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- Karlsson, MariAnne, 1956, et al.
(author)
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Use-centred design of medical and health care technology: a pilot study of field tests as a development tool
- 2011
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In: International Journal of Biomedical Engineering and Technology. - : InderScience Publishers. - 1752-6426 .- 1752-6418. ; 5:1, s. 11-28
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Journal article (peer-reviewed)abstract
- The purpose of the project described in the paper was to develop a process through which users, staff as well as patients, can be involved in field evaluations of medical and health-care technology. Interviews with different stakeholders and the experiences from four case studies have led to the following conclusions: Users have the potential to act as active evaluators rather than passive subjects or participants only. However, user involvement in field evaluations must be supported by a formation of facilitators or ‘door openers’ to the health-care organization, moderators enhancing the dialogue between developers and users, and mentors for the users acting as evaluators.
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| 2. |
- Lagerin, Annica, et al.
(author)
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District nurses' experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care : a qualitative study
- 2021
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In: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 22
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Journal article (peer-reviewed)abstract
- Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults' medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults' ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients' medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults' medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.
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| 3. |
- Lagerin, Annica, et al.
(author)
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District nurses' use of a decision support and assessment tool to improve the quality and safety of medication use in older adults : a feasibility study
- 2020
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In: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 21
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Journal article (peer-reviewed)abstract
- Aim: To investigate whether district nurses (DNs) can identify factors related to the quality and safety of medication use among older patients via a clinical decision support system (CDSS) for medication and an instrument for assessing the safety of drug use [the Safe Medication Assessment tool (SMA)]. A secondary aim was to describe patients' experiences of the assessment. Background: DNs in Stockholm County have the opportunity to establish special units at primary health care centers (PHCCs) for patients aged 75 years and older. The units conduct drug utilization reviews and create care plans for older adults. Methods: Nine DNs at 7 PHCCs in Stockholm County used the tools with 45 patients aged 75 years and older who used one or more drugs. Outcome measures were the number of drugs, potential drug-related problems, nursing interventions, and patient satisfaction. Prevalences of drug-related problems and nursing interventions were calculated. Eleven patients answered a telephone questionnaire on their experiences of the assessment. Findings: DNs identified factors indicative of drug-related problems, including polypharmacy (9.8 drugs per person), potential drug-drug interactions (prevalence 40%), potential adverse drug reactions (2.7 per person), and prescribers from more than two medical units (60%). DNs used several nursing interventions to improve the safety of medication use (e.g., patient education, initiating a pharmaceutical review). The patients thought it was meaningful to receive information about their drug use and important to identify potential drug-related problems. With the support of the CDSS and the SMA tool, the DNs could identify several factors related to inappropriate or unsafe medication and initiated a number of interventions to improve medication use. The patients were positive toward the assessments. Using these tools, the DNs may help promote safe medication use in older patients.
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| 4. |
- Lundh, Lena, et al.
(author)
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Biomarkers, Clinical Course, and Individual Needs in COPD Patients in Primary Care : The Study Protocol of the Stockholm COPD Inflammation Cohort (SCOPIC)
- 2022
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In: The International Journal of Chronic Obstructive Pulmonary Disease. - : Dove Medical Press Ltd.. - 1176-9106 .- 1178-2005. ; 17, s. 993-1004
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Journal article (peer-reviewed)abstract
- Background: To facilitate effective personalized medicine, primary health care needs better methods of assessing and monitoring chronic obstructive pulmonary disease (COPD).Aim: This cohort study aims to investigate how biomarkers relate to clinical characteristics and COPD patients' subjective needs over time.Methods: Patients (n=750) in different COPD severity according to the GOLD criteria and age- and sex-matched controls (n=750) will be recruited over a period of 5 years from 15 primary health care centers in Region Stockholm, Sweden, and followed for 10 years in the first instance. Data on patients' subjective needs will be collected via telephone/email, data on clinical/physiological variables (eg, symptoms, exacerbations, comorbidities, medications, smoking habits, lung function) from existing databases that are based on medical records, and data on biomarkers via repeated blood sampling. Quantitative and qualitative methods will be used. Initial results are expected after 2 years (feasibility test), and a larger body of evidence after 5 years.Discussion: The study is expected to provide definitive and clinically useful scientific evidence about how biomarkers relate to clinical variables and patients' subjective needs. This new evidence will facilitate accurate, and personalized COPD management by the use of valid biomarkers. It will provide useful tools for primary care professionals and may facilitate optimal self-management.
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| 5. |
- Lundh Snis, Ulrika, 1970-, et al.
(author)
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Nordic Innovation Networks in Education : Dealing with Educational Challenges with Cross Boarder Collaboration and User Driven Design
- 2012
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In: Uddevalla Symposium 2012<em> </em>. - 9789197794343 ; , s. 553-571
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Conference paper (peer-reviewed)abstract
- This is an EU-funded project related to cross boarder collaboration for educational purposes supported by information and communication technologies between Danish, Norwegian and Swedish schools. The project started in 2011 and extends to 2014 so this empirically dominated paper reports on early findings related to cross-border collaboration challenges. The aim of the project is to develop innovative cross-border teaching models by the means of user-driven, practice-based co-design processes between practitioners and researchers. In the first year, 18 classes from 13 schools in Denmark, Norway and Sweden in the Öresund-Kattegatt-Skagerack region participated. Organized in so called Nordic class-match groups (consisting of students and teachers from one class in each country) new cross-border teaching models are co-created, tested and evaluated in an iterative process. Since teaching models are subject dependent, the project develop teaching models in several subject domains, i.e. math, language, science and social studies / history. Heretofore findings show, however, that organizational and technical issues have superseded and squeezed out subject-oriented discussions due to surprisingly many practical issues that needed to be handled first. We have identified three major thresholds to overcome. The first is related to technical difficulties in schools when diverse IT systems are to be synchronized. The second threshold concerns scheduling coordination difficulties in order to allow synchronous cross boarder collaboration. The third threshold concerns linguistic and communication difficulties rooted in participants communicating in their respective Nordic language. Being able to communicate within Nordic languages are explicit learning goals in all three schools systems, and therefore part of the project aim and consequently all participants are expected to use their native languages when communicating. The next phase of the project is therefore to find solutions to these technical, organizational and linguistic barriers, and already now we see some barrier breaking models taking shape in the active network of Nordic teachers, students, school leaders, IT support teams and researchers.
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| 8. |
- Adebäck, Petra, et al.
(author)
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Children or adolescents who lost someone close during the Southeast Asia tsunami 2004 – The life as young
- 2022
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In: Brain and Behavior. - Oxford, United Kingdom : John Wiley & Sons. - 2162-3279 .- 2162-3279. ; 12:5
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Journal article (peer-reviewed)abstract
- Introduction: To lose a person close suddenly, during childhood or adolescence, can be devastating. Many children or adolescents experienced the 2004 Indonesian tsunami when they were between 10- and 15-years-old. This study, from Stockholm, Sweden, describes the long-term effects of loss, eight- or nine-years post disaster, in young adulthood.Method: A mixed-method approach was used including statistical analyses (n = 210) and interpretative phenomenological analysis (IPA).Results: It was shown that there was a significant difference between bereaved (n=34) and nonbereaved (n = 176) respondents concerning, psychological distress, posttraumatic stress symptoms, and self-rated health. Three themes were found by using the IPA approach (n=9): Living in traumas, carrying heavy baggage, and living with change.Conclusion: The respondents described personal feelings of grief that are not expressed in their outward appearance or behavior in their daily living. When meeting young adults that have lost someone close in childhood or adolescence, this is important to have in mind.
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| 9. |
- Adebäck, Petra, et al.
(author)
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Late Reminders Nine Years Post Disaster in Adults Who As Children or Adolescents Were Exposed to the 2004 Southeast Asian Tsunami
- 2022
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In: Child Care in Practice. - : Taylor & Francis Group. - 1357-5279 .- 1476-489X. ; 28:3, s. 290-304
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Journal article (peer-reviewed)abstract
- Objective: The main aim of this study was to determine if young adults, who as children and adolescents were heavily exposed to the 2004 tsunami in Southeast Asia, had late reminders of this disaster nine years post disaster and, if so, how they handled these late reminders.Method: The subjects who had been exposed when they were between 10 and 15 years old were interviewed nine years post disaster when they had reached adulthood.Results: All those interviewed stated that they had experienced different late reminders of the 2004 tsunami even nine years later. They said that they could plan in advance or deal with late reminders should they occur. Two types of reminders were identified, one type designated as external and the other as internal. The interview subjects described how they had handled these reminders by striving for balance by thinking, talking, letting feelings out, doing something else or by avoiding.Conclusions: These young adults strived to find a balance between their function as adults in society and continued effects from the 2004 tsunami. A person, even if not affected functionally, can be affected in different ways in adulthood by the natural disaster they had experienced during childhood or adolescence. This is something important for anyone to think about when he or she meets persons who have been heavily exposed to a natural disaster many years earlier.
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| 10. |
- Annika, Lindh, 1984-, et al.
(author)
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Description of inhalation technique in patients with COPD in primary care
- 2018
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In: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52:Suppl. 62
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Journal article (other academic/artistic)abstract
- Introduction: A recent systematic review showed that only about one third of the patients had a correct inhalation technique and the number had not improved the last 40 years¹.Aim: The aim was to describe errors, separated into errors related to devices and errors related to inhalation technique, that occur when patients with COPD inhale medications.Method: In this descriptive study, patients with a COPD diagnosis were recruited from a randomized controlled trial performed 2015-2016 in primary care in four county councils in Sweden. A COPD nurse assessed the inhalation technique using a checklist with errors related to devices and to inhalation technique with possibility to write additional comments.Results: In total, 167 patients using 287 inhalers were assessed, 52% (n = 86) were female, mean age 71 years. A total of 163 errors were noted in the checklist, of which 87 were related to inhalation technique and 76 were related to devices. Except from this the COPD nurse had written comments regarding 53 errors that were not included in the checklist. At least one error (range: 1-7 errors) was made by 46% (n = 76) of the patients.Conclusion: The results show that many patients do not use the device correctly. Both errors related to inhalation technique and related to devices were present. This implies that there is a need to focus on both aspects when teaching patients how to inhale their medication. The checklist used in this study needs to be further improved.
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