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Sökning: LAR1:gu > Göteborgs universitet > Waern Margda 1955 > Engelska

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  • Ali, Lilas, 1981-, et al. (författare)
  • Person-centred psychosis care in the inpatient setting:Staff experiences of an educational intervention.
  • 2016
  • Ingår i: International Forum on Quality and Safety in Health Care. Gothenburg, Sweden 12-15 April 2016.
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Introduction: The key component in this research project is to test and implement a person-centred psychosis care approach that leads to an active partnership between health professionals and patients. Only by transforming the relationship between the patient and the care provider from the present state of dependency into an equal partnership can we achieve a more effective care model with enhanced financial efficacy and patient self-efficacy. Person-centred psychosis care means to shift away from a model in which the patient is the passive target of a medical intervention to a model where a contractual arrangement is made involving the patient as an active part in the care and the decision-making process. The patient illness narrative is the starting point for building a collaborative, equalitarian health professional-patient partnership that confirms capacities in patients. The patient narrative is the patient´s account of his/her illness, symptoms, and the impact on life. Finally the narrative and agreed partnership needs to be documented in order to secure further care. Methods: The person centered care intervention will be implemented at all four in-patient wards at the Psychosis clinic. An implementation group has been formed and representatives from the four wards are included in this group (section leaders, heads of the wards, and senior ward psychiatrists). The implementation group makes decisions regarding the organization and content of the staff education sessions. The research process has a participatory design which is structured by the foundation pillars in the gPCC model and composes of four workshops together with 33% of the staff in the psychosis care wards, at the department of psychosis, Sahlgrenska University Hospital. All workshops focus on person-centred care and how to implement this care approach at all four in-patient wards at the Psychosis clinic. Now that the educational intervention has been completed it is in our belief that the care offered on the ward is more person-centred. This project will explore this with a simple “before” and “after” design. The primary outcome will be patient empowerment as measured by the “Making Decisions Empowerment Scale”. This scale been validated and used internationally in studies involving persons with severe mental ill-health. Results: All the participants in this project have completed the second phase of the gPCC implementation model and they have agreed on person-centred tasks to implement in their units. Our hypothesis is that persons who receive inpatient treatment after the implementation of the intervention will score higher on ratings of empowerment and consumer satisfaction than those on the “pre-intervention” wards. Further, we hypothesize that shorter hospital stays and less use of involuntary treatments will be observed on the post-intervention wards. Discussion: A person-centered care approach can increase partnership between mental health service users and providers. A basic tenant of person-centered care is that the patient is seen as a capable person who has self-respect and self-esteem. A key element in person-centred care is the dialogue between the professional and the patient, a dialogue with the person, rather than talking to (or informing) a person. The staff education package in itself provides us with an excellent opportunity for transfer of research findings into the care setting. The members of the teaching staff are used as active researchers who will incorporate results from ongoing of the teacher’s results from our ongoing clinical projects on cognition, adherence, and stigma.
  • Allerby, K., et al. (författare)
  • Stigma and burden among relatives of persons with schizophrenia: Results from the Swedish COAST study
  • 2015
  • Ingår i: Psychiatric Services. - 1075-2730. ; 66:10, s. 1020-1026
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim was to apply a structured questionnaire, the Inventory of Stigmatizing Experiences (ISE), to study experiences of stigma (associated stigma) among relatives of persons with schizophrenia who attended outpatient clinics, using an approach based on assertive community treatment in a Swedish major city. A second aim was to explore the relationship between associated stigma and overall burden among these relatives. Methods: Relatives (N=65) of persons taking oral antipsychoticswho attended outpatient clinics completed a mailed questionnaire that included the ISE and the Burden Inventory for Relatives of Persons with Psychotic Disturbances. Associations were analyzed with ordinal logistic regression. Results: More than half of the relatives (53%) stated that their ill relative had been stigmatized, but only 18% (N=11) reported that they themselves had been stigmatized (responses of sometimes, often, or always). One-fifth of the relatives (23%) acknowledged that they avoided situations that might elicit stigma. Neither experienced stigma nor anticipated stigma was associated with overall burden level in ordinal logistic regression models. The impact of stigma on both the relative's personal quality of life and the family's quality of life were both significantly associated with overall burden after adjustment for patient age and level of functioning. Conclusions: Stigma had an impact on quality of life at the personal and family levels, and this was associated with overall burden. Increased awareness among service providers may decrease the impact of stigma on relatives, but associations need to be examined in larger studies in diverse cultures and treatment settings.
  • Andersson, Christina, 1955-, et al. (författare)
  • Drinking context and problematic alcohol consumption in young Swedish women
  • 2013
  • Ingår i: Addiction Research and Theory. - 1606-6359. ; 21:6, s. 457-468
  • Tidskriftsartikel (refereegranskat)abstract
    • Previous research has indicated that a variety of contextual factors are involved in the development of drinking behavior. An integrated perspective can extend our understanding of the context and circumstances in which individuals drink. In this study, a person-oriented approach, cluster analysis, was used to identify drinking context clusters in a population of 20- and 25-year-old Swedish women. A further aim was to analyze how these clusters were associated with problematic alcohol consumption (high episodic drinking (HED) and alcohol use disorder (AUD)). A total of 760 respondents were interviewed, some in 1996 and some in 2001. Self-reported effects of drinking and situational factors associated with drinking alcohol were used in the cluster analysis procedure. Logistic regression models were used to analyze the associations with problematic alcohol consumption. The results revealed four distinct clusters of drinking patterns: coping drinkers, social drinkers, controlled drinkers, and moderate drinkers. Differences between clusters concerning problematic alcohol consumption were found. HED was significantly more common among the social drinkers and alcohol use disorder was more prevalent among the coping drinkers. Age differences and to a lesser extent secular trends in drinking pattern could be observed. The findings suggest that information on drinking context can help to explain differences in patterns of risky drinking and AUD. This highlights the importance of identifying groups of individuals with potentially harmful drinking patterns, which could be the target of specific preventive actions.
  • Andersson Sundell, Karolina, 1978-, et al. (författare)
  • Socio-economic determinants of early discontinuation of anti-depressant treatment in young adults.
  • 2013
  • Ingår i: European journal of public health. - 1464-360X. ; 23:3, s. 433-440
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Early discontinuation of anti-depressant treatment is common. This study analysed whether socio-economic factors influence early discontinuation among new anti-depressant users aged 20-34 years. METHODS: Our study population included all Swedes aged 20-34 years who purchased anti-depressants in 2006 and had not purchased such drugs in the preceding 6 months (n = 25 003). We obtained prescription data from the Swedish Prescribed Drug Register. Information about demographic and socio-economic factors (country of birth, marital status, household size, education level, occupation, income and social assistance) was collected from Statistics Sweden by record linkage. We defined early discontinuation as filling only one anti-depressant prescription within a 6-month period. We used multiple logistic regression analysis to analyse the socio-economic factors associated with early discontinuation. RESULTS: We identified 6536 individuals (26.1%) as early discontinuers. Early discontinuation was less common among women [odds ratio (OR) = 0.82; 95% confidence intervals (CI) 0.75-0.87] and in those with at least two years of higher education (OR = 0.71; 95% CI 0.61-0.83), whereas it was more common among those born outside Sweden (OR = 1.76; 95% CI 1.48-2.10) and those who received social assistance (OR = 1.26; 95% CI 1.11-1.44). Compared with selective serotonin re-uptake inhibitors, SSRI, early discontinuation was more common among individuals who started treatment with a tri-cyclic anti-depressant, TCA, (OR = 2.58; 95% CI 2.24-2.98) or an anti-depressant other than SSRIs, TCAs or selective serotonin-norepinephrine re-uptake inhibitors/norepinephrine (noradrenaline) re-uptake inhibitors (OR = 2.90; 95% CI 2.05-4.10). CONCLUSION: Early discontinuation occurred more commonly among social assistance recipients and those with immigrant background, suggesting that those groups might require greater support when initiating anti-depressant therapy.
  • Beckman, Nils, et al. (författare)
  • Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001.
  • 2008
  • Ingår i: BMJ (Clinical research ed.). - 1468-5833. ; 337
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study secular trends in self reported sexual behaviour among 70 year olds. DESIGN: Cross sectional survey. Settings Four samples representative of the general population in Gothenburg, Sweden. PARTICIPANTS: 1506 adults (946 women, 560 men) examined in 1971-2, 1976-7, 1992-3, and 2000-1. MAIN OUTCOME MEASURES: Sexual intercourse, attitudes to sexuality in later life, sexual dysfunctions, and marital satisfaction. RESULTS: From 1971 to 2000 the proportion of 70 year olds reporting sexual intercourse increased among all groups: married men from 52% to 68% (P=0.002), married women from 38% to 56% (P=0.001), unmarried men from 30% to 54% (P=0.016), and unmarried women from 0.8% to 12% (P<0.001). Men and women from later birth cohorts reported higher satisfaction with sexuality, fewer sexual dysfunctions, and more positive attitudes to sexuality in later life than those from earlier birth cohorts. A larger proportion of men (57% v 40%, P<0.001) and women (52% v 35%, P<0.001) reported very happy relationships in 2000-1 compared with those in 1971-2. Sexual debut before age 20 increased in both sexes: in men from 52% to 77% (P<0.001) and in women from 19% to 64% (P<0.001). CONCLUSION: Self reported quantity and quality of sexual experiences among Swedish 70 year olds has improved over a 30 year period.
  • Bergh, Ingrid, 1956-, et al. (författare)
  • Pain and its relation to cognitive function and depressive symptoms: a Swedish population study of 70-year-old men and women.
  • 2003
  • Ingår i: Journal of pain and symptom management. - 0885-3924. ; 26:4, s. 903
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate the prevalence of pain and its characteristics, and to examine the association of pain with cognitive function and depressive symptoms, in a representative sample of 70-year-old men and women. Data were collected within the gerontological and geriatric population studies in Göteborg, Sweden (H-70). A sample of 124 men and 117 women living in the community took part in the study. A questionnaire was applied which included four different aspects of pain experience: prevalence, frequency of episodes of pain, duration and number of locations. In close connection to this, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. The prevalence of pain during the last 14 days was higher in women (79%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />91) than in men (53%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />65) (P&lt;0.001). Women (68%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />78) also reported pain that had lasted for &gt;6 months to a greater extent than men (38%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />46) (P&lt;0.001). The frequency of episodes of pain was also higher among women, 64% (n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />74) reporting daily pain or pain several days during the last 14 days while 37% of the men (n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />45) did so (P&lt;0.001). Women (33%, n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />38) also reported pain experience from ?3 locations more often than men (11%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />13) (P&lt;0.001). On the other hand, the association between depressive symptoms and pain experience was more evident in men than in women. Women were taking significantly more antidepressants compared to men (P&lt;0.03). The results show that pain is common in 70-year-old people and especially in women. However, associations between depressive symptoms and the four aspects of pain experience were more pronounced among men
  • Bertilsson, Monica, et al. (författare)
  • Capacity to work while depressed and anxious - a phenomenological study.
  • 2013
  • Ingår i: Disability and rehabilitation. - 1464-5165. ; 35:20, s. 1705-1711
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with one’s ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost “refueling” and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individual’s capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.Implications for RehabilitationThe reduced capacity to work due to depression and anxiety is not always understandable or observable for others, therefore, the rehabilitation process would benefit from increased knowledge and understanding of the difficulties afflicted individuals experience at work.Identifying tasks that contribute to “refueling” at work might enhance the success of the rehabilitation.Rehabilitation programs could be tailored to better address the inabilities that impact on the capacity to work when depressed and anxious.
  • Billstedt, Eva, 1961-, et al. (författare)
  • Secular changes in personality: study on 75-year-olds examined in 1976-1977 and 2005-2006.
  • 2013
  • Ingår i: International Journal of Geriatric Psychiatry. - 0885-6230. ; 28:3, s. 298-304
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: In order to study secular changes in personality factors neuroticism and extroversion, representative population samples of non-demented 75-year-olds underwent psychiatric examinations in 1976-1977 (total n = 223, 138 women, 85 men) and 2005-2006 (total n = 556, 322 women and 234 men). METHODS: Eysenck Personality Inventory was used at both occasions. Demographic factors (educational level, marital status, having children) were registered. RESULTS: Seventy-five-year-olds examined in 2005-2006 had higher values on extroversion and lower values on the Lie scale compared with those examined in 1976-1977. Neuroticism did not differ between the two birth cohorts. Neuroticism scores were higher in women than in men both in 1976-1977 and 2005-2006, and Lie score was higher in women than in men in 2005-2006. CONCLUSIONS: Our findings suggest that present cohorts of 75-year-olds are more extroverted and less prone to respond in a socially desirable manner than those born three decades earlier. Neuroticism levels remained unchanged, suggesting this trait may be less influenced by environmental factors than the other traits studied.
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