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Sökning: swepub > Malmö universitet > Engelska > Umeå universitet

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  • Oresland, Stina, et al. (författare)
  • Patients as 'safeguard' and nurses as 'substitute' in home health care
  • 2009
  • Ingår i: Nursing Ethics. - Sage Publications. - 0969-7330. ; 16:2, s. 219-230
  • Tidskriftsartikel (refereegranskat)abstract
    • One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.
  • Davidson, Thomas, et al. (författare)
  • Reimbursement systems influence prosthodontic treatment of adult patients
  • 2015
  • Ingår i: Acta Odontologica Scandinavica. - 0001-6357. ; 73:6, s. 414-420
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patients age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.
  • Hultin, M, et al. (författare)
  • Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 543-552
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health-related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.
  • Berg, Katarina, et al. (författare)
  • Psychometric evaluation of the post-discharge surgical recovery scale
  • 2010
  • Ingår i: Journal of Evaluation In Clinical Practice. - Blackwell Publishing Ltd. - 1356-1294. ; 16:4, s. 794-801
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale, aim and objectives Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post-discharge surgical recovery (PSR) scale, an instrument to monitor the patients recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness. Methods Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbachs alpha. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self-rated health was assessed using Pearsons correlation coefficient. Patients ability to work and their self-rated health on postoperative day 14 were used as external indicators of change. Results Six items showed floor or ceiling effects. Cronbachs coefficient alpha was 0.90 and the average inter-item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one-factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non-improved patients varied (AUC 0.58-0.81). There was a strong correlation between change scores in PSR and health (0.63). Conclusions The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.
  • Franzén, Karin M, 1958-, et al. (författare)
  • Surgery for urinary incontinence in women 65 years and older : a systematic review
  • 2015
  • Ingår i: International Urogynecology Journal. - Springer. - 0937-3462. ; 26:8, s. 1095-1102
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesis: Urinary incontinence (UI) is common among the elderly, but the literature is sparse on the surgical treatment of UI among the elderly. This systematic review aims to assess the effectiveness of surgical interventions as treatment for urinary incontinence in the elderly population ≥65 years of age.Methods: Randomized controlled trials (RCT) and prospective nonrandomized studies (NRS) were included. The databases PubMed (NLM), EMBASE (Elsevier), Cochrane Library (Wiley), and Cinahl (EBSCO) were searched for the period 1966 up to October 2013. The population had to be ≥65 years of age and had to have undergone urethral sling procedures, periurethral injection of bulking agents, artificial urinary sphincter surgery, bladder injection treatment with onabotulinumtoxin A or sacral neuromodulation treatment. Eligible outcomes were episodes of incontinence/urine leakage, adverse events, and quality of life.The studies included had to be at a moderate or low risk of bias. Mean difference (MD) or standard mean difference (SMD)as well as risk difference (RD) and the 95 % CI were calculated.Results: Five studies-all on the suburethral sling procedure in women- that fulfilled the inclusion criteria were identified. The proportion of patients reporting persistent SUI after surgery ranged from 5.2 to 17.6 %. One study evaluating quality of life (QoL) showed a significant improvement after surgery. The complication rates varied between 1 and 26 %, mainly bladder perforation, bladder emptying disturbances, and de novo urge.Conclusion: The suburethral sling procedure improves continence as well as QoL among elderly women with SUI; however, evidence is limited.
  • Nordenram, G, et al. (författare)
  • Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation : a systematic review with meta-synthesis
  • 2013
  • Ingår i: Acta Odontologica Scandinavica. - Taylor & Francis. - 0001-6357. ; 71:3-4, s. 937-951
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation.Background: Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function.Materials and methods: The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded.Results: The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation.Conclusions: In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.
  • Klingberg, G, et al. (författare)
  • Specialist paediatric dentistry in Sweden 2008-a 25-year perspective
  • 2010
  • Ingår i: INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY. - 0960-7439. ; 20:5, s. 313-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Paediatric dentistry in Sweden has been surveyed four times over the past 25 years. During this period postgraduate training, dental health, and the organization of child dental care have changed considerably. Aim. To investigate services provided by specialists in paediatric dentistry in Sweden in 2008, and to compare with data from previous surveys. Design. The same questionnaire was sent to all 30 specialist paediatric dental clinics in Sweden that had been used in previous surveys. Comparisons were made with data from 1983, 1989, 1996 and 2003. Results. Despite an unchanged number of specialists (N = 81 in 2008), the number of referrals had increased by 16% since 2003 and by almost 50% since 1983. There was greater variation in reasons for referrals. The main reason was still dental anxiety/behaviour management problems in combination with dental treatment needs (27%), followed by medical conditions/disability (18%), and high caries activity (15%). The use of different techniques for conscious sedation as well as general anaesthesia had also increased. Conclusions. The referrals to paediatric dentistry continue to increase, leading to a heavy work load for the same number of specialists. Thus, the need for more paediatric dentists remains.
  • Rohlin, M, et al. (författare)
  • Treatment of Adult Patients with Edentulous Arches: A Systematic Review
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 553-567
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. Materials and Methods: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). Results: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. Conclusions: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism.
  • Sunnegardh-Gronberg, K, et al. (författare)
  • Treatment of Adult Patients with Partial Edentulism: A Systematic Review
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 568-581
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The purpose of this systematic review was to identify and critically appraise published studies of treatment methods used in general practice to rehabilitate adult patients with single tooth loss or partial edentulism, with special emphasis on outcomes reported after at least 5 years of follow-up. Materials and Methods: Three databases were searched using specified indexing terms. Publications were included if the study design, research questions, and sample size satisfied pre-established criteria. Reference lists of relevant publications and systematic reviews were also searched. The quality of evidence was classified according to the GRADE system as high, moderate, low, or very low. Results: The search yielded 7,675 titles, of which 1,130 were read in full text. A final total of 15 publications were deemed eligible for inclusion: 5 of moderate quality and 10 of low quality. The five studies of moderate quality were all related to implant-based treatment. The 5-year survival rates for implant-supported single crowns and prostheses were 91% and 94.7%, respectively (implant survival rates: 98.5% and 94.9%, respectively). The underlying scientific evidence was low in quality. No relevant publications were identified regarding the economic aspects of treatment. Conclusion: Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss or partial edentulism.
  • Berg, Katarina, et al. (författare)
  • Postoperative recovery after different orthopedic day surgical procedures
  • 2011
  • Ingår i: International Journal of Orthopaedic and Trauma Nursing. - Amsterdam : Elsevier. - 1878-1241. ; 15:4, s. 165-175
  • Tidskriftsartikel (refereegranskat)abstract
    • Orthopedic day surgery is common. Postoperative recovery may differ according to surgical procedures and personal factors. We studied postoperative recovery up to 2 weeks after different orthopedic day surgical procedures and tried to identify possible predictors associated with recovery. Three-hundred and fifty eight patients who had undergone knee arthroscopy or surgery to the hand/arm, foot/leg or shoulder were included. Data were collected on postoperative days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale, the emotional state, physical comfort and physical independence dimensions in the Quality of Recovery-23 and a general health question. Multiple linear regression was used to explore predictors of recovery. The shoulder patients experienced significantly lower postoperative recovery and general health 1 and 2 weeks after surgery compared to the other patient groups (p < 0.001). Significant predictors of recovery were age, perceived health and emotional status on the first postoperative day and type of surgery. Postoperative recovery after common orthopedic day surgical procedures varies and factors influencing it need to be further explored. The impact of a patient’s emotional state on recovery after day surgery can be of particular interest in this work. Post-discharge planning needs to be tailored to the surgical procedure.
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