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1.	Abdulhadi, Nadia M. Noor, et al. (författare) Doctors' and nurses' views on patient care for type 2 diabetes : an interview study in primary health care in Oman 2013 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 14:3, s. 258-269 Tidskriftsartikel (refereegranskat)abstract Aim: This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care. Background: Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the healthcare system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels. Method: Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings: Organizational barriers and barriers related to patients and healthcare providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.
2.	Al-Alawi, Kamila, et al. (författare) Are the resources adoptive for conducting team-based diabetes management clinics? : An explorative study at primary health care centers in Muscat, Oman 2018 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 20, s. 1-28 Tidskriftsartikel (refereegranskat)abstract AIM: The aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches.BACKGROUND: The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines.METHOD: A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FINDINGS: The study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
3.	Albin, Björn, et al. (författare) Health and consumption of health care and social service among old migrants in Sweden 2005 Ingår i: Primary Health Care Research and Development. - : SAGE Publications. - 1463-4236 .- 1477-1128. ; 6:1, s. 37-45 Tidskriftsartikel (refereegranskat)abstract Due to migration, an increasing number of the elderly in Sweden will be foreign-born, ‘old migrants’. Old migrants will need help from society with health care and social service. Migration may influence people's health and thus also their consumption of health care and social service. The aim of the present study was to discuss migration and health with the focus on old migrants by a review of literature, and to describe the pattern of health care and social service consumption among old migrants living in Sweden, studying whether there were any differences compared with old people born in Sweden. The results showed that there is a lack of data describing old migrants' health. Available data indicate poorer self-rated health, more chronic illness and impaired mobility capacity. There are some Swedish studies describing morbidity and mortality among migrants in Sweden. These are consistent: migrants have more health problems in general and migrants from the Nordic countries have a higher mortality rate. There are no public statistics about old migrants' consumption of health care and social service in Sweden. Some studies show that old migrants consume less than native Swedes. Other studies indicate the same or higher consumption of health care, but lower consumption of social service among migrants. In conclusion, few studies concern health and consumption of health care and social care among old migrants; the results are divergent and there could be several different explanations for dissimilarities, such as migrational background, cultural distance, time of residence, socioeconomic position and adaptation in the new society. Thus, further studies are needed.
4.	Backlund, L., et al. (författare) How accurately do general practitioners and students estimate coronary risk in hypercholesterolaemic patients? 2004 Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 5:2, s. 145-152(8) Tidskriftsartikel (refereegranskat)
5.	Berlin, Anita, et al. (författare) Psychometric characteristics of a modified Sympathy-Acceptance-Understanding-Caring competence model questionnaire among foreign-born parents encountering nurses in primary child health care services 2016 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 17:3, s. 298-310 Tidskriftsartikel (refereegranskat)abstract The aim was to determine the psychometric properties of the Sumpathy-Acceptance-Understanding-Caring Competence (SAUK) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspectives are challenging and problematic worlwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identifiy related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
6.	Bohman, Doris, et al. (författare) Primary healthcare nurses' experiences of physical activity referrals : an interview study 2015 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 16:3, s. 270-280 Tidskriftsartikel (refereegranskat)abstract CONCLUSION: Our findings suggest that viewing the PAR as a complex intervention, with all that this entails, might be one approach to increasing the number of PARs being issued. Simpler systems, more time and the potential for testing the effectiveness of follow-ups could be possible ways of achieving this. AIM: The aim of this study is to illuminate primary health care (PHC) nurses' experiences of physical activity referrals (PARs). BACKGROUND: Despite extensive knowledge about the substantial health effects physical activities can produce, fewer and fewer people in our modern society regularly engage in physical activity. Within health care and, particularly, within the PHC arena, nurses meet people on a daily basis who need help to engage in a healthier lifestyle. The possibility of issuing written prescriptions for physical activities, often referred to as PARs, has been introduced as a tool to support such lifestyles. However, even though PHC nurses can prescribe physical activities, studies investigating their experience in this type of nursing intervention are rare. METHODS: For this study, 12 semi-structured interviews were conducted with PHC nurses, and the transcribed texts were analysed using a qualitative content analysis. FINDINGS: Two categories--PARs, an important nursing intervention, and PARs, the necessity of organisational support--reflected the nurses' experiences in using PARs.
7.	Borglin, Gunilla, et al. (författare) Public health care nurses' views of mothers' mental health in paediatric healthcare services : a qualitative study 2015 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 16:5, s. 470-480 Tidskriftsartikel (refereegranskat)abstract Aim: To investigate public health nurses’ perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services. Background: Although maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses. Methods: For this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard’s description of the four-step qualitative content analysis. Findings: Three categories – external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support – were interpreted to reflect the nurses’ perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum. Conclusion: We found that public health nurses can have an important role in supporting mothers’ mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers’ transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.
8.	Carrera-Bastos, Pedro, et al. (författare) Randomised controlled trial of lifestyle interventions for abdominal obesity in primary health care 2024 Ingår i: PRIMARY HEALTH CARE RESEARCH AND DEVELOPMENT. - 1463-4236 .- 1477-1128. ; 25 Tidskriftsartikel (refereegranskat)abstract Aim: Assess effects on waist circumference from diet with or without cereal grains and with or without long-term physical exercise.Background: Elevated waist circumference is an indicator of increased abdominal fat storage and is accordingly associated with increased cardiovascular mortality. This is likely due to the association between lifestyle-induced changes in waist circumference and cardiovascular risk factors. Reductions in waist circumference may be facilitated by diet without cereal grains combined with long-term physical exercise.Methods: Two-year randomised controlled trial with factorial trial design in individuals at increased risk of cardiovascular disease with increased waist circumference. Participants were allocated diet based on current Swedish dietary guidelines with or without cereal grains (baseline diet information supported by monthly group sessions) and with or without physical exercise (pedometers and two initial months of weekly structured exercise followed by written prescription of physical activity) or control group. The primary outcome was the change in waist circumference.Findings: The greatest mean intervention group difference in the change in waist circumference among the 73 participants (47 women and 26 men aged 23-79 years) was at one year between participants allocated a diet without cereal grains and no exercise and participants allocated a diet with cereal grains and no exercise [M = -5.3 cm and -0.9 cm, respectively; mean difference = 4.4 cm, 4.0%, 95% CI (0.0%, 8.0%), P = 0.051, Cohen's d = 0.75]. All group comparisons in the change in waist circumference were non-significant despite the greatest group difference being more than double that estimated in the pre-study power calculation. The non-significance was likely caused by too few participants and a greater than expected variability in the change in waist circumference. The greatest mean intervention group difference strengthens the possibility that dietary exclusion of cereal grains could be related to greater reduction in waist circumference.
9.	Ejlertsson, Lina, et al. (författare) Is it possible to gain energy at work? : a questionnaire study in primary health care 2020 Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 21 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work.METHODS: Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression.RESULTS: The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88).CONCLUSIONS: The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees' energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development.
10.	Ejlertsson, Lina, et al. (författare) Is it possible to gain energy at work? A questionnaire study in primary health care 2020 Ingår i: Primary Health Care Research and Development. - 1463-4236. ; 21 Tidskriftsartikel (refereegranskat)abstract Abstract Objectives: The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work. Methods: Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression. Results: The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88). Conclusions: The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees' energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development.
11.	Fjell, Astrid, et al. (författare) Older people living at home : experiences of healthy ageing 2021 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 22 Tidskriftsartikel (refereegranskat)abstract AIM: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support.BACKGROUND: The purpose of WHO's Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons.METHOD: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis.FINDINGS: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: 'Embracing life', 'Dealing with challenges' and 'Considering the future'.
12.	Friman, Anne, et al. (författare) District nurses' knowledge development in wound management : ongoing learning without organizational support 2014 Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 15:4, s. 386-95 Tidskriftsartikel (refereegranskat)abstract AIM: The aim of this study was to describe district nurses' (DNs') experiences of their knowledge development in wound management when treating patients with different types of wounds at healthcare centers.BACKGROUND: In primary healthcare, DNs are mainly responsible for wound management. Previous research has focused on DNs' level of expertise regarding wound management, mostly based on quantitative studies. An unanswered question concerns DNs' knowledge development in wound management. The present study therefore intends to broaden understanding and to provide deeper knowledge in regard to the DNs' experiences of their knowledge development when treating patients with wounds.METHODS: A qualitative descriptive design was used. Subjects were a purposeful sample of 16 DNs from eight healthcare centers in a metropolitan area in Stockholm, Sweden. The study was conducted with qualitative interviews and qualitative content analysis was used to analyze the data.RESULTS: The content analysis resulted in three categories and 11 sub-categories. The first category, 'ongoing learning by experience,' was based on experiences of learning alongside clinical practice. The second category 'searching for information,' consisted of various channels for obtaining information. The third category, 'lacking organizational support,' consisted of experiences related to the DNs' work organization, which hindered their development in wound care knowledge.CONCLUSIONS: The DNs experienced that they were in a constant state of learning and obtained their wound care knowledge to a great extent through practical work, from their colleagues as well as from various companies. A lack of organizational structures and support from staff management made it difficult for DNs to develop their knowledge and skills in wound management, which can lead to inadequate wound management.
13.	Friman, Anne, et al. (författare) General practitioners' knowledge of leg ulcer treatment in primary healthcare : an interview study 2020 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 21 Tidskriftsartikel (refereegranskat)abstract AIM: To describe general practitioners' (GPs') knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers.BACKGROUND: Earlier research regarding GPs' knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs' understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs' perspective.METHODS: Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis.RESULTS: Four themes were identified. 'Education and training' describe the GPs' views regarding their knowledge and knowledge development in relation to leg ulcer treatment. 'Experience' refers to GPs' thoughts about the importance of clinical experience when treating leg ulcers. 'Prioritization' describes the issues GPs raised around managing the different knowledge areas in their clinical work. 'Time constraints' explore the relationship between GPs' sense of time pressure and their opportunities to participate in professional development courses.CONCLUSIONS: The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.
14.	Friman, Anne, et al. (författare) General practitioners’ perceptions of their role and their collaboration with district nurses in wound care 2019 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 20 Tidskriftsartikel (refereegranskat)abstract Aim: To explore the perceptions of general practitioners (GPs) regarding their role and their collaboration with district nurses (DNs) in the management of leg ulcers in primary healthcare.Background: Earlier research regarding the treatment of leg ulcers in a primary care context has focussed primarily on wound healing. Less is known about GPs’ understandings of their role and their collaboration with DNs in the management of leg ulcers. Since the structured care of patients with leg ulcers involving both GP and DN is currently rather uncommon in Swedish primary care, this study sets out to highlight these aspects from the GP’s perspective.Methods: Semi-structured individual interviews with 16 GPs including both private and county council run healthcare centres. Thematic analysis was used to analyse the data.Results: Four themes were identified. The first theme: ‘role as consultant and coordinator’ shows how the GPs perceived their role in wound care. In the second theme: ‘responsibility for diagnosis’ the GPs’ views on responsibility for wound diagnosis is presented. The third theme: ‘desire for continuity’ is based on the GPs’ desire for continuity concerning various aspects. In the fourth theme: ‘collaboration within the organisation’ the importance of the organisation for collaboration between GPs and DNs is presented.Conclusions: The GP’s often work on a consultation-like basis and feel that they become involved late in the patients’ wound treatment. This can have negative consequences for the medical diagnosis and, thereby, lead to a prolonged healing time for the patient. Shortcomings regarding collaboration are mainly attributed to organisational factors.
15.	Glenngård, Anna, et al. (författare) Process measures or patient reported experience measures (PREMs) for comparing performance across providers? : A study of measures related to access and continuity in Swedish primary care 2018 Ingår i: Primary health care research & development. - 1463-4236. ; 19:01, s. 23-32 Tidskriftsartikel (refereegranskat)abstract Aim: To study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables. Background: Access and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important. Methods: Four regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils. Findings: Although ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and registered measures may be the preferred option. Above all, our findings points towards the importance of a pre-analysis of the measures in use; to explore the pros and cons if measures are used for different purposes before they are put into
16.	Guisado-Clavero, M., et al. (författare) The role of primary health care in long-term care facilities during the COVID-19 pandemic in 30 European countries: a retrospective descriptive study (Eurodata study) 2023 Ingår i: Primary Health Care Research and Development. - 1463-4236. ; 24 Tidskriftsartikel (refereegranskat)abstract Background and aim:Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic.Methods:Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care.Results:Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom's follow-up was performed mainly by PHC.Conclusion:PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.
17.	Guisado-Clavero, Marina, et al. (författare) The role of primary health care in long-term care facilities during the COVID-19 pandemic in 30 European countries : A retrospective descriptive study (Eurodata study) 2023 Ingår i: Primary Health Care Research and Development. - 1463-4236. ; 24 Tidskriftsartikel (refereegranskat)abstract Background and aim: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic. Methods: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care. Results: Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom's follow-up was performed mainly by PHC. Conclusion: PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.
18.	Gustafsson, Silje, et al. (författare) Self-care for minor illness 2015 Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 16:1, s. 71-78 Tidskriftsartikel (refereegranskat)abstract Aim: To describe experiences with and knowledge of minor illness, self-care interventions used in minor illness and channels of information used when providing self-care for minor illness.Background: Although minor illness is self-limiting, symptoms can be substantial and have a great impact on the affected person’s wellbeing. Possibilities to seek and find information about health and self-care have significantly increased through internet-based communities, forums, and websites. Still, a considerable number of consultations with general practitioners are for conditions that are potentially self-treatable. Seeking advanced care for minor illnesses is costly for society and can create discomfort for patients as they are down-prioritized at emergency departments.Methods: Study participants were recruited randomly from the Swedish Adress Register. A questionnaire was sent out, and the final sample included 317 randomly selected persons aged 18–80 and living in Sweden.Findings: Having experienced a specific illness correlated with self-reported knowledge. Preferred self-care interventions differed between different conditions, but resting and self-medicating were commonly used, along with consulting health care facilities. Compliance to advice was the highest for official information channels, and family members were a popular source of advice.
19.	Hadziabdic, Emina, 1974-, et al. (författare) Beliefs about illness : comparing foreign- and native-born persons with type 2 diabetes living in Sweden in a cross-sectional survey 2023 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 24 Tidskriftsartikel (refereegranskat)abstract Aim:Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born persons diagnosed with type 2 diabetes living in Sweden (in the following termed 'Swedish-born'). Background:Beliefs about illness are individual, culturally related, based on knowledge, and guide health-related behaviour, and thus have an impact on health. The question is whether beliefs differ between foreign- and native-born persons diagnosed with type 2 diabetes. No previous comparative studies have been found on this. Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born (Swedish) persons diagnosed with type 2 diabetes living in Sweden. Methods:Cross-sectional survey, 138 participants, comprising 69 foreign- and 69 Swedish-born persons aged 33-90 vs 48-91 years. Data were analysed with descriptive and analytic statistics. Findings:Beliefs about illness differed between foreign- and Swedish-born persons concerning causes of diabetes and healthcare-seeking behaviour. Foreign-born persons more often than Swedish-born persons reported uncertainty or lack of knowledge about whether heredity (67% vs 90%, P = 0.002) and pancreatic disease (40% vs 62%, P = 0.037) could cause diabetes. To a higher extent than Swedish-born persons, they reported that emotional stress and anxiety could cause the disease. Furthermore, they claimed they had sought care due to diabetes during the last 6 months to a higher extent than Swedish-born persons (30% vs 4%, P = 0.000).The findings confirmed that dissimilarities in beliefs about illness, including the causes of diabetes and healthcare-seeking behaviour, exist between foreign- and Swedish-born persons with type 2 diabetes.
20.	Hadziabdic, Emina, 1978-, et al. (författare) Development of a group-based diabetes education model for migrants with type 2 diabetes, living in Sweden 2020 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press (CUP). - 1463-4236 .- 1477-1128. ; 21 Tidskriftsartikel (refereegranskat)abstract Aim: To develop a diabetes education model based on individual beliefs, knowledge and risk awareness, aimed at migrants with type 2 diabetes, living in Sweden.Background: Type 2 diabetes is rapidly increasing globally, particularly affecting migrants living in developed countries. There is ongoing debate about what kind of teaching method gives the best result, but few studies have evaluated different methods for teaching migrants. Previous studies lack a theoretical base and do not proceed from the individuals' own beliefs about health and illness, underpinned by their knowledge, guiding their health-related behaviour.Methods: A diabetes education model was developed to increase knowledge about diabetes and to influence self-care among migrants with type 2 diabetes. The model was based on literature review, on results from a previous study investigating knowledge about diabetes, on experience from studies of beliefs about health and illness, and on collaboration between researchers in diabetes care and migration and health and staff working in a multi-professional diabetes team.Findings: This is a culturally appropriate diabetes education model proceeding from individual beliefs about health and illness and knowledge, conducted in focus-group discussions in five sessions, led by a diabetes specialist nurse in collaboration with a multi-professional team, and completed within three months. The focus groups should include 4-5 persons and last for about 90 min, in the presence of an interpreter. A thematic interview guide should be used, with broad open-ended questions and descriptions of critical situations/health problems. Discussions of individual beliefs based on knowledge are encouraged. When needed, healthcare staff present at the session answer questions, add information and ensure that basic principles for diabetes care are covered. The diabetes education model is tailored to both individual and cultural aspects and can improve knowledge about type 2 diabetes, among migrants and thus increase self-care behaviour and improve health.
21.	Hadziabdic, Emina, et al. (författare) Family members’ experiences of the use of interpreters in healthcare 2014 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 15:2, s. 156-169 Tidskriftsartikel (refereegranskat)abstract Aim The aim was to explore adults’ experiences of their family members’ use of interpreters in health-care encounters.Background Language barriers are a major hindrance for migrants to receive appropriate healthcare. In a foreign country, family members often need support in care of migrant patients. No previous studies focusing on adult family members’ experiences of the use of interpreters in healthcare have been found.Method A purposive sample of 10 adult family members with experiences of the use of interpreters in health-care encounters. Data were collected between May and September 2009 by focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.Findings Three categories emerged from the analysis: (1) Experiences of the use of professional interpreters, (2) Experiences of being used as an interpreter and (3) Experiences of what needs to be improved when using interpreters. The main findings showed no agreement in family members’ experiences; interpretation should be individually and situationally adapted. However, when family members acted as interpreters, their role was to give both practical and emotional support, and this led to both positive and negative emotions. Use of simple language, better collaboration in the health-care organization and developing the interpreters’ professional attitude could improve the use of professional interpreters. The type of interpreter, mode of interpretation and patient's preferences should be considered in the interpretation situation. In order to achieve high-quality healthcare, health-care professionals need to organize a good interpretation situation case-by-case, choose the appropriate interpreters with the patient in focus and cooperate with members of the patient's social network.
22.	Hadziabdic, Emina, 1974-, et al. (författare) Healthcare staffs perceptions of using interpreters : a qualitative study 2010 Ingår i: Primary Health Care Research and Development. - Cambridge, UK. - 1463-4236 .- 1477-1128. ; 11:3, s. 260-270 Tidskriftsartikel (refereegranskat)abstract Aim: To describe how healthcare professionals experience and perceive the use of interpreters in their contacts with patients with whom they do not share a common language. Methods: An explorative descriptive study. The study was conducted in different healthcare settings in Sweden and included 24 healthcare staff, of whom 11 were physicians, 9 nurses, 2 physiotherapists and 2 assistant nurses. Data were generated through written descriptions of the use of interpreters in healthcare and analysed using qualitative content analysis. Findings: Two main categories emerged: 1) aspects related to the interpreter and 2) organizational aspects. It was shown that having a face-to-face, professional, trained interpreter, with a good knowledge of both languages and of medical terminology, translating literally and objectively, was perceived positively. The organizational aspects that affected the perception were functioning or non-functioning technical equipment, calm in the interpretation environment, documentation of the patients’ language ability, respect for the appointed time, and the level of availability and service provided by the interpreter agency. Conclusion: It is important to develop a well-functioning interpreter organization that offers trained interpreters with a professional attitude to improve and ensure cost-effective and high-quality encounters and care.
23.	Hallgren Elfgren, Ing-Marie, et al. (författare) Swedish Diabetes Register, a tool for quality development in primary health care 2013 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 14:3, s. 250-257 Tidskriftsartikel (refereegranskat)abstract Introduction In Sweden, quality indicators in health care have been the basis for developing National Quality Registers. The Swedish National Diabetes Register (NDR) – one of the largest diabetes registers globally – was introduced in primary health care (PHC) in the county of Östergötland by an implementation project, 2002–2005.Aim The aim of the present paper was to investigate, by using the results of the NDR, whether the registration led to sustained outcomes of medical results of diabetes care in PHC in the county during the period 2005–2009.Method HbA1c, blood pressure (BP), albuminuria and low-density lipoprotein-cholesterol were registered online in the NDR. In 2005 and 2006, goal achievement for HbA1c was measured and compared between PHC centres (PHCC) within the county. In 2007, achievements to national goals were compared between the PHCCs within the county and with those Swedish counties that had attained a sufficiently high registration rate. In 2008 and 2009, the average county results were compared with the corresponding national average measurements for all 21 Swedish counties combined.Result In 2005, a clear improvement trend for HbA1c and BP was shown within the county. In 2007–2009, goal achievements in the county studied were slightly better than the other counties measured and the country as a whole in almost every comparison.Discussion The present study has shown association between medical results and registration in the NDR. As the project was primarily a quality improvement work, the results have continuously influenced the development of diabetes care. Both the health professions and the county council now have – in the NDR – an effective and rapid method for evaluation and follow-up of diabetes care. The systematic documentation, followed by comparisons and analyses, create ideas for care improvements.
24.	Hallgren Elfgren, Ing-Marie, et al. (författare) The Swedish National Diabetes Register in clinical practice and evaluation in primary health care 2016 Ingår i: Primary Health Care Research and Development. - : CAMBRIDGE UNIV PRESS. - 1463-4236 .- 1477-1128. ; 17:6, s. 549-558 Tidskriftsartikel (refereegranskat)abstract The purpose of this project is to describe the use of the Swedish National Diabetes Register (NDR) in clinical practice in a Swedish county and to specifically monitor the diabetes care routines at two separate primary health-care centres (PHCC) with a special focus on older patients. Background: According to Swedish law, all health-care units have to maintain a system for quality evaluation and improvement. As the NDR holds the most important quality indicators, implementation of the NDR in primary care was carried out by an implementation project in 2002-2005. Methods: Initially, a digital questionnaire about NDR routines was sent to all PHCC. Statistics about hemoglobin adult 1c (HbA1c) and blood pressure (BP) was presented for the diabetes teams at two centres who were also interviewed. The responses became the basis for a focus group interview with both teams together, with data subject to content analysis. Findings: The study showed that reporting to the NDR has become a compulsory routine in primary care. The diabetes nurse specialist was responsible for the practical management of the register and used the NDR for continuous monitoring of the patients. Most centres used the NDRs statistics for evaluation and analyses annually. The diabetes nurse adapted the visits to the patients wishes and general condition. Only in terms of target values for HbA1c and BP did they accept slightly higher values for the older patients. Since the NDR was implemented, the registration rate has remained at 75% and has not increased. The reason given was that patients with diabetes living in nursing homes are checked up by the municipal nurse who does not use the NDR. However, the risk of omitting older patients in the NDR could be considerably decreased if data could be transferred from the electronic patient record.
25.	Hamberg Levedahl, Kerstin, et al. (författare) How persons with systemic mastocytosis describe the time between symptom onset and receiving diagnosis 2022 Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 23 Tidskriftsartikel (refereegranskat)abstract Aim: The aim of the study was to explore how persons with systemic mastocytosis (SM) described the time between the onset of symptoms and signs and getting the diagnosis.Background: SM is a rare disease caused by the accumulation of clonal mast cells with abnormal function. The symptoms and signs of the disease are varied, often diffuse and affect individuals differently. Due to this complexity, a multi-disciplinary diagnostic approach is required, in which general practitioners play an important part in identifying and referring patients relevant for such investigations.Methods: Sixteen persons with SM were interviewed about their experiences of the time before the diagnosis was received. Systematic text condensation was used in the analysis process.Findings: The time between symptom and signs onset and diagnosis was perceived as difficult. SM often had a complex and unpredictable effect on a person’s daily life, long before diagnosis. In the analysis, three themes were found. Having symptoms and signs with an unknown cause included the participants’ descriptions of numerous symptoms and signs, often years before diagnosis. These could be severe and result in worries for both participants and their next-of-kin. Dealing with the symptoms and signs encompassed the different ways in which the participants coped with the symptoms and signs, and sought relief. Being a patient without a diagnosis underlined the lack of information and knowledge within healthcare, often resulting in a delayed or incorrect diagnosis. The study highlighted the importance of a person-centred approach and the need to increase knowledge of the disease within primary care, to shorten this stressful and vulnerable time.

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