| 1. |
- Sparring, V., et al.
(författare)
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Changing healthcare utilization patterns in diabetes mellitus : case-control studies 1 year and 8 years after diagnosis
- 2012
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 29:6, s. 784-791
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Tidskriftsartikel (refereegranskat)abstract
- Aims To describe healthcare utilization patterns in young and middle-aged patients with diabetes 1 year and 8 years after diagnosis and to compare with the general population at two time points, 16 years apart. Methods Four cohorts with disease duration of 1 year or 8 years were selected from the Diabetes Incidence Study in Sweden, which registers all incident cases of diabetes in the 15- to 34-year age group. Control subjects were selected from the population register matched by age, sex and county of residence. A postal questionnaire was sent to the 1983 and 1992 cohorts in 1991 and 1993, and to the 1999 and 2008 cohorts in 2007 and 2009. Nine hundred and thirteen patients with diabetes and 1679 control subjects responded. Results One year after diagnosis, 49% of patients with diabetes in the 1992 cohort compared with 4.2% in the 2008 cohort reported visits to departments of internal medicine and endocrinology. A similar pattern was seen 8 years after diagnosis. The use of day care was 45 times higher among patients with diabetes compared with control subjects. Utilization of outpatient hospital care was higher among patients with diabetes compared with control subjects, even when excluding visits to diabetes clinics. Conclusions Excess use of health care among patients with diabetes remained 16 years after the first follow-up. Utilization patterns were stable, except for a major decrease in inpatient care 1 year after diagnosis and an increase in day care 8 years after diagnosis. Observed changes probably reflect successive reforming of diabetes care in Sweden.
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| 2. |
- Sparring, Vibeke, et al.
(författare)
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Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15-34 years - a Swedish population-based study using EQ-5D
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 377-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diabetes with onset in younger ages affects both length of life and health status due to debilitating and life-threatening long-term complications. In addition, episodes and fear of hypoglycaemia and of long-term consequences may have a substantial impact on health status. This study aims to describe and analyse health-related quality of life (HRQoL) in individuals with onset of diabetes at the age of 15-34 years and with a disease duration of 1, 8, 15 and 24 years compared with control individuals matched for age, sex and county of residence. Methods: Cross-sectional study of 839 individuals with diabetes and 1564 control individuals. Data on socioeconomic status and HRQoL using EQ-5D were collected by a postal questionnaire. Insulin treatment was self-reported by 94% of the patients, the majority most likely being type 1. Results: Individuals with diabetes reported lower HRQoL, with a significantly lower mean EQ VAS score in all cohorts of disease duration compared with control individuals for both men and women, and with a significantly lower EQ-5D(index) for women, but not for men, 15 years (0.76, p = 0.022) and 24 years (0.77, p = 0.016) after diagnosis compared with corresponding control individuals. Newly diagnosed individuals with diabetes reported significantly more problems compared with the control individuals in the dimension usual activities (women: 13.2% vs. 4.0%, p = 0.048; men: 11.4% vs. 4.1%, p = 0.033). In the other dimensions, differences between individuals with diabetes and control individuals were found 15 and 24 years after diagnosis: for women in the dimensions mobility, self-care, usual activities and pain/discomfort and for men in the dimension mobility. Multivariable regression analysis showed that diabetes duration, being a woman, having a lower education and not being married or cohabiting had a negative impact on HRQoL. Conclusions: Our study confirms the negative impact of diabetes on HRQoL and that the difference to control individuals increased by disease duration for women with diabetes. The small difference one year after diagnosis could imply a good management of diabetes care and a relatively quick adaptation. Our results also indicate that gender differences still exist in Sweden, despite modern diabetes treatment and management in Sweden.
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| 3. |
- Taha, Hana, et al.
(författare)
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Educational Intervention to Improve Breast Health Knowledge among Women in Jordan
- 2010
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Ingår i: Asian Pacific Journal of Cancer Prevention. - : Asian Pacific Organization for Cancer Prevention. - 1513-7368 .- 2476-762X. ; 11:5, s. 1167-1173
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breast cancer is the most common cancer among women in Jordan and on average 70% of the cases present at advanced stages. The aim of this study was to assess the effectiveness of a public educational campaign conducted by the Jordan Breast Cancer Program to improve breast health knowledge among Jordanian women and to relate their knowledge to breast health practices. Methods: The campaign was conducted in five governorates in Jordan with a total of 105 public group lectures about breast cancer focusing on early detection. The total number of participants was 2,554 women with a median age of 37 years (range: 15-73 years). Median number of women per lecture was 24 (range: 9-38). Before the lectures, the women answered a structured questionnaire about their knowledge and practices. After the intervention 2,418 of them filled a post-test questionnaire with the same content. Correct answers on the 15 knowledge questions yielded a maximum score of 15. Determinants of breast health practices were identified using multivariable logistic regression analysis. Results: The mean knowledge score increased significantly from 10.9 in the pre-test to 13.5 in the post-test (p < 0.001). The percentage with a minimum of 14 correct answers to the 15 questions increased from 18 to 63% (p < 0.001). Adequate breast health practices were generally low but increased significantly with increasing age and attendance at a previous lecture on breast cancer. Breast health practices were also higher among married women and housewives, and significantly associated with older age and greater breast health knowledge (p < 0.001). Conclusions: Group educational lectures appeared effective for improving breast health knowledge among Jordanian women. However, even with the noticeable level of knowledge at the baseline, there were low breast health practices among the study participants. This necessitates further in-depth research to explore womens experiences and socio-cultural barriers to breast health seeking behaviour in Jordan.
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| 4. |
- Taha, Hana, et al.
(författare)
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Home visits to improve breast health knowledge and screening practices in a less privileged area in Jordan
- 2014
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Breast cancer is the most common cancer afflicting women in Jordan. This study aimed to assess the effects of an educational intervention through home visits, including offering free mammography screening vouchers, on changing women's breast health knowledge and screening practices for early detection of breast cancer in a less privileged area in Jordan.METHODS: Two thousand four hundred breast health awareness home visits were conducted and 2363 women aged 20-79 years (median: 41) answered a pre-test interview-administrated questionnaire to assess their breast health knowledge and practices at the baseline. After a home-based educational session, 625 women aged 40 years or older were referred to free mammography screening. Five hundred and ninety six homes were revisited six months later and out of these 593 women participated in a post-test. The women's retained breast health knowledge, the changes in their reported breast health practices and their usage of the free mammography voucher, were assessed.RESULTS: The mean knowledge score increased significantly (p < 0.001) from 11.4 in the pre-test to 15.7 in the post-test (maximum score: 16). At the six month follow-up the post-test showed significant (p < 0.001) improvement in women's perceived breast self-examination (BSE) knowledge, reported BSE practice and mammography screening. Out of 625 women that received a voucher for free mammography screening 73% attended the mammography unit, while only two women without a voucher went for mammography screening at the assigned unit. Women who received a follow-up visit were more likely to use the free mammography voucher compared to those who were not followed-up (83% vs. 67%; p < 0.001).CONCLUSIONS: Home visits by local community outreach workers that incorporated education about breast cancer and breast health in addition to offering free mammography screening vouchers were effective in improving women's breast health knowledge and practices in a less privileged area in Jordan.
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| 5. |
- Taha, Hana, et al.
(författare)
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"Voices of Fear and Safety" Women's ambivalence towards breast cancer and breast health : a qualitative study from Jordan
- 2012
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 12, s. 21-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women's views and perceptions about breast cancer and breast health. Methods: We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Results: Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women's prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women's perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband's rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women's perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Conclusions: Women's ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care.
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