| 1. |
- Eriksson, Andrea, et al.
(författare)
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How is health promotion research undertaken in a Nordic context? : A scoping review on doctoral dissertations from 2008-2018
- 2020
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 97:3, s. 488-502
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Tidskriftsartikel (refereegranskat)abstract
- This scoping review was commenced as a collaboration within the NordicHealth Promotion Research Network (NHPRN). The overall aim was to explore how research under the label ‘health promotion’ was undertaken in a Nordic context. The search for dissertations published in Denmark, Finland, Iceland, Norway and Sweden was limited to the years 2008 to 2018. Manual searches of university websites, as well as different databases in the Nordic countries, were required for collecting dissertations from all universities. The collection of dissertations was more difficult than expected. There were 56 published PhD dissertations from 6 universities in Denmark, 51 from 8 universities in Finland, 0 from Iceland, 53 from 7 universities in Norway and 193 from 22 universities in Sweden. Almost half of the analysed dissertations combined qualitative and quantitative methods. About one-third of the dissertations had a settings approach, followed by a societal approach and individual approach. Finland and Sweden presented more intervention studies than the other countries. A majority of the intervention studies included individual lifestyle issues. Based on the analysis of the research approaches, more dissertations embracing societal perspectives and broader determinants of health may be recommended for future Nordic dissertations.
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| 3. |
- Finbraten, Hanne Soberg, et al.
(författare)
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Explaining variance in health literacy among people with type 2 diabetes : the association between health literacy and health behaviour and empowerment
- 2020
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Ingår i: BMC Public Health. - : BMC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background To reflect the health literacy (HL) skills needed for managing type 2 diabetes (T2DM) in everyday life, HL in people with T2DM should be measured from a broader perspective than basic skills, such as proficiency in reading and writing. The HLS-Q12, based on the European Health Literacy Survey Questionnaire (HLS-EU-Q47), assesses four cognitive domains across three health domains. International studies on people with T2DM show inconsistent results regarding the association between HL and general health and the association between HL and glycaemic control. Moreover, knowledge is needed related to the link between HL and empowerment for those with T2DM. The aims of this study were to examine the association between i) HL and general health and diabetes outcomes, ii) HL and health behaviours and iii) HL and empowerment in people with T2DM. Methods During March and April 2015, 388 adults with T2DM responded to a paper-and-pencil self-administered questionnaire. A sequential multiple regression analysis was applied to explore the association between HL, as measured by the HLS-Q12, and health conditions, HbA1c, health behaviours and empowerment. Results For people with T2DM, higher levels of HL were associated with higher levels of education, better overall health conditions and higher self-perceived empowerment. No empirical evidence strengthening either the link between HL and glycaemic control or the link between HL and health behaviours was found. Conclusions The independent variables education level, overall health condition and empowerment explained about one-third of the total observed variance in HL.
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| 4. |
- Finbråten, Hanne Søberg, 1972-, et al.
(författare)
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Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire : Latent trait analyses using Rasch modelling and confirmatory factor modelling
- 2018
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 18:506
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is widely used in assessing health literacy (HL). There has been some controversy whether the comprehensive HLS-EU-Q47 data, reflecting a conceptual model of four cognitive domains across three health domains (i.e. 12 subscales), fit unidimensional Rasch models. Still, the HLS-EU-Q47 raw score is commonly interpreted as a sufficient statistic. Combining Rasch modelling and confirmatory factor analysis, we reduced the 47 item scale to a parsimonious 12 item scale that meets the assumptions and requirements of objective measurement while offering a clinically feasible HL screening tool. This paper aims at (1) evaluating the psychometric properties of the HLS-EU-Q47 and associated short versions in a large Norwegian sample, and (2) establishing a short version (HLS-Q12) with sufficient psychometric properties.MethodsUsing computer-assisted telephone interviews during November 2014, data were collected from 900 randomly sampled individuals aged 16 and over. The data were analysed using the partial credit parameterization of the unidimensional polytomous Rasch model (PRM) and the 'between-item' multidimensional PRM, and by using one-factorial and multi-factorial confirmatory factor analysis (CFA) with categorical variables.ResultsUsing likelihood-ratio tests to compare data-model fit for nested models, we found that the observed HLS-EU-Q47 data were more likely under a 12-dimensional Rasch model than under a three- or a one-dimensional Rasch model. Several of the 12 theoretically defined subscales suffered from low reliability owing to few items. Excluding poorly discriminating items, items displaying differential item functioning and redundant items violating the assumption of local independency, a parsimonious 12-item HLS-Q12 scale is suggested. The HLS-Q12 displayed acceptable fit to the unidimensional Rasch model and achieved acceptable goodness-of-fit indexes using CFA.ConclusionsUnlike the HLS-EU-Q47 data, the parsimonious 12-item version (HLS-Q12) meets the assumptions and the requirements of objective measurement while offering clinically feasible screening without applying advanced psychometric methods on site. To avoid invalid measures of HL using the HLS-EU-Q47, we suggest using the HLS-Q12. Valid measures are particularly important in studies aiming to explain the variance in the latent trait HL, and explore the relation between HL and health outcomes with the purpose of informing policy makers.
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| 5. |
- Finbråten, Hanne Søberg, 1972-
(författare)
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Measuring health literacy : Evaluating psychometric properties of the HLS-EU-Q47 and the FCCHL, suggesting instrument refinements and exploring health literacy in people with type 2 diabetes and in the general Norwegian population
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim was to measure health literacy (HL) in people with type 2 diabetes (T2DM) and in the general Norwegian population.Methods: Sampling 388 people with T2DM (papers I, II and IV) and 900 individuals (III) in the general Norwegian population a cross-sectional design was applied. Rasch modelling and confirmatory factor analysis were used to evaluate the psychometric properties of the 47 items HLS-EU-Q47 questionnaire (I and III) and the 14 items FCCHL scale (II), and to develop and evaluate a 12 item short version, HLS-N-Q12 (III and IV), based on HLS-EU-Q47. Descriptive and inferential statistics were used to describe HL and to investigate associations between HL and various independent variables.Main results: The HLS-EU-Q47 displayed psychometric shortcomings in both populations (I and III). A 12-dimensional model described the data best. Several items showed misfit to the Rasch model and statistical dependence. Aiming at meeting the requirements of objective measurement, the HLS-N-Q12 was suggested (III and IV). Evaluating the FCCHL in people with T2DM, the data fitted a three-dimensional model best (II). Several items showed misfit to the Rasch model and unordered response categories. However, a three-dimensional 12-item version of the FCCHL had acceptable psychometric properties. Education, good general health and empowerment were positively associated with HL in people with T2DM, explaining about 17% of the total variance in HL (IV).Conclusions: In both populations, the HLS-N-Q12 displayed solid psychometric properties and might therefore be used as a measure of HL for both clinical and research purposes. Nurses and other health professionals must be aware that HL influence individuals’ proficiency in managing their health. Hence, nurses and other health professionals should map HL in individuals and adapt health information accordingly.
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| 7. |
- Finbråten, Hanne Søberg, 1972-, et al.
(författare)
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Validating the European Health Literacy Survey Questionnaire in people with type 2 diabetes : Latent trait analyses applying multidimensional Rasch modelling and confirmatory factor analysis
- 2017
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Ingår i: Journal of Advanced Nursing. - Oxford : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 73:11, s. 2730-2744
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To validate the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in people with type 2 diabetes mellitus.BACKGROUND: The HLS-EU-Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients.DESIGN: Cross-sectional study applying confirmatory latent trait analyses.METHODS: Using a paper-and-pencil self-administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis.RESULTS: Response violation and trait violation (multidimensionality) of local independence were identified. Fitting the 'multidimensional random coefficients multinomial logit' model, 1-, 3- and 12-dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items and several subscales suffered from poor targeting and low reliability. Despite multidimensionality in the data, we did not observe any unordered response categories.CONCLUSION: Interpreting the domains as distinct but related latent dimensions, the data fit a 12-dimensional Rasch model and a 12-factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall 'health literacy score'. To support the plausibility of claims based on the HLS-EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to confine response dependency; adding 'harder' items and applying a six-point rating scale to improve subscale targeting and reliability; and revising items to improve model fit. This article is protected by copyright. All rights reserved.
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| 9. |
- Hov, Reidun, et al.
(författare)
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Nurses' contributions to health : Perceptionsof first-year nursing students in Scandinaviaand Indonesia
- 2018
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Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; , s. -9
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Tidskriftsartikel (refereegranskat)abstract
- Nursing students need an understanding of how nurses care for people’s health from a global perspective. The aim of this studywas to explore how nurses can contribute to health from the perspectives of first-year nursing students in Scandinavia (Sweden,Norway) and Indonesia. Data were collected using an open-ended question about nurses’ contribution to health, and analysedusing qualitative content analysis. Three common categories emerged: ‘Promoting health and preventing disease’, ‘Performingcare and treatment’, ‘Establishing a relationship with patients and being compassionate’. ‘Possessing and implementing knowledgeand skills’ was common to Norway and Indonesia. ‘Being a team member’ was emphasised by the Indonesian participants.The Norwegian participants focused on health promotion, whereas those from Indonesia prioritised disease prevention. TheScandinavian participants emphasised individuality, while those from Indonesia focused on the community. The findings indicatethat nursing education should take account of different cultures and include student exchange programmes.
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| 10. |
- Höye, Sevald, et al.
(författare)
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A Healthy Person : The Perceptions of Indonesian and Scandinavian Nursing Students
- 2016
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Ingår i: Global qualitative nursing research. - : Sage Publications. - 2333-3936. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this exploratory study was to investigate how nursing students in Indonesia and Scandinavia characterize a healthy person. Two hundred thirty-two nursing students from Indonesia, 50 students from Sweden, and 119 students from Norway participated by answering an open-ended question. Qualitative content analysis was used to identify patterns of health in a cultural and national context. The characteristics of a healthy person were summarized in the theme “external and inner balance,” which are intertwined because of the wholeness of self-image and appearance. The subcategories were having a strong and positive body image, feeling well and having inner harmony, following the rules of life, coping with challenges, and acting in unison with the environment. There were more similarities than differences between the Indonesian and Scandinavian nursing students’ understanding of being a healthy person. The difference is that the Scandinavian students mentioned individuality, whereas the Indonesian students referred to collective values.
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