| 1. |
- af Sandeberg, Margareta, et al.
(författare)
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Psychometric properties of the DISABKIDS Chronic Generic Module (DCGM-37) when used in children undergoing treatment for cancer
- 2010
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to evaluate data quality and psychometric properties of an instrument for measurement of health-related quality of life: DISABKIDS Chronic Generic Module (DCGM-37) used in school-aged children with cancer. Methods: All school-children diagnosed with cancer in Sweden during a two-and-a-half year period were invited to participate in the study. Analysis was performed on combined data from two assessments, two and-a-half and five months after start of cancer treatment (n = 170). The instrument was examined with respect to feasibility, data quality, reliability and construct and criterion-based validity. Results: Missing items per dimension ranged from 0 to 5.3 percent, with a majority below three percent. Cronbach's alpha values exceeded 0.70 for all dimensions. There was support for the suggested groupings of items into dimensions for all but six of the 36 items of the DCGM-37 included in this study. The instrument discriminated satisfactorily between diagnoses reflecting treatment burden. Conclusions: The results indicate satisfactory data quality and reliability of the DCGM-37 when used in children undergoing treatment for cancer. Evaluation of construct validity showed generally acceptable results, although not entirely supporting the suggested dimensionality. Continued psychometric evaluation in a larger sample of children during and after treatment for cancer is recommended.
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| 2. |
- Andersson, Ann-Christine, et al.
(författare)
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Five Types of Practice-Based ImprovementIdeas in Health Care Services: An EmpiricallyDefined Typology
- 2011
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Ingår i: Quality Management in Health Care. - : Lippincott Williams & Wilkins. - 1063-8628 .- 1550-5154. ; 20:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the health care sector. This study is based on a Swedish county council improvement program. Health care departments and primary health care centers in the Kalmar County Council were invited to apply for money to accomplish improvement projects. A qualitative content analysis was done of 183 proposed applications from various health care departments and primary health care centers. The following 5 types of improvement projects were identified: organizational process, evidence and quality, competence development, process technology, and proactive patient work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. These projects point to the various problems and experiences health care professionals encounter in their day-to-day work. To generalize beyond this improvement program and to validate the typology, we applied it to all articles found when searching for quality improvement projects in the journal Quality Management in Health Care during the last 2 years and found that all of them could be fitted into at least 1 of those 5 categories. This article provides valuable insights into the current state of improvemen work in Swedish health care, and will serve as a foundation for further investigations in this quality improvement program.
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| 3. |
- Andersson, Ann-Christine, et al.
(författare)
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Practice-based improvement ideas in healthcare services
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective. The present study will contribute to knowledge of how practitioners in a healthcare region engage in quality improvement initiatives. The focus is on individual placement needs, problems/issues and the ability to organize work on the development, implementation and institutionalization of ideas for the healthcare sector. Design and settings. This study is based on the Kalmar county council Improvement Program. Healthcare departments and primary healthcare centers in the county council were invited to apply for money to accomplish improvement projects. The aim is to empirically identify and present the different kinds of practice-based improvement ideas developed in healthcare services. The 202 applications received from various healthcare departments and primary healthcare centers are analyzed using qualitative content analysis. Outcome and Results. Five types of improvement projects were identified: Organizational Process; Evidence and Quality; Competence Development; Process Technology; and Proactive Patient Work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. In addition, a common characteristic among the studied project applications is to increase patient safety, effectiveness and availability of care, and education/training. Those intentions are found in many of the applications and therefore give the impression of being most important to caregivers today. Conclusions. These projects point to the various problems and experiences healthcare professionals encounter in their day-to-day work. This paper provides valuable insights into the current state of improvement work in Swedish healthcare, and will serve as a foundation for further investigations in this quality program.
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| 4. |
- Andersson, Ann-Christine, et al.
(författare)
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Who conducts quality improvement initiatives in healthcare services? An evaluation of an improvement program in acounty council in Sweden
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose – The aim of this paper is to contribute to the knowledge of who engages in quality improvement initiatives and to describe whether staff professions or gender are relevant variables. Design/methodology/approach – This paper contains an evaluation of the participants in a specific defined strategic improvement initiative program in one county council in southeast Sweden. The improvement program was initiated by county council politicians to encourage improvement initiatives and to spread improvement skills and knowledge in the organization. The program is driven both “top down” (teaching/convincing line managers to demand improvements) and “bottom up” through improvement programs using methodology to help teams identify, plan and adopt improvements in their daily work. Data was collected from special applications (called Free Applications, FA) and from participants in the education program (called Improvement Program, IP), both of which include information about profession and 2 gender. A content analysis was made. After the first categorization of which types of improvement projects practitioners engage in, further analysis of staff disciplines, professions (hierarchy) and gender was done. The results were compared to the overall structure of staff presence in the county council. Findings – Changes in participation occurred over time. The FA (Free Applications) part (n=202) shows a higher share of leaders and managers (35%), but their participation in the IP (Improvement Program) (n=477) fluctuated (8-26%). Physicians were more represented in the FA than in the IP. The largest single group was nurses. Overall the gender perspective reflects the conditions of the county council, but in FA the representation of women was lower. Five types of improvement projects were identified: 1) Organizational process focus; 2) Evidence and quality; 3) Competence development; 4) Process Technology; and 5) Proactive patient work. Managers were most represented in the category “Organizational process”. The largest difference was seen in the category “Proactive patient work” with the highest occurrence among women (86%) and less among men (17%) and managers (21%). The patient as a contributor taking active part was not found in either the FA or the IP. Research limitations/implications – This study shows differences in participation between free applications and methodology-guided programs when it comes to professions and gender in the country council improvement drive. It may be useful for further research regarding how to successfully work for and implement improvements and change in healthcare environments. Practical implications – The study will discuss and contribute to further knowledge of whether profession, hierarchy and gender have an impact (obstructive or as an asset) in performing improvement work in healthcare settings. Originality/value - Not much has been written about who is accomplishing quality improvements in terms of profession and gender. This paper provides some valuable insights into the differences between staff categories (professions) and gender in the improvement work in Swedish healthcare.
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| 5. |
- Andersson, Helene, et al.
(författare)
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MRSA - global threat and personal disaster : Patients' experiences
- 2011
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Ingår i: International Nursing Review. - : Wiley. - 0020-8132 .- 1466-7657. ; 58:1, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- ANDERSSON H., LINDHOLM C. & FOSSUM B. (2011) MRSA - global threat and personal disaster: patients' experiences. International Nursing Review58, 47-53 Aim: To ascertain and describe the patients' knowledge, perceptions and experiences of being methicillin-resistant Staphylococcus aureus (MRSA) positive. Background: Antibiotic resistant bacteria are a serious global threat. MRSA can cause wound infection, pneumonia, septicaemia and mortality. This qualitative study has focused on patients' experiences of living with MRSA. Methods: Fifteen patients with MRSA-infected wounds were interviewed. All data were transcribed verbatim and analysed according to content analysis. Findings: Information about the MRSA diagnosis often caused a shock-like reaction. Patients' perception of being MRSA positive was stigmatizing as plague or leprosy; they felt dirty and felt that they were a severe threat to their environment. Fears of infecting someone else and being rejected were commonly expressed. The key findings emerged as a theme: Being exposed to others' shortcomings and being a threat to others' health. Three categories were identified: understanding and emotional reactions, treatment by the healthcare professionals and consequences and expectations. Gaps in both patient and staff knowledge of MRSA led to unnecessary misunderstandings, causing fear, social isolation and suffering. Conclusions: Living with MRSA can be extremely stressful for the patients. Knowledge and empathy from staff involved in their care is crucial to optimize patients' experiences. Staff education to meet patients' demand for information and prevent contamination is essential.
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| 6. |
- Ardalan, Ali, et al.
(författare)
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Impact of the Bam Earthquake, 26 December 2003, on Activities of Daily Living and Instrumental Activities of Daily Living of Older People
- 2011
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Ingår i: Prehospital and Disaster Medicine. - 1049-023X .- 1945-1938. ; 26:2, s. 99-108
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: This study compares self-reported Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) status among elderly survivors of the 2003 Bam Earthquake before, two months after, and five years after the event, and explores related determinants.METHODS: A two-stage cluster survey was conducted on 210 elderly survivors in the earthquake-stricken area five years after the event.RESULTS: Both ADL and IADL scores decreased two months after earthquake compared to prior status (p <0.001). No differences were observed between two months and five years after the event (p >0.05). Access to medical services were not related to level of ADL or IADL (p = 0.52 and p = 0.74, respectively). Elderly survivors with lower functional capability in terms of ADL experienced more problems in access to relief items (p = 0.04), but no similar association was found for IADL (p = 0.26).CONCLUSION: The Bam earthquake adversely affected functional capacity of the elderly. Disaster responders must take into account functional capacity of elders when planning for medical and relief operations.
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| 7. |
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| 8. |
- Ardalan, A., et al.
(författare)
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Post-disaster quality of life among older survivors five years after the Bam earthquake : implications for recovery policy
- 2011
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779. ; 31:2, s. 179-196
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Tidskriftsartikel (refereegranskat)abstract
- Older people are among the most vulnerable in major disasters. In their aftermath, it is crucial to institute efforts that will maintain a high level of elders' quality of life (QoL). This paper presents QoL assessments of elderly survivors five years after the Bam earthquake in Iran, and evaluates the determinants. A cross-sectional analysis of 210 randomly-selected survivors was carried out in 2008 using the WHOQOL-BREF questionnaire. A comparison of the results with data on the general population showed that experiencing the earthquake may adversely affect psychological dimensions of QoL even five years after, but paradoxically the earthquake resulted in better social relationships in affected communities than in the general population. Lower QoL associated with female gender, higher age, living alone, severe earthquake-related injury, poor quality of living conditions, increased dependency in the activities of daily living, living in an urban area, and being temporarily housed. Recovery experts and donors should carry out long-term monitoring of health status and QoL in disaster-affected communities, with a focus on psychological wellbeing. Intervention programmes that emphasise post-disaster quality of care and satisfactory housing may lead to better QoL of the victims and may shorten the recovery phase.
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| 9. |
- Berggren, Magnus, et al.
(författare)
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Audio Processing Solution for Video Conference Based Aerobics
- 2010
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Ingår i: 2010 Digest of Technical Papers, International Conference on Consumer Electronics. - Las Vegas : IEEE. - 9781424443147 - 9781424443161 ; , s. 407-408
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Konferensbidrag (refereegranskat)abstract
- In this paper an audio processing solution for video conference based aerobics is presented. The proposed solution leaves the workout music unaltered by separating it from the speech and processing each signal separately. The speech signal processing is also performed at a lower sample rate, which saves computational power. Real time evaluation of the system shows that high quality music as well as a good two-way communication is maintained during the aerobic session.
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| 10. |
- Burström, Kristina, et al.
(författare)
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A Swedish child-friendly pilot version of the EQ-5D instrument : the development process
- 2011
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 21:2, s. 171-177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Revising existing health related-quality of life (HRQoL) instruments used among adults with the intention of making them child-friendly enables the collection of similar HRQoL data in children, adolescents and adults. The aim of this article is to describe and discuss the development process of a Swedish child-friendly pilot version of the EQ-5D instrument. Methods: We modified the existing Swedish EQ-5D adult version to make it child-friendly. Within a multidisciplinary research group, we investigated linguistic and interpretation issues by performing face-to-face and group interviews with children and adolescents aged 6–17 years. Results: The first modification of the adult language was to change single words into words intelligible to and used by children [e.g. changing ‘depression’ (depression) into ‘ledsen’ (sad)]. The second related to whole expressions (using verb-form in the headings of dimensions).Conclusion: The advantage of being able to collect much the same data from children and adolescents, for example in population surveys covering all ages and in chronic childhood diseases, as for adults might outweigh possible disadvantages of modifying existing HRQoL instruments. The Swedish child-friendly EQ-5D pilot version resulting from this development process is further tested for feasibility and construct validity in a clinical interview study; initial results are reported in a subsequent paper.
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