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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Allmänmedicin) > Södertörns högskola

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1.
  • Eneroth, Mari, et al. (författare)
  • 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
  • Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 35:2, s. 208-213
  • Tidskriftsartikel (refereegranskat)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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2.
  • Gustafsson Sendén, Marie, et al. (författare)
  • Gender bias in assessment of future work ability among pain patients - an experimental vignette study of medical students' assessment
  • 2019
  • Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 19:2, s. 407-414
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Pain is a prevalent problem in many countries. Women are more often on sick-leave for pain than men. Such gender differences have been explained through biological factors, different demands for on the job market, and home conditions. Fewer studies have focused on how gender stereotypes may bias the medical assessment of pain patients. The aim of the present research was to investigate if a gender bias in medical students' evaluations of chronic pain patients can contribute to explaining the gender differences in sick-leave due to pain. Specifically, we investigated whether medical students' estimates of a patient's accuracy of their own work ability and amount of domestic work differed between female and male patients, and how such estimates influenced the medical students' judgments of the patient's work ability. Methods: Medical students (n = 137; 60 women; 74 men; three unspecified) read a vignette describing a patient with pain and filled out a questionnaire. The vignette was identical and gender neutral, except for the name of the patient signaling gender. A between-subjects experimental design was used in which participants were randomly assigned to an experimental condition. Participants then judged the patient's work ability, the accuracy of the patient's self-assessed work ability, and the amount of domestic work they believed was performed by the patient. All ratings were made on seven-point items. Results: The results showed that there was no main effect of gender on perceived future work ability of the patient, F (1,131) = 0.867, p = 0.353. However, male patients were considered to be more accurate in their self-assessed work ability than female patients F (1,131) = 5.925 p = 0.016 (M-female = 4.87, SDfemale = 1.22, and M-male = 5.33, SDmale = 1.02). Moreover, female patients were thought to perform more domestic work, F (1,131) = 25.56, p < 0.001 (M-female = 4.14, SDfemale = 1.41, and M-male = 3.07, SDmale = 1.16). Finally, perceived amount of domestic work moderated the effects of perceived future work ability for female but not for male patients, B = 0.42, p = 0.005. Hence, there was a positive effect of amount of domestic work performed on work ability judgments for women, such that the more domestic work they were assumed to perform, the more they were perceived to be able to work. Conclusions: Gender stereotypes influenced assessments of future work ability in pain patients, mainly because women were assumed to perform more domestic work which had a positive effect on perceived work ability. Because domestic work should have a negative effect on recovery, expectations from the physician that domestic work is expected by female patients may in fact have the opposite effect prolonging sick-leave. Moreover, the students trusted the male patients' ability to assess their own work capacity more than women's.
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3.
  • Henning, Claes, et al. (författare)
  • Detailed analysis of the characteristics of sample volume in blood culture bottles
  • 2019
  • Ingår i: Journal of Clinical Microbiology. - : American Society for Microbiology. - 0095-1137 .- 1098-660X. ; 57:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Blood volume is the most important variable, for detection of microorganisms in blood cultures (BC). Most standards recommend 40-60 ml blood, collected in several BC bottles filled up to 10 ml. We measured blood volume in individual BC bottles, and analysed the association of hospital, bottle type, day of the week, daily sampling time, and age and gender of the patient, with sampling volume and BC result. The variation in blood volume per BC bottle was analysed in a mixed linear model using hospital, bottle type, weekday, sampling time, age and gender as fixed factors, and patient ID and episode as random factors to control for repetitive sampling of individual patients. Only 18 % of all bottles were filled with the recommended 8-10 ml, and 47 % were filled with less than 8 ml. The mean (±SE) volume was larger in positive 9.09 (±0.15) compared to negative bottles 8.47 (±0.07) (p<0.001). Blood volume was larger in BacT/ALERT-FA Plus than in -FN Plus BC bottles (p<0.001). There was significantly lower volumes collected during the night (p<0.001). The volume of blood collected decreased significantly with increasing patient age (p<0.001). Larger volumes were collected from males compared to females, 8.78 (±0.06) vs. 8.36 (±0.06) ml (mean ± SE) respectively (p<0.001). The odds of detecting a positive patient increases with 13 % for each additional ml blood drawn. Our results show that we need to work actively with development of blood sampling routines to overcome age and gender effects, and to optimize blood sampling volumes.
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4.
  • Svärd, Veronica, et al. (författare)
  • Physician’s use of sickness certification guidelines : a nationwide survey of 13 750 physicians in different types of clinics in Sweden
  • 2021
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To explore physicians’ experiences of using the national sickness certification guidelines introduced in 2007 and the types of information they used, in general and in different types of clinics.Design Cross-sectional survey.Setting Most physicians working in Sweden in 2017.Participants A questionnaire was sent to 34 718 physicians; 54% responded. Analyses were based on answers from the 13 750 physicians who had sick leave cases.Outcome measures To what extent the guidelines were used and what type of information from them that was used.Results Ten years after the sickness certification guidelines were introduced in Sweden, half of the physicians used them at least once a month. About 40% of physicians in primary healthcare and occupational health services used the guidelines every week. The type of information used varied; 53% used recommendations about duration and 29% about degree of sick leave. Using information about function and activity/work capacity, respectively, was more common within primary healthcare (37% and 38%), psychiatry (42% and 42%), and occupational health services (35% and 41%), and less common in surgery and orthopaedic clinics (12% and 12%) who more often used information about duration (48% and 53%). Moreover, 10% stated that the guidelines were very, and 24% fairly problematic to apply. Half (47%) stated that the guidelines facilitated their contacts with patients and 29% that they improved quality in their management of sick leave cases. More non-specialists, compared with specialists, found that the guidelines facilitated contacts with patients (OR 3.28, 95% CI 3.04 to3.55).Conclusions The majority of the physicians used the sickness certification guidelines, although this varied with type of clinic. Half stated that the guidelines facilitated patient contacts. Yet, some found it problematic to apply the guidelines. Further development of the guidelines is warranted as well as more knowledge about them among physicians.
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