:2, s. 141-150
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The study was undertaken to assess the cost-effectiveness of the Chlamydia Monday, 2007. This is a community-based intervention aimed at reducing the prevalence of chlamydia by information and increased availability of testing, treatment and contact tracing in Stockholm. The aim was to analyze the cost-effectiveness by estimating costs, savings and effects on health associated with the intervention, and to determine if cost-effectiveness varies between men and women. Methods: A societal perspective was adopted, meaning all significant costs and consequences were taken into consideration, regardless of who experienced them. A cost-effectiveness model was constructed including costs of the intervention, savings due to avoiding potential costs associated with medical sequels of chlamydia infection, and health gains measured as quality adjusted life years (QALY). Sensitivity analyses were done to explore model and result uncertainty. Results: Total costs were calculated to be (sic)66,787.21; total savings to (sic)30,370.14; and total health gains to 9.852324 QALYs (undiscounted figures). The discounted cost per QALY was (sic)8,346.05 ((sic)10,810.77/QALY for women and (sic)6,085.35/QALY for men). Sensitivity analyses included changes in effectiveness, variation of prevalence, reduced risk of sequel progression, inclusion of prevented future production loss and shortened duration for chronic conditions. The cost per QALY was consistently less than (sic)50,000, which is often regarded as cost-effective in a Swedish context. Conclusions: The Chlamydia Monday has been demonstrated by this study to be a cost-effective intervention and should be considered a wise use of society's resources.
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10.
  • Gusdal, Annelie K, 1963-, et al. (författare)
  • District nurses' use for an assessment tool in their daily work with elderly patients' medication management
  • 2011
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:4, s. 354-360
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To explore the capability of the Safe Medication Assessment (SMA) tool in identifying factors highly related to unsafe medication management among elderly patients and to investigate the district nurses' (DNs) opinions of the SMA's usefulness as a tool in their daily primary healthcare practice. Introduction: Elderly patients who experience many medical conditions often use multiple drugs. As well as the combined decline in physical and cognitive functions, the elderly are at high risk for medication-related problems. It is essential to develop a screening procedure to distinguish elderly at risk of an unsafe medication management.METHODS: An explorative study. During a 3-6-month period, 25 voluntary DNs used SMA with 160 patients (consecutively chosen and meeting four specified criteria) in their daily practice. Furthermore, DNs responded to questions regarding SMA's usefulness.RESULTS: The result showed that SMA had the capability to identify factors highly related to unsafe medication management among the elderly included in the study. In 64% of assessments DNs identified areas of new information and in 23% of the assessments DNs intervened. They found SMA to be satisfactory regarding its level of simplicity, relevance, completeness, intelligibility, and time for implementation.CONCLUSIONS: SMA alerted the DNs to patients' attitudes about medication and empowered them in identifying elderly patients who had unsafe medication management. SMA was also perceived as a useful assessment tool by the DNs.
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