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1.	Alijanzadeh, Mehran, et al. (författare) Measurement Invariance and Differential Item Functioning of the Health Literacy Instrument for Adults (HELIA) : A Large-Scale Cross-Sectional Study in Iran 2022 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:10 Tidskriftsartikel (refereegranskat)abstract Health literacy is important for health behavior engagement. Therefore, it is important to have a good instrument assessing health literacy with a theoretical framework. The present study aimed to examine the measurement invariance and differential item functioning (DIF) of a newly developed health literacy instrument; that is, the Health Literacy Instrument for Adults (HELIA). Confirmatory factor analysis (CFA) and Rasch models were used to examine the data collected from a large Iranian sample (N = 9678; 67.3% females; mean age = 36.44 years). All the participants completed the HELIA. CFA was used to examine if the HELIA had a five-factor structure (including reading, access to information, understanding, appraisal, and decision making/behavioral intention factors) and multigroup CFA to examine if the five-factor structure of HELIA was invariant across gender, educational level, accommodation, and age subgroups. Rasch models were used to examine whether each factor of HELIA was unidimensional and DIF contrast in Rasch to examine if the HELIA items were interpreted similarly across the aforementioned subgroups. The CFA results supported the five-factor structure of HELIA, and the Rasch models verified that each HELIA factor is unidimensional. Additionally, multigroup CFA supported the measurement invariance of HELIA across the following subgroups: male vs. female; highly educated vs. poorly educated; city residents vs. suburban residents; and younger age vs. older age. The DIF contrasts in the Rasch models additionally showed that there are no substantial DIF items in the HELIA across aforementioned subgroups. Therefore, the HELIA is a feasible and comprehensive instrument assessing health literacy across different populations in Iran.
2.	Glasdam, Stinne, et al. (författare) Experiences of Everyday Life among Individuals with Co-Existence of Serious Mental Illness and Cancer : —A Qualitative Systematic Literature Review 2023 Ingår i: Healthcare (Switzerland). - 2227-9032. ; 11:13 Tidskriftsartikel (refereegranskat)abstract Daily life with severe mental health (SMI) and cancer comorbidity entails multiple challenges. The study aims to explore everyday life experiences among individuals with SMI and cancer comorbidity from the perspectives of patients, significant others, and involved healthcare professionals. The study is registered in PROSPERO (CRD42021259604). A qualitative systematic review was conducted through searches in the databases MEDLINE, CINAHL, PsychInfo, and Web of Sciences (last search 14 February 2023). Inclusion criteria were empirical qualitative research studies investigating experiences of healthcare and everyday life among persons living with SMI and who were subsequently diagnosed with cancer from the perspective of the individuals themselves, their significant others, and healthcare professionals involved in their care. Exclusion criteria:Literature reviews, quantitative studies, intervention studies, quantitative parts of mix-methods studies, non-English languages, persons February 2023, were included and analysed through a thematic analysis. The PRISMA 2020 checklist guided the study. The results were presented in four themes: ‘Navigating between different worlds and logics’, ‘Decision-making capacity depending on the assessor’, ‘Cancer must give way to severemental illness or vice versa’, and ‘Significant others as a safety net’. Research about the everyday lives of persons with SMI and cancer comorbidities from patients’ and relatives’ perspectives is lacking and thus called for.
3.	Lukic, Sandra, et al. (författare) Reflexive Views of Virtual Communities of Practice among Informal and Formal Caregivers of People with a Dementia Disease 2024 Ingår i: Healthcare. - Basel : MDPI. - 2227-9032. ; 12:13, s. 1-11 Tidskriftsartikel (refereegranskat)abstract Knowledge seems to mitigate the consequences of dementia and new educational strategiesare required. This study aimed to qualitatively explore the reflexive views and experiences of virtual Communities of Practice (vCoP) among informal and formal caregivers of people with dementia and explore vCoP as a tool for learning and knowledge development. Data were collected in a sequence of virtual workshops and analyzed and synthesized using thematic analysis. For the informal caregivers, one main theme emerged: Learning and support, comprising three subthemes: Strategies for learning; Creating emotional support; and in need of professional support. Among formal caregivers, one main theme emerged: Professional development, comprising two subthemes: Sharing and gaining knowledge and Knowledge as a professional tool. vCoP and collaborative learning using an educational platform seem to support learning and professional development among informal and formal caregivers, respectively. As a collaborative, virtual activities seem to provide practical and emotional support and promote professional development; vCoP seem to have the potential to promote the resilience and sustainability of care. Further research is necessary to gain an understanding of the effects of Communities of Practice (CoP) and vCoP and their successful implementation in care practices aswell as the potential of using CoP in continuing professional development, CPD.
4.	Ahlström, Gerd, et al. (författare) A Psychometric Evaluation of the Family Collaboration Scale and an Investigation of How the Close Family of Frail Older Patients Perceive the Collaboration with Healthcare Professionals on Acute Medical Wards at Hospitals in Sweden 2022 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:3 Tidskriftsartikel (refereegranskat)abstract The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members' perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents' ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.
5.	Ahlström, Gerd, et al. (författare) Breaking up and a new beginning when one’s partner goes into a nursing home : An interview study 2021 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 9:6 Tidskriftsartikel (refereegranskat)abstract In aging societies worldwide, spouses take on great responsibility for care when their partner continues to live at home. Nursing home placement occurs when the partner becomes too frail due to multimorbidity, and this will cause a change in the spouse’s life. This study aimed to explore the spouse’s experience of their partner’s move to a nursing home. Two interviews were conducted at 9-month intervals within the project entitled “Implementation of Knowledge-Based Palliative Care in Nursing Homes”. Thirteen spouses from both urban and rural areas were included, with an age-range of 60–86 years (median 72). Qualitative content analysis was performed. The main findings were captured in two themes: Breaking up of close coexistence and Towards a new form of daily life. The first encompassed processing loneliness, separation and grief, exhaustion, increased burden, and a sense of guilt. The second encompassed a sense of freedom, relief, acceptance, support and comfort. Professionals in both home care and nursing home care need to develop and provide a support programme conveying knowledge of the transition process to prevent poor quality of life and depression among the spouses. Such a programme should be adaptable to individual needs and should ideally be drawn up in consultation with both partners.
6.	Alftberg, Åsa, et al. (författare) Conversations about Death and Dying with Older People : An Ethnographic Study in Nursing Homes 2018 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 6:2 Tidskriftsartikel (refereegranskat)abstract Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.
7.	Andersen, Pia, et al. (författare) Physical Activity on Prescription with Counsellor Support : A 4-Year Registry-Based Study in Routine Health Care in Sweden 2018 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 6:2 Tidskriftsartikel (refereegranskat)abstract Background: Public health gains from physical activity on prescription (PAP) depend on uptake in routine care. We performed an evaluation of the implementation, in a Swedish county council, of counsellors who give personalized support to PAP recipients aimed at facilitating PAP delivery. The aim was to compare characteristics between PAP recipients and the health care population as well as between PAP recipients who used and did not use counsellor support. We also investigated professional belonging and health care setting of health care professionals who prescribed PAP. Methods: All patients' >= 18 years who received PAP during 2009-2012 in primary and secondary care in the County Council of Kronoberg were included (n = 4879). Data were retrieved from electronic medical records. Main outcome measures were patient and professional characteristics. Results: A third of the PAP recipients had diseases in >= 5 diagnostic groups and more than half had >= 11 office visits the year before receiving PAP. Counsellor support was used by one-third and PAP recipients who used counsellor support had more multiple diagnoses and office visits compared with non-users. Physicians issued 44% of prescriptions and primary care was the predominant setting. The amount of PAP did not change over time, but the proportion of physicians' prescriptions decreased while the proportion of nurses' prescriptions increased. Conclusions: PAP recipients had high morbidity and were frequent health care attenders, indicating that PAP was predominantly used for secondary or tertiary prevention. PAP rates did not increase as intended after the implementation of counsellor support.
8.	Axmon, Anna, et al. (författare) Chronic Respiratory Disorders and Their Treatment among Older People with Intellectual Disability and/or Autism Spectrum Disorder in Comparison with the General Population 2017 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:3 Tidskriftsartikel (refereegranskat)abstract Respiratory disorders are common among people with intellectual disabilities (ID). However, few studies have investigated these disorders among older people with ID. We identified 7936 people, aged 55+ years, with ID and a reference cohort from the general population. Data on diagnoses of chronic respiratory disorders, with a focus on asthma and chronic obstructive pulmonary disease (COPD), were collected, as was information on health care visits due to such disorders. We also added data on the prescription of drugs for obstructive airway diseases. Whereas the risk of having at least one diagnosis of asthma during the study period was similar in the two cohorts, people with ID were less likely than the general population to have been diagnosed with COPD. The same was found for health care visits due to asthma and COPD, respectively. The patterns of drug prescription were similar among people with ID and the general population, with the exception of adrenergics for systemic use, which were more commonly prescribed to people with ID. Thus, older people with ID do not seem to have an increased risk of asthma or COPD. Moreover, the indications are that when diagnosed with any of these disorders, they receive treatment adapted to their particular needs.
9.	Axmon, Anna, et al. (författare) Pain and Pain Medication among Older People with Intellectual Disabilities in Comparison with the General Population 2018 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 6:2, s. 1-12 Tidskriftsartikel (refereegranskat)abstract Little is known about pain and pain treatment among people with intellectual disabilities (IDs). We aimed to describe pain and pain medications among older people with ID compared to the general population. Data on diagnoses and prescriptions were collected from national registers for the period between 2006 and 2012 for 7936 people with an ID and a referent cohort from the general population. IDs were associated with a decreased risk of being diagnosed with headaches, musculoskeletal pain, and pain related to the circulatory and respiratory systems, but they were associated with increased risk of being diagnosed with pain related to the urinary system. Among men, IDs were associated with an increased risk of being diagnosed with visceral pain. People with IDs were more likely to be prescribed paracetamol and fentanyl regardless of the type of pain but were less likely to be prescribed COX(1+2) and COX2 inhibitors and weak opioids. Healthcare staff and caregivers must be made aware of signs of pain among people with IDs who may not be able to communicate it themselves. Further research is needed to investigate whether people with IDs are prescribed paracetamol rather than other pain drugs due to physicians trying to avoid polypharmacy or if there are other reasons not to prescribe a greater range of pain treatments.
10.	Carlsson, Gunilla, et al. (författare) Falls and Fear of Falling among Persons Who Receive Housing Adaptations-Results from a Quasi-Experimental Study in Sweden 2017 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:4 Tidskriftsartikel (refereegranskat)abstract While health might deteriorate through the ageing and disablement process, the impacts of disability can be reduced by adapting the environment. This study aimed to investigate the effects of applying a standardized research-based strategy to housing adaptation as compared to ordinary practice with respect to falls and fear of falling. Another aim was to investigate the overall effects of housing adaptations on fall-related outcomes over time. In total, 196 clients were included at baseline, with follow-up at 3 and 6 months after the housing adaptation was implemented. The only significant difference between the two approaches was identified with respect to fear of falling at 3 months after the housing adaptation, but not after 6 months. The number of clients reporting actual falls increased over time in both sites, whereas the number of reported near-falls decreased most in the intervention site, but without significant differences. Thus, the patterns of differences between the sites are inconsistent, as are the patterns of change in fall-related outcomes. An overall conclusion is that if the goal is to improve fall-related outcomes, housing adaptation should be complemented with other interventions preventing falls and explicitly address the clients' activity limitations. In addition, longer follow-up times are necessary.
11.	Eekholm, Signe, et al. (författare) 'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy : An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia 2021 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 9:11 Tidskriftsartikel (refereegranskat)abstract The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses' (RNs') adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ''stolen time'-delivering nursing at the bottom of a hierarchy', and three themes: (1) 'under the dominance of stronger paradigms', (2) 'the loss of professional identity', and (3) 'the power of leadership'. These themes, each comprising two to three subthemes, illustrated that RNs' adherence to EBG recommendations was strongly influenced by the individual RN's professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager's leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.
12.	Fagerdahl, AM, et al. (författare) An Interprofessional E-Learning Resource to Prepare Students for Clinical Practice in the Operating Room-A Mixed Method Study from the Students' Perspective 2021 Ingår i: Healthcare (Basel, Switzerland). - : MDPI AG. - 2227-9032. ; 9:8 Tidskriftsartikel (refereegranskat)abstract The operating room is a challenging learning environment for many students. Preparedness for practice is important as perceived stress and the fear of making mistakes are known to hamper learning. The aim was to evaluate students’ perspectives of an e-learning resource for achieving preparedness. A mixed methods design was used. Students (n = 52) from three educational nursing and medical programs were included. A questionnaire was used to explore demographics, student use of the e-learning resource, and how the learning activities had helped them prepare for their clinical placement. Five focus group interviews were conducted as a complement. Most students (79%) stated that the resource prepared them for their clinical placement and helped them to feel more relaxed when attending to the operating room. In total, 93% of the students recommended other students to use the e-learning resource prior to a clinical placement in the operating room. Activities containing films focusing on practical procedures were rated as the most useful. We conclude that an e-learning resource seems to increase students’ perceived preparedness for their clinical practice in the operating room. The development of e-learning resources has its challenges, and we recommend student involvement to evaluate the content.
13.	Fagerdahl, AM (författare) The Patient's Conceptions of Wound Treatment with Negative Pressure Wound Therapy 2014 Ingår i: Healthcare (Basel, Switzerland). - : MDPI AG. - 2227-9032. ; 2:3, s. 272-81 Tidskriftsartikel (refereegranskat)
14.	Fernandes, Sara, et al. (författare) Children’s Attitudes and Behaviors about Oral Health and Dental Practices 2021 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 9:4 Tidskriftsartikel (refereegranskat)abstract The present study sought to contribute to a better understanding of children’s attitudes and behaviors regarding oral health and dental practices. The sample was composed of 101 children (8–10 years), collected from several schools in the Lisbon metropolitan area. Our main goals were to collect a survey of information about the beliefs, attitudes, habits and knowledge of children about oral and dental issues in order to not only have an overview of them but also to serve as a basis and a starting point for the development of intervention programs to increase positive attitudes and behaviors related to oral health and promote greater knowledge about these subjects. In general, children reported positive behaviors regarding dental habits and oral hygiene practices. Children’s opinions and beliefs about dentists were also globally positive; however, the results suggested that younger children reported more positive attitudes, emotions and previous experiences. Regarding children’s knowledge about these dental issues, the results were quite negative and worrying, ruled by ignorance and incorrect beliefs and behaviors. In sum, all the results and conclusions of this study may contribute to the development of educational programs within the scope of the promotion of oral health and hygiene practices—“An Adventure about Oral Health.”
15.	Fänge, Agneta Malmgren, et al. (författare) Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future : A Survey Study in Sweden, Italy, Germany and the United Kingdom 2022 Ingår i: Healthcare. - Basel : MDPI. - 2227-9032. ; 10:2, s. 1-13 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 07.10.2020 and the 17.12.2020: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.
16.	Gams, M, et al. (författare) Similarities and Differences between EU Platforms in the AHA and AAL Domains from a Software Viewpoint 2022 Ingår i: Healthcare (Basel, Switzerland). - : MDPI AG. - 2227-9032. ; 10:2 Tidskriftsartikel (refereegranskat)abstract The EU PlatformUptake project’s main goal is to investigate the usage of EU open and partly-open platforms in active and healthy aging (AHA) and ambient-assisted living (AAL) domains, from a software viewpoint. The aim of the project was to provide tools for a deeper interpretation and examination of the platforms, gather user feedback, and use it to improve the state-of-the-art approach in the AHA and AAL domains, and define instructions to enhance the platforms within the recommended order. The emphasis is on the software viewpoint for decision makers. In this paper, we present (i) the PlatformUptake methodology for AHA open platform assessments and its main objectives; (ii) clustering of the analyzed platforms; and (iii) the taxonomies generated from the text descriptions of the chosen platforms. With the use of the clustering tools, we present which platforms could be grouped together due to their similarities. Different numbers of clusters were obtained with two clustering approaches, resulting in the most informative two and four cluster groups. The platforms could be rather neatly presented in this way and, thus, potentially guide future platform structuring. Moreover, taxonomies, i.e., decision trees of platforms, were generated to easily determine each specific platform or to find platforms with the desired properties. Altogether, the computer comprehension of the platforms may be important additions to the human way of dealing with the AHA platforms, influencing future design, publications, related work, and research.
17.	Gams, M, et al. (författare) Similarities and Differences between EU Platforms in the AHA and AAL Domains from a Software Viewpoint 2022 Ingår i: Healthcare (Basel, Switzerland). - : MDPI AG. - 2227-9032. ; 10:2 Tidskriftsartikel (refereegranskat)abstract The EU PlatformUptake project’s main goal is to investigate the usage of EU open and partly-open platforms in active and healthy aging (AHA) and ambient-assisted living (AAL) domains, from a software viewpoint. The aim of the project was to provide tools for a deeper interpretation and examination of the platforms, gather user feedback, and use it to improve the state-of-the-art approach in the AHA and AAL domains, and define instructions to enhance the platforms within the recommended order. The emphasis is on the software viewpoint for decision makers. In this paper, we present (i) the PlatformUptake methodology for AHA open platform assessments and its main objectives; (ii) clustering of the analyzed platforms; and (iii) the taxonomies generated from the text descriptions of the chosen platforms. With the use of the clustering tools, we present which platforms could be grouped together due to their similarities. Different numbers of clusters were obtained with two clustering approaches, resulting in the most informative two and four cluster groups. The platforms could be rather neatly presented in this way and, thus, potentially guide future platform structuring. Moreover, taxonomies, i.e., decision trees of platforms, were generated to easily determine each specific platform or to find platforms with the desired properties. Altogether, the computer comprehension of the platforms may be important additions to the human way of dealing with the AHA platforms, influencing future design, publications, related work, and research.
18.	Georgieva, Irina, et al. (författare) Prevalence, new incidence, course and risk factors of PTSD, depression, anxiety, and panic disorder during the Covid-19 pandemic in 11 countries 2021 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 9:6 Tidskriftsartikel (refereegranskat)abstract We aimed to evaluate the prevalence and incidence of post-traumatic stress disorder (PTSD), depression, anxiety and panic disorder (PD) among citizens in 11 countries during the COVID-19 pandemic. We explored risks and protective factors most associated with the development of these mental health disorders and their course at 68 days follow up. We acquired 9543 unique responses via an online survey that was disseminated in UK, Belgium, Netherlands, Bulgaria, Czech Republic, Finland, India, Latvia, Poland, Romania, and Sweden. The prevalence and new incidence during the pandemic for at least one disorder was 48.6% and 17.6%, with the new incidence of PTSD, anxiety, depression, and panic disorder being 11.4%, 8.4%, 9.3% and 3%, respectively. Higher resilience was associated with lower mental health burden for all disorders. Ten to thirteen associated factors explained 79% of the variance in PTSD, 80% in anxiety, 78% in depression, and 89% in PD. To reduce the mental health burden, governments should refrain from implementing many highly restrictive and lasting containment measures. Public health campaigns should focus their effort on alleviating stress and fear, promoting resilience, building public trust in government and medical care, and persuading the population of the measures’ effectiveness. Psychosocial services and resources should be allocated to facilitate individual and community-level recovery from the pandemic.
19.	Hall, P, et al. (författare) A Scoping Review of Non-Pharmacological, Non-Surgical Secondary Prevention Strategies in Ischaemic Stroke and TIA in National Stroke Guidelines and Clinical Audit Documents 2022 Ingår i: Healthcare (Basel, Switzerland). - : MDPI AG. - 2227-9032. ; 10:3 Tidskriftsartikel (refereegranskat)abstract The Stroke Action Plan for Europe (2018–2030) calls for national-level secondary prevention plans that address lifestyle, in addition to prevention medications and surgical interventions. This scoping review examines national stroke care guideline and audit documents across WHO regions to identify non-pharmacological, non-surgical stroke secondary prevention recommendations and associated performance indicators. Using a snowballing methodology, 27 guideline documents met the inclusion criteria. Sixteen (59%) detailed, non-pharmacological, non-surgical stroke secondary prevention-addressing known, modifiable population attributable risk factors, of physical inactivity (N = 11), smoking (N = 11), unsafe alcohol consumption (N = 10), diet (N = 8), weight (N = 5), stress (N = 4) and depression (N = 2). Strategies recommended to address these risk factors were: assessment of stroke risk/risk factors (N = 4); provision of advice and information on reducing lifestyle related risk (N = 16); education and counselling for lifestyle behaviour change (N = 8) and onward referral for specialist management of risk (N = 4). Of the nine stroke audits/registries identified, only three (33%) included non-pharmacological, non-surgical quality indicators of documented provision of advice or information on the following: general lifestyle (N = 2); smoking cessation for current smokers (N = 2); reduction in alcohol consumption, where relevant (N = 1), exercise participation (N = 1) and diet (N = 1). Preventive quality indicators addressing the management of weight, stress or depression were absent. This review highlights current gaps in optimal stroke secondary prevention recommendations and their implementation.
20.	Holmgren, Marianne, et al. (författare) Is Obesity More Than a Double Burden among People with Mobility Disability? : The Effect of Obesity on HRQoL and Participation in Society 2017 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:4 Tidskriftsartikel (refereegranskat)abstract Obesity is more common in individuals with mobility disability than in those without this condition. Individuals with mobility disability also have lower health-related quality of life (HRQoL) and are limited in their participation in society. Therefore, this study aimed to investigate the body mass index (BMI) status and the association of overweight or obesity on HRQoL and participation in society among those with mobility disability in comparison to those without mobility disability. This cross-sectional study was based on a health survey conducted in Sweden in 2012 (n = 18,322; age, 18-64 years). Logistic regression with and without interaction analysis was applied. Effect modification by overweight status was significant for, moderate pain. For obesity, effect modification was seen for low general health, pain (moderate and severe), and not participating in work. BMI was higher among those with mobility disability, but no associations between overweight or obesity and HRQoL or participation in society were observed for those with mobility disability. Overweight and obesity did not add an additional burden to mobility disability, probably because mobility disability is associated with low HRQoL and low participation in society. Despite these results, population obesity prevention strategies are still needed.
21.	Holst, Göran, et al. (författare) Signs in People with Intellectual Disabilities : Interviews with Managers and Staff on the Identification Process of Dementia. 2018 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 6:3 Tidskriftsartikel (refereegranskat)abstract The life expectancy of people with intellectual disabilities (ID) has steadily increased, which has been accompanied by an increased risk of dementia. Staff and managers are key resources for safety diagnosis since they deliver information about people with ID behavior every day. The aim of the present study was to explore the identification process employed by staff and managers to detect signs of suspected dementia in people with an ID within intellectual disability services (ID-services). Twenty managers and 24 staff within an ID-service were interviewed and qualitative latent content analysis was applied. A model consisting of three themes on three levels of resources for the identification process of signs of suspected dementia emerged from the analysis. On the first level was the time and continuity in the care relationship, which is crucial for identifying and responding to changes in cognitive ability that indicate dementia. On the second level, the staff identify deficiencies in their own knowledge, seek support from colleagues and managers within their workplace and, on the third level, outside their workplace. Staff and managers expressed a need for early and continuous guidance and education from specialists in dementia and primary healthcare. This finding indicates an urgent need for intervention research and digital support for staff in dementia care.
22.	Hultqvist, Jenny, et al. (författare) Satisfaction with Daily Occupations for Elderly People (SDO-E)—Adaptation and Psychometric Testing 2017 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:4 Tidskriftsartikel (refereegranskat)abstract Satisfaction with everyday occupations has been shown to be important for health and well-being in various populations. Research into satisfaction with everyday occupations among elderly persons is, however, lacking. The aim was to investigate the psychometric properties of an adapted test version of the Satisfaction with Daily Occupations instrument (SDO) for elderly people, called SDO-E. Five hospital-based occupational therapists working with elderly people evaluated the content validity and usability of the SDO-E. The elderly participants consisted of 50 people from outside of the health services and 42 inpatients at an internal medicine clinic. They completed the SDO-E and rated their perceived health, activity level, and general satisfaction with daily occupations. The SDO-E showed fair content validity and utility, acceptable internal consistency, good preliminary construct validity and relevant known-groups validity. The SDO-E thus appears to be a useful screening tool for assessing activity level and satisfaction with daily occupations among elderly people, and a complement to other self-report instruments concerning factors connected with health and well-being. Future research should further explore the content validity of the SDO-E, particularly the views of the elderly themselves, and investigate the SDO-E in terms of sensitivity to change.
23.	Ivarsson, Bodil, et al. (författare) Novel Insight into How Nurses Working at PH Specialist Clinics in Sweden Perceive Their Work 2020 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 8:2 Tidskriftsartikel (refereegranskat)abstract Outpatient pulmonary hypertension (PH) specialist centers have an important role in the optimal management of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The aim of the present study was to gain an understanding of the work facing nurses at the outpatient PH specialist centers in Sweden. All nurses (n = 14) working at the outpatient PH specialist centers in Sweden were included. Qualitative content analysis was employed to analyze the interviews, wherein an overarching theme emerged: "Build and maintain a relationship with the patient". Three categories described the nurses' experiences: "Ambiguous satisfaction regarding information and communication", "Acting as a coordinator" and "Professional and personal development". To provide good patient care, the nurses described the key components as the ability to give information on all aspects of the disease and their availability by phone for patients, their relatives, and other healthcare resources. This requires evidence-based, specialist knowledge about the disease, its care, and treatments as well as experience. In conclusion, working as a nurse at the outpatient PH specialist centers highlight the advantages, expectations, and difficulties in working with patients with a rare and life-threatening illness. The overall knowledge and skills were high, but the nurses expressed a need for in-depth and continued training.
24.	Jeetoo, Jamil, et al. (författare) An Empirical Analysis of Income Elasticity of Out-of-Pocket Healthcare Expenditure in Mauritius 2022 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:1 Tidskriftsartikel (refereegranskat)abstract A free universal healthcare provision exists in Mauritius. Yet the share of out-of-pocket healthcare expenditure out of total household expenditure has been growing over time. This study estimates income elasticity of out-of-pocket healthcare expenditure using Mauritian household data within an Engel curve framework. In the absence of longitudinal data on out-of-pocket healthcare expenditure patterns, the study proposes the application of the pseudo-panel approach using cross-sectional Household Budget Survey waves from 1996/97 to 2017. Income elasticity of out-of-pocket healthcare expenditure is estimated to be 0.938, which is just below unity. This implies that out-of-pocket healthcare demand is not considered to be a luxury, but a necessity in Mauritius. In order to see the differences in income elasticities by income groups, separate regressions are estimated for each income quartile over different years. The results indicate that income elasticities of out-of-pocket healthcare expenditure vary non-monotonically.
25.	Jeetoo, Jamiil, et al. (författare) Willingness to Pay to Improve Quality of Public Healthcare Services in Mauritius 2022 Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:1 Tidskriftsartikel (refereegranskat)abstract Mauritius has a universal free healthcare system, based on the Beveridge model which is financed by taxpayers. There are growing considerations over improving quality of healthcare services. The purpose of the study is to employ a contingency valuation (CV) to investigate the willingness of Mauritians people to pay to improve the quality of public healthcare services and the associated determinants using the double-bounded dichotomous choice model. A drop off survey with a sample size of 974 respondents from the working population is used. The empirical analysis shows that the majority of the sample was willing to pay for improving quality of public healthcare services. Other than the conventional determinants of respondentsâ€™ demographic and socioeconomic characteristics, the findings support the assertion that psycho-social constructs such as the Theory of Planned Behaviour, Norm-Activation, Public Good Theory, and Perceived Response Efficacy are found to significantly affect Willingness-to-Pay (WTP). The results of this study might be of use to policymakers to help with both priority setting and fund allocation.

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