1.
Wennick, Anne, et al.
(author)
Attained education and self-assessed health later in life when diagnosed with diabetes in childhood : a population-based study
2011
In: Pediatric Diabetes. - : Wiley-Blackwell. - 1399-543X .- 1399-5448. ; 12:7, s. 619-626
Journal article (peer-reviewed) abstract
Background: Previous studies have reported conflicting findings on academic achievement in children with type 1 diabetes, and generally lower self-assessed health status among respondents with diabetes. Objective: Thus, in this study, using the theoretical framework of the human-capital model, a population-based survey data set for Sweden, and explanatory variables following predictions from theory and previous empirical human-capital studies, individuals diagnosed with diabetes before the age of 19 were examined whether they differ from the general population at the same age concerning (i) educational level attained and (ii) self-assessed health later in life. Special attention was devoted to the association between education and health. Subjects: A set of pooled cross-sectional population survey data complemented with register data, comprising 20 670 individuals (of whom 106 individuals were diagnosed with diabetes), aged 19–38 yr, from 1988 to 2000, was created from the Swedish Biennial Survey of Living Conditions. Method: The influence of childhood diabetes was analyzed using multiple regression analysis, controlling for educational level, wage, sex, age, marital status, and parental ethnicity. Results: Childhood diabetes was associated with lower levels of attained education and self-assessed health in comparison with the general population. More educated individuals reported better health, though. Conclusions: In terms of the rapid increase in the incidence of diabetes in many countries, it is important to bear in mind that investments made both in education and in health, early in life, may facilitate the capability of the individual to experience healthy time later in life.
2.
Nilsson, Gabriella, et al.
(author)
How dislocation and professional anxiety influence readiness for change during the implementation of hospital-based home care for children newly diagnosed with diabetes : an ethnographic analysis of the logic of workplace change
2018
In: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 18(1):61
Journal article (peer-reviewed) abstract
BackgroundIn 2013–14, the evidence based care model Hospital-based Home Care for children newly diagnosed with diabetes was implemented at a large paediatric diabetes care facility in the south of Sweden. The first step of the implementation was to promote readiness for change among the professionals within the diabetes team through regular meetings. The aim was to analyse the implicit facilitators and barriers evident on a cultural micro level in discussions during the course of these meetings. What conceptions, ideals and identities might complicate, or facilitate, implementation?MethodsA case study was conducted during the implementation process. This article draw on ethnographic observations carried out at team meetings (n = 6) during the introductory element of implementation. From a discourse theoretical perspective, the verbal negotiations during these meetings were analysed.ResultsThree aspects were significant in order to understand the dislocation during this element of implementation: an epistemological disagreement that challenged the function of information within care practice; a paradoxical understanding of the time-knowledge intersection; and expressions of professional anxiety. More concretely, the professionals exhibited an unwillingness to give up the opportunity to provide structured, age-independent information; a resistance against allowing early discharge; and a professional identity formed both by altruistic concern and occupational guardiancy. The findings suggest the necessity of increased awareness of the conceptions and ideals that constitute the basis of a certain professional practice; a deeper understanding of the cultural meaning that influences care practice within a specific logic in order to predict in what way these ideals might be challenged by the implemented evidence.ConclusionsOur main contribution is the argument that the implemented evidence in itself needs to be examined and problematized from a cultural analytical perspective before initiation in order to be able to actively counter negative connotations and resistance.
