| 1. |
- Daniel, Maria, et al.
(author)
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Effect of Myocardial Infarction With Nonobstructive Coronary Arteries on Physical Capacity and Quality-of-Life
- 2017
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In: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 120:3, s. 341-346
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Journal article (peer-reviewed)abstract
- Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011. A bicycle exercise stress test was performed 6 weeks after hospitalization and QoL was investigated by the Short Form Survey 36 at 3 months' follow-up. Both a healthy and a CHD group that were age and gender matched were used as controls. The MINOCA group had a lower physical capacity (139 ± 42 W) compared with the healthy control group (167 ± 53 W, p <0.001) but better than the CHD control group (124 ± 39 W, p = 0.023). Patients with MINOCA had lower physical and mental component summary scores compared with the healthy controls (p <0.001) and lower mental component summary (p = 0.012), mental health (p = 0.016), and vitality (p = 0.008) scores compared with the CHD controls. In conclusion, the findings of this first study on exercise capacity and QoL in patients with MINOCA showed both physical and mental distress from 6 weeks to 3 months after the acute event similar to CHD controls and in some perspectives even lower scores especially in the mental component of QoL.
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| 2. |
- Eneroth, Mari, et al.
(author)
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A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 271-
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Journal article (peer-reviewed)abstract
- Background: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Results: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.
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| 3. |
- Eneroth, Mari, et al.
(author)
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Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP
- 2017
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In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 35:2, s. 208-213
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Journal article (peer-reviewed)abstract
- Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.
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| 4. |
- Fridner, Ann, et al.
(author)
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From Awareness to Action Using the Survey Feedback Method
- 2014
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In: Journal of Health Science. - 2328-7136. ; 2:7, s. 325-329
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Journal article (peer-reviewed)abstract
- Reports from European university hospitals show an increase in work-related mental strain. Four European university hospitals started a comprehensive research program called Health and Organisation among University hospitals Physicians in Europe—the HOUPE Study in the year 2003. Based on the results from the HOUPE study, the authors conducted an intervention project together with HR-consultants at one of the participating hospitals. A collected cross-sectional survey in 2005 among permanently employed academic physicians (N = 1800, response rate 60%) at Karolinska University Hospital in Sweden. Results from the study were used in survey feedback seminars (N = 250). This method is a way of systematic collection of data to process and give feedback to the organisation’s members in order to initiate organisational change. By providing results based on the total sample, on each division, and unpublished data from each clinic the authors aimed to improve physicians’ health and work satisfaction and thereby enhance the health of the physicians. Feedback seminars can arouse many emotions and might make people defensive. The role of resistance in the process of change is a paradox in that resistance slows down change. However, without resistance there will be no change at all. The authors conducted 20 feedback seminars of three hours duration where results were discussed relating mainly to the psychosocial work environment, psychological distress, and career paths, i.e., job demands, control at work, social interactions, leadership, commitment to the organisation, harassment at work, burnout, depression and suicide ideation. Altogether, 250 physicians participated in these meetings. To achieve acceptance for organisational change, data about relevant conditions in the organisation have to be processed in a systematic way in collaboration with all those who will benefit from changes, in concrete work units as divisions and clinics.
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| 5. |
- Fridner, Ann, et al.
(author)
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Possible reasons why female physicians publish fewer scientific articles than male physicians : A cross-sectional study
- 2015
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In: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 15
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Journal article (peer-reviewed)abstract
- Background: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine.Methods: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles.Results: Male physicians published significantly more articles than female physicians p <. 001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22–7.20) and male physicians (OR = 2.10; 95% CI 1.08–4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08–2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12–0.70) whilst the publishing rate among male physicians was not affected by exhaustion.Conclusions: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.
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| 6. |
- Gustafsson Sendén, Marie, et al.
(author)
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Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization
- 2016
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In: Annals of Occupational and Environmental Medicine. - : Korean Society of Occupational and Environmental Medicine. - 2052-4374. ; 28
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Journal article (peer-reviewed)abstract
- Background: It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick.Methods: General practitioners (GP’s) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables.Results: Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism.Women reported reasons related with “concern for others” and “workload” more strongly than men. Men reported reasons related with “capacity” and “money” more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities.Conclusions: Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.
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| 7. |
- Loikas, Desirée, et al.
(author)
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Does patient's sex influence treatment in primary care? Experiences and expressed knowledge among physicians : a qualitative study
- 2015
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In: BMC Family Practice. - London, UK : BioMed Central. - 1471-2296. ; 16
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Journal article (peer-reviewed)abstract
- BACKGROUND: Biological and sociocultural differences between men and women may play an important role in medical treatment. Little is known about the awareness of these differences among general practitioners (GPs) and if they consider such differences in their medical practice. The aim of this study was to explore GPs' perception of sex and gender aspects in medical treatment.METHODS: We conducted five focus group discussions (FGDs) with 29 physicians (mainly GPs) in Sweden. A discussion guide with semi-structured questions was used. All FGDs were audio-recorded and transcribed word-by-word. Data were analysed through inductive thematic analysis with no predetermined categories.RESULTS: Three main categories emerged from the data. The first category emphasised GPs' experiences of sex and gender differences in diagnosing and assessment of clinical findings. Medical treatment in men and women was central in the second category. The third category emphasised GPs' knowledge of sex differences in drug therapy.CONCLUSIONS: The GPs stated they had little knowledge of sex and gender differences in drug treatment, but gave multiple examples of how the patient's sex affects the choice of treatment. Sex and gender aspects were considered in diagnosing and in the treatment decision. However, once the decision to treat was made the choice of drug followed recommendations by local Drug and Therapeutics Committee, which were perceived to be evidence-based. In the analysis we found a gap between perceived and expressed knowledge of sex and gender differences in drug treatment indicating a need of education about this to be included in the curriculum in medical school and in basic and specialist training for physicians. Education could also be a tool to avoid stereotypical thinking about male and female patients.
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| 8. |
- Nero, Daniella, et al.
(author)
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Personality Traits in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries.
- 2019
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In: The American journal of medicine. - : Elsevier BV. - 1555-7162 .- 0002-9343. ; 132:3, s. 374-381
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Journal article (peer-reviewed)abstract
- The purpose of this study was to describe type A behavior pattern and trait anger in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and compare them with patients with coronary heart disease and healthy controls. Type A behavior pattern and anger have been linked to coronary heart disease in previous studies. This is the first study to assess type A behavior pattern and trait anger in MINOCA patients.One hundred MINOCA patients, consecutively recruited during 2007-2011 at 5 coronary care units in Stockholm, were matched for sex and age to 100 coronary heart disease patients and 100 healthy controls. All participants completed the Bortner Rating Scale to quantify type A behavior pattern and the Spielberger Trait Anger Scale to quantify anger 3 months after the acute event.MINOCA patients' Bortner Rating Scale score was 70.9 ± 10.8 (mean ± SD) and Spielberger Trait Anger Scale score was 14 (12-17) (median; interquartile range). Coronary heart disease patients' Bortner Rating Scale score was 70.5 ± 10.2 and Spielberger Trait Anger Scale score was 14 (12-17). Healthy controls' Bortner Rating Scale score was 71.9 ± 9.1 and Spielberger Trait Anger Scale score was 13 (11-16).We found no significant differences in Bortner Rating Scale score and Spielberger Trait Anger Scale score among MINOCA, coronary heart disease patients, and healthy controls, regardless of whether total scores, subscales, or cutoffs were used to classify type A behavior pattern and trait anger. However, we cannot exclude the existence of an occasional episode of anger or mental stress in relation to the coronary event. This is the first study to assess type A behavior pattern and trait anger in patients with MINOCA, and future studies need to confirm the current findings before any firm conclusions can be made.
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| 9. |
- Wall, Maja, et al.
(author)
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Suicidal ideation among surgeons in Italy and Sweden : a cross-sectional study
- 2014
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In: BMC Psychology. - : Springer Science+Business Media B.V.. - 2050-7283. ; 2, s. 53-
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Journal article (peer-reviewed)abstract
- Background: Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons’ suicidal ideation. A surgeon’s work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions. Methods: A cross-sectional study of surgeons was performed in Italy (N=149) and Sweden (N=272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured. Results: Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective. Conclusions: A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.
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| 10. |
- Berglund, Annika, et al.
(author)
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Factors facilitating or hampering nurses identification of stroke in emergency calls
- 2015
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In: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:11, s. 2609-2621
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Journal article (peer-reviewed)abstract
- Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.Design. A qualitative study using interpretive phenomenology.Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.
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