| 1. |
- Gunnarsson, Maria S., et al.
(författare)
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In primary health care, never prescribe antibiotics to patients suspected of having an uncomplicated sore throat caused by group A beta-haemolytic streptococci without first confirming the presence of this bacterium
- 2012
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 44:12, s. 915-921
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are several consensus-describing decision rules for patients in primary health care with a sore throat. The objective of this study was to estimate the number of unnecessary antibiotic prescriptions in primary health care given to patients with a sore throat, due to these different decision rules. A further aim was to suggest revised rules for decision-making in primary health care, when a sore throat caused by group A beta-haemolytic streptococci (GAS) is suspected. Methods: The design was a reanalysis of previously published articles describing the prevalence of GAS and physician behaviour when treating patients with a sore throat. The risk of unnecessary antibiotic prescribing in different situations was estimated and applied to the Swedish population. Results: Introducing the rule of never prescribing antibiotics without first confirming the presence of GAS would result in an annual reduction in Sweden of 20,360-25,192 unnecessary antibiotic prescriptions in children and 65,311-98,160 in adults. Conclusions: The single most important rule in primary health care to minimize the risk of unnecessary antibiotic prescription to patients with an uncomplicated sore throat, and where an infection with GAS is suspected, is to never prescribe antibiotics at the first visit without first confirming the presence of this bacterium. Adding more decision rules may to some extent further reduce the number of unnecessary antibiotic prescriptions.
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| 2. |
- Ahlen, G. C., et al.
(författare)
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The physician's self-evaluation of the consultation and patient outcome: A longitudinal study
- 2013
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 31:1, s. 26-30
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To study whether the physician's evaluation of the consultation correlates to patient outcome one month later concerning symptom relief, sick leave, and drug compliance as perceived by the patient. The study also investigated whether the patient's evaluation of the consultation correlated to patient outcome. Design. A longitudinal study using questionnaires. Setting. A county in south-western Sweden. Subjects. Forty-six physicians and 316 primary care patients aged 16 years or more with a new complaint lasting one week or more were invited. A total of 289 patients completed a questionnaire presented at the consultation; 273 patients were reached in a follow-up telephone interview one month after the consultation. Main outcome measures. The association between each statement in the physician-patient questionnaire (PPQ) from the consultation and the answers obtained from the telephone interview were analysed by either multiple linear or logistic regression analysis. Results. Five out of 10 items in the PPQ were significantly associated with patient outcome. Physician's self-evaluation of the consultation was much more strongly associated with patient outcome than the patient's evaluation. Conclusion. The difference between the physician's and patient's evaluation of the consultation to predict patient outcomes indicates that the physician's self-evaluation of the consultation is of importance.
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| 3. |
- Ahlén, Gerd, 1951, et al.
(författare)
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Physician patient questionnaire to assess physician patient agreement at the consultation.
- 2007
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Ingår i: Family practice. ; 24:5, s. 498-503
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to validate an instrument of physician-patient agreement in the consultation. A secondary aim was to assess this agreement. METHOD: The setting was a county in the southwest of Sweden with a cross-sectional survey of primary care patients and physicians using separate coded questionnaires. Forty-six physicians and 316 patients aged 16 or more with a new complaint lasting 1 week or more. Thirteen items were evaluated and index of proportional agreement for the dichotomized answers agree (P(pos)) and disagree (P(neg)) was calculated. RESULTS: In 10 of the 13 items, a high level of agreement between physician and patient was seen. Discussion. Index of proportional agreement was useful in finding statements in a questionnaire on agreement for both physicians and patients that could be used for educational purposes and as a check-up for the GP in daily practice.
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| 4. |
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| 5. |
- Balch, Graeme, et al.
(författare)
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Oral corticosteroids for painful acute otitis externa (swimmer's ear): A triple-blind randomised controlled trial.
- 2019
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Ingår i: Australian journal of general practice. - 2208-7958. ; 48:8, s. 565-572
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Tidskriftsartikel (refereegranskat)abstract
- Acute otitis externa is often painful. The aim of this study was to evaluate the efficacy of 10 mg oral prednisolone twice daily for four days in addition to conventional therapy.Patients attending general practice clinics in Far North Queensland, Australia, for acute painful otitis externa were given a study capsule with either 10 mg prednisone or placebo.Seventy-three patients were randomised. Results from 19 patients in the intervention group and 11 patients in the control group were analysed. Oral corticosteroids did not decrease the time to being completely pain-free but decreased the time for pain to reduce from more than 'moderate pain' to less than 'moderate pain', from 3.7 days to 2.4 days (P= 0.012, log rank test).Oral corticosteroids seem to be effective in reducing more than 'moderate pain' to less than 'moderate pain'. However, this result needs to be confirmed in a larger trial.
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| 6. |
- Billhult, Annika., et al.
(författare)
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Analytisk statistik : Inferential statistics
- 2012
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Ingår i: Vetenskaplig teori och metod - Från idé till examination inom omvårdnad. - Lund : Studentlitteratur. - 9789144071350 ; , s. 317-326
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
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| 8. |
- Billhult, Annika., et al.
(författare)
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Enkäter : Questionnaires
- 2012
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Ingår i: Vetenskaplig teori och metod - Från idé till examination inom omvårdnad. - Lund : Studentlitteratur. - 9789144071350 ; , s. 139-149
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
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| 10. |
- Billhult, Annika, et al.
(författare)
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The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer -- a randomized controlled clinical trial.
- 2008
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Ingår i: Autonomic neuroscience : basic & clinical. - : Elsevier BV. - 1566-0702. ; 140:1-2, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this study was to examine the effect of repeated effleurage massage treatments compared with a visit control group on circulating lymphocytes by studying the number and activity of peripheral blood NK cells, CD4+ and CD8+ T cells in women with breast cancer. Furthermore, the effect of repeated effleurage massage treatments on the levels of cortisol in saliva and oxytocin in plasma as well as degree anxiety, depression and quality of life was studied. DESIGN: A single centre, prospective, randomized, controlled trial. SETTINGS/LOCATION: The study was conducted in a radiation department, in a hospital in south-western Sweden. SUBJECTS: Twenty-two women (mean age=62) with breast cancer undergoing radiation were included in this study. INTERVENTIONS: The patients were randomly assigned to effleurage massage therapy (20 min of effleurage on ten occasions) or to control visits (ten 20-minute visits). OUTCOME MEASURES: Blood samples were collected before the first and last massage/control visit for analysis of peripheral blood NK, T cells and oxytocin. Saliva was analysed for cortisol. In addition, the patients completed the Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire and Spielbergers State Trait Anxiety Inventory prior to the first and last massage/control visit. RESULTS: Effleurage massage treatment had no significant effect on the number, frequencies or activation state of NK cells or CD4+ or CD8+ T cells. Furthermore, no significant changes between groups were detected on cortisol and oxytocin concentrations, anxiety, depression or quality of life. CONCLUSIONS: Significant effect of effleurage massage on cellular immunity, cortisol, oxytocin, anxiety, depression or quality of life could not be demonstrated in this study. Several possible explanations to the results of this study are discussed.
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