| 1. |
- Eriksson, Magnus, et al.
(författare)
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A new database of the references on international clinical practice guidelines : a facility for the evaluation of clinical research
- 2020
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Ingår i: Scientometrics. - : Springer. - 0138-9130 .- 1588-2861. ; 122:2, s. 1221-1235
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Tidskriftsartikel (refereegranskat)abstract
- Although there are now several bibliographic databases of research publications, such as Google Scholar, Pubmed, Scopus, and the Web of Science (WoS), and some also include counts of citations, there is at present no similarly comprehensive database of the rapidly growing number of clinical practice guidelines (CPGs), with their references, which sometimes number in the hundreds. CPGs have been shown to be useful for the evaluation of clinical (as opposed to basic) biomedical research, which often suffers from relatively low counts of citations in the serial literature. The objectives were to introduce a new citation database, clinical impact (R), and demonstrate how it can be used to evaluate research impact of clinical research publications by exploring the characteristics of CPG citations of two sets of papers, as well as show temporal variation of clinical impactand the WoS. The paper includes the methodology used to retain the data and also the rationale adopted to achieve data quality. The analysis showed that although CPGs tend preferentially to cite papers from their own country, this is not always the case. It also showed that cited papers tend to have a more clinical research level than uncited papers. An analysis of diachronous citations in both clinical impactand the WoS showed that although the WoS citations showed a decreasing trend after a peak at 2-3 years after publication, this was less clear for CPG citations and a longer timescale would be needed to evaluate their impact on these documents.
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| 2. |
- Pallari, E., et al.
(författare)
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Lung cancer research and its citation on clinical practice guidelines
- 2021
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Ingår i: Lung Cancer. - : Elsevier Ireland Ltd. - 0169-5002 .- 1872-8332. ; 154, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- Background: The impact of medical research is usually judged on the basis of citations in the serial literature. A better test of its utility is through its contribution to clinical practice guidelines (CPGs) on how to prevent, diagnose, and treat illness. This study aimed to compare the parameters of lung cancer research papers with those cited as references in lung cancer CPGs from 16 countries, and the Cochrane Collaboration. These comparisons were mainly based on bibliographic data compiled from the Web of Science (WoS).Methodology: We examined 7357 references (of which 4491 were unique) cited in a total of 77 lung cancer CPGs, and compared them with 73,214 lung cancer papers published in the WoS between 2004 and 2018.Results: References used by lung CPGs were much more clinical than the overall body of research papers on this cancer, and their authors predominantly came from smaller northern European countries. However, the leading institutions whose papers were cited the most on these CPGs were from the USA, notably the MD Anderson Cancer Center in Texas, the Memorial Sloan Kettering Cancer Center, New York, and the Mayo Clinic in Rochester, Minnesota. The types of research cited by the CPGs were primarily clinical trials, as well as three treatment modalities (chemotherapy, radiotherapy and surgery). Genetics, palliative care and quality of life were largely neglected. The median time gap between papers cited on a lung CPG and its publication was 3.5 years longer than for WoS citations.Conclusions: Analysis of the references on CPGs allows an alternative means of research evaluation, and one that may be more appropriate for clinical research than citations in academic journals. Own-country references show the direct contribution of research to a country's health care, and other-country references show the esteem in which this research has been held internationally. © 2021 King's College London
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| 3. |
- Billhult, Annika, et al.
(författare)
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Acupuncture with manual and low frequency electrical stimulation as experienced by women with polycystic ovary syndrome: a qualitative study
- 2012
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Ingår i: BMC Complementary and Alternative Medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Polycystic ovary syndrome (PCOS) affects 5-10 percent of all fertile women and is associated with anovulation/oligoovulation, hyperandrogenism, and polycystic ovaries. Pharmacological treatment is often effective but associated with unwanted side effects. Acupuncture treatments have been shown to improve menstrual bleeding patterns and ovulation as well as hyperandrogenism, without side effects. The purpose of the present study was to describe the experience of acupuncture for women diagnosed with PCOS. Methods Eight women with PCOS living in western Sweden, were interviewed following repeated acupuncture treatments. Data was analyzed using systematic text condensation as described by Malterud. Results The experience of acupuncture for women diagnosed with PCOS can be described in five categories; the experience of hope, getting results, feelings of responsibility, skepticism and proof of effect, and feeling normal. Conclusion Since acupuncture is a promising treatment for the symptoms of the common syndrome PCOS, the present study adds to the knowledge base by providing the important experiences of patients receiving the treatment. Acupuncture provides a possibility for patients to gain hope as the treatment shows results. The results show that acupuncture empowers the patients to take responsibility for their future well-being, although they may have been initially skeptical to the treatment. Because the syndrome had affected them for some time, even small changes offered a chance for them to feel that their bodies were capable of normal function. Trial Registration The trial is registered at Clinical Trials.gov with Identifier number NCT00484705.
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| 4. |
- Billhult, Annika., et al.
(författare)
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Analytisk statistik : Inferential statistics
- 2012
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Ingår i: Vetenskaplig teori och metod - Från idé till examination inom omvårdnad. - Lund : Studentlitteratur. - 9789144071350 ; , s. 317-326
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 5. |
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| 6. |
- Billhult, Annika., et al.
(författare)
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Enkäter : Questionnaires
- 2012
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Ingår i: Vetenskaplig teori och metod - Från idé till examination inom omvårdnad. - Lund : Studentlitteratur. - 9789144071350 ; , s. 139-149
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
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| 8. |
- Billhult, Annika, et al.
(författare)
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Light pressure massage for patients with severe anxiety
- 2009
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Ingår i: Complementary Therapies in Clinical Practice. - : Churchill Livingstone. - 1744-3881 .- 1873-6947. ; 15:2, s. 96-101
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Tidskriftsartikel (refereegranskat)abstract
- Generalised anxiety disorder (GAD) is common in the western world with a lifetime prevalence of 4.3 to 5.9% and is twice as common in women as in men. GAD can have a decisive impact on a patient's everyday life as it is surrounded by unfocused worries and the severe anxiety may interfere with normal social functions. The treatments include cognitive behavioural therapy and/or psychopharmacological drugs. In previous studies the positive effects of massage on anxiety have been shown. The present study described the experience of receiving massage for eight patients with GAD. Findings revealed that the patients were able to rediscover their own capacity during the massage period. This was illuminated by the experience of being relaxed in body and mind, the experience of unconditional attention, the experience of decreased anxiety and the experience of increased self-confidence. The paper ends with a discussion of clinical implications.
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| 9. |
- Billhult, Annika, et al.
(författare)
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Massage relieves nausea in women with breast cancer who are undergoing chemotherapy.
- 2007
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Ingår i: Journal of alternative and complementary medicine (New York, N.Y.). - : Mary Ann Liebert Inc. - 1075-5535 .- 1557-7708. ; 13:1, s. 53-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the present study was to examine the effect of massage on nausea, anxiety, and depression in patients with breast cancer undergoing chemotherapy. DESIGN: This work was a single-center, prospective, randomized, controlled trial. SETTINGS/LOCATION: This study was conducted in an oncology clinic, in a hospital in southwestern Sweden. SUBJECTS: Thirty-nine (39) women (mean age = 51.8) with breast cancer undergoing chemotherapy were enrolled. INTERVENTIONS: The patients were randomly assigned to a massage therapy group (20 minutes of massage on five occasions) or a control group (five 20-minute visits). OUTCOME MEASURES: All patients recorded nausea and anxiety on the Visual Analogue Scale before and after each intervention. They also completed the Hospital Anxiety and Depression Scale. RESULTS: Massage treatment significantly reduced nausea compared with control treatment (p = 0.025) when improvement was measured as a percentage of the five treatment periods. Differences in anxiety and depression between the two treatment regimes could not be statistically demonstrated. CONCLUSIONS: This study complements previous studies on the effect of massage and supports the conclusion that massage reduces nausea in these patients.
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| 10. |
- Billhult, Annika
(författare)
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The effect of massage for women with breast cancer.
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Breast cancer is the most common type of cancer in females. The effect of massage in the field of oncology has been investigated to some extent. The present thesis explored the effect of light pressure effleurage massage in women with breast cancer in six main domains; nausea, anxiety, depression, quality of life, stress and cellular immunity. It also described the experience of massage during chemotherapy. The effect of light pressure effleurage was investigated on nausea, anxiety and depression in women with breast cancer undergoing chemotherapy. Five part-body massage treatments were given during chemotherapy infusion. Massage significantly lowered nausea (p=0.025) compared with control treatment. No significant differences were shown between study groups on anxiety and depression. The experience of light pressure effleurage during chemotherapy treatment was studied using phenomenology as theoretical framework. The essential meaning of receiving massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: a distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring and finally they just felt good. The effect of light pressure effleurage on immunity was investigated in women with breast cancer undergoing radiation. Ten massage treatments, 20 minutes duration, was administered to hands or feet during three weeks. Main variables were NK (Natural Killer) and T cells. The effect of massage on cortisol, oxytocin, anxiety, depression and quality of life was also studied. We were not able to demonstrate any significant differences between study groups on any of the variables in this study. Possible explanation to the lack of response was that the patients were included during radiation treatment and that this therapy, even when given tangientially only to the breast, has some direct immunosuppressive effect. Another explanation was that ongoing radiation therapy is a strong psychological stressor that indirectly affects the immune and neuroendocrine systems. The immediate effect of light pressure massage on immunity was also investigated. Patients received one full-body massage, 45 minutes duration. Main variable was NK cells, secondary variables cortisol, blood-pressure and heart rate. Massage treatment had significant effect on NK cell function compared with the control group (p=0.03). Furthermore, massage significantly lowered systolic blood-pressure (p=0.03) and heart rate (p=0.04) compared with the control group. No significant effects were demonstrated on cortisol or diastolic blood-pressure.
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| 11. |
- Billhult, Annika, et al.
(författare)
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The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer -- a randomized controlled clinical trial.
- 2008
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Ingår i: Autonomic neuroscience : basic & clinical. - : Elsevier BV. - 1566-0702. ; 140:1-2, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this study was to examine the effect of repeated effleurage massage treatments compared with a visit control group on circulating lymphocytes by studying the number and activity of peripheral blood NK cells, CD4+ and CD8+ T cells in women with breast cancer. Furthermore, the effect of repeated effleurage massage treatments on the levels of cortisol in saliva and oxytocin in plasma as well as degree anxiety, depression and quality of life was studied. DESIGN: A single centre, prospective, randomized, controlled trial. SETTINGS/LOCATION: The study was conducted in a radiation department, in a hospital in south-western Sweden. SUBJECTS: Twenty-two women (mean age=62) with breast cancer undergoing radiation were included in this study. INTERVENTIONS: The patients were randomly assigned to effleurage massage therapy (20 min of effleurage on ten occasions) or to control visits (ten 20-minute visits). OUTCOME MEASURES: Blood samples were collected before the first and last massage/control visit for analysis of peripheral blood NK, T cells and oxytocin. Saliva was analysed for cortisol. In addition, the patients completed the Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire and Spielbergers State Trait Anxiety Inventory prior to the first and last massage/control visit. RESULTS: Effleurage massage treatment had no significant effect on the number, frequencies or activation state of NK cells or CD4+ or CD8+ T cells. Furthermore, no significant changes between groups were detected on cortisol and oxytocin concentrations, anxiety, depression or quality of life. CONCLUSIONS: Significant effect of effleurage massage on cellular immunity, cortisol, oxytocin, anxiety, depression or quality of life could not be demonstrated in this study. Several possible explanations to the results of this study are discussed.
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| 12. |
- Billhult, Annika, et al.
(författare)
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The effect of massage on immune function and stress in women with breast cancer - A randomized controlled trial.
- 2009
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Ingår i: Autonomic neuroscience. - : Elsevier BV. - 1872-7484 .- 1566-0702. ; 150:1-2, s. 111-115
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the short-term effects of light pressure effleurage on circulating lymphocytes by studying the number and activity of peripheral blood natural killer (NK) cells in patients with breast cancer compared to a control group. Furthermore, the effect of light pressure effleurage on salivary cortisol levels, heart rate and blood pressure was studied. DESIGN: Single centre, prospective, randomized and controlled study. METHODS: Thirty women, aged 50 to 75 years (mean 61 sd=7.2) with breast cancer undergoing radiation therapy in a hospital in southwestern Sweden were enrolled in the study. They were allocated to either receive massage in the form of a full-body light pressure effleurage treatment, or a control visit where they were given an equal amount of attention. Blood samples, saliva, notation of heart rate and blood pressure were collected before and after massage/control visit. Differences in change over time between groups were analyzed by Student's t-test. RESULTS: Light pressure effleurage massage decreased the deterioration of NK cell activity occurring during radiation therapy. Furthermore it lowered heart rate and systolic blood pressure. No effects were demonstrated on cortisol and diastolic pressure. CONCLUSIONS: A single full-body light pressure effleurage massage has a short-term effect on NK cell activity, systolic blood pressure and heart rate in patients with breast cancer. However, the long-term clinical importance of these findings needs to be further investigated.
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| 13. |
- Billhult, Annika, et al.
(författare)
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The experience of massage during chemotherapy treatment in breast cancer patients.
- 2007
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Ingår i: Clinical nursing research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 16:2
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe the experience of massage for breast cancer patients during chemotherapy treatment. Ten patients received massage at five occasions. They were interviewed and analysis was conducted using Giorgi's ideas of phenomenological research. The essential meaning of getting massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: the patients experienced distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring, and finally they just felt good. In conclusion, the findings of this study show that massage offered a retreat from uneasy, unwanted, negative feelings connected with chemotherapy treatment. It is a treatment that can be added to the arsenal of treatment choices available to the oncological staff.
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| 14. |
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| 15. |
- Henricson, Maria, 1972-, et al.
(författare)
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Förberedelse, tillvägagångssätt, effekter och påverkan
- 2010
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Ingår i: Taktil beröring och lätt massage - från livets början till livets slut. - Lund : Studentlitteratur. - 9789144056494 ; , s. 15-30
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 16. |
- Henricson, Maria, 1972-, et al.
(författare)
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Kvalitativ design
- 2012
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Ingår i: Vetenskaplig teori och metod. Från idé till examination inom omvårdnad. - Lund : Studentlitteratur. - 9789144071350 ; , s. 129-137
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
- Henricson, Maria, 1972-, et al.
(författare)
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Kvalitativ metod
- 2023. - 3. uppl
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Ingår i: Vetenskaplig teori och metod. - Lund : Studentlitteratur AB. - 9789144161389 ; , s. 115-125
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
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| 19. |
- Hultgren, Fredrik, et al.
(författare)
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From resistance to rescue - patients' shifting attitudes to antihypertensives: A qualitative study.
- 2014
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 32:4, s. 163-69
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. The objective of this study was to gain a deeper knowledge and understanding of experiences of antihypertensive drug treatment. Design. Interview study. Setting. A primary health care centre in western Sweden. Method. Qualitative interviews and analyses through systematic text condensation described by Malterud. Subjects. Ten informants in pharmacological treatment for high blood pressure (six men and four women). Main outcome measure. Experiences of hypertension drug treatment. Results. The findings revealed a process starting with resistance to drug treatment related to lack of control, side effects, and unwanted awareness of impaired health. These negative feelings then changed into a positive desire for lifestyle changes caused by a fear of cardiovascular disease which in turn changed the attitude towards drugs into seeing them as a rescue remedy and something normal and this then evoked health care trust. Conclusion. Despite initial resistance to treatment, the experience of antihypertensive drug treatment became more positive with time. Confidence in the health care system is important for adherence to treatment. General practitioners have a key role in this regard
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| 20. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Mandibular bone structure, bone mineral density, and clinical variables as fracture predictors: a 15-year follow-up of female patients in a dental clinic
- 2013
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Ingår i: Oral Surgery Oral Medicine Oral Pathology Oral Radiology. - : Elsevier BV. - 2212-4403. ; 116:3, s. 362-368
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To compare three mandibular trabeculation evaluation methods, clinical variables, and osteoporosis as fracture predictors in women. Study design. One hundred and thirty-six female dental patients (35-94 years) answered a questionnaire in 1996 and 2011. Using intra-oral radiographs from 1996, five methods were compared as fracture predictors: (1) mandibular bone structure evaluated with a visual radiographic index, (2) bone texture, (3) size and number of intertrabecular spaces calculated with Jaw-X software, (4) fracture probability calculated with a fracture risk assessment tool (FRAX), and (5) osteoporosis diagnosis based on dual-energy-X-ray absorptiometry. Differences were assessed with the Mann-Whitney test and relative risk calculated. Results. Previous fracture, gluco-corticoid medication, and bone texture were significant indicators of future and total (previous plus future) fracture. Osteoporosis diagnosis, sparse trabeculation, Jaw-X, and FRAX were significant predictors of total but not future fracture. Conclusion. Clinical and oral bone variables may identify individuals at greatest risk of fracture.
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| 21. |
- Jonasson, Lise-Lotte, 1956-, et al.
(författare)
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Older adults' experiences of participation in daily activities in Swedish assisted living
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: According to Swedish law, older adults in Sweden should be able to live a good, safe, and independent life with social and healthcare provided, based on their individual needs. In assisted living in Swedish eldercare the environment affects the older adults' ability to participate in decision-making and strengthens their ability to feel meaningfulness. The ability of staff working in social and healthcare to invite older adults to participate varies. It is important to examine how older adults perceive their situation, as caregivers in eldercare tend to focus on routine work and experience difficulties in meeting the individual needs of older adults. The aim of this study was to explore how older adults in assisted living experienced participation in daily activities.METHODS: A qualitative interview study was conducted in two municipalities in the western part of Sweden. An exploratory and inductive design was used. Individual interviews were conducted with 11 older adults living in two different assisted living facilities. The data were analysed using thematic analysis.RESULTS: The interviews resulted in three themes: Being involved, Sense of well-being, and Influenced by the context. The older adults' experiences of participation were interpreted as feelings of being involved in daily life activities, and how they felt involved in their own care and nursing. Participation created prerequisites for well-being. Sense of well-being could be related to feelings of security and social community. The organisation and work environment of the healthcare staff had a great impact on their ability to increase the participation of the older adults. The older adults were aware of the everyday work situation of the providers of social and healthcare and were Influenced by the context.DISCUSSION/CONCLUSION: Important conditions for a good quality of life and participation for the older adults are to be treated with respect, receive information, and be able to choose. The older adults expressed several good ideas for improvements and a willingness to be involved in the development of the organisation at different levels. It is essential to invite older adults in assisted living to participate in the design of care and nursing.
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| 22. |
- Linström, Ann-Charlotte, et al.
(författare)
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Occupational therapists experiences of rehabilitation of patients with limited awareness after stroke
- 2013
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 20:4, s. 264-271
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: The aim of this study was to describe occupational therapists’ experiences of rehabilitation of patients with limited awareness after stroke. Methods: To capture occupational therapists’ experiences, a qualitative approach was chosen using five focus groups consisting of 22 participants engaged in group discussions with open-ended questions based on the aim. Discussions were taped, transcribed verbatim, and analysed according to Kreuger’s method. The analysis revealed one general description, constant adjustment, with three themes emerging during the analysis: adjustments in choice of activity, adjustments in choice of environment, and therapeutic adjustments. These themes interacted and were dependent on the desired effect of the interventions. Adjustments were made continuously depending on their effect. The occupational therapists strove for patients to avoid unnecessary risks, make realistic decisions, and live as independently as possible.
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| 23. |
- Ma, H. X., et al.
(författare)
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Value of qualitative research in polycystic ovary syndrome
- 2014
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Ingår i: Chinese Medical Journal. - 0366-6999. ; 127:18, s. 3309-3315
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Tidskriftsartikel (refereegranskat)abstract
- Objective This article aims to introduce the benefits of qualitative research and to discuss how such research can be applied to the study of polycystic ovary syndrome (PODS). Data sources Relevant articles were published in English as of May 2013 from Pubmed. Terms "polycystic ovary syndrome/PODS, qualitative research and methodology" were used for searching. Study selection Articles studying PODS with qualitative methods were reviewed. Articles associated with the use of qualitative research in clinical research were cited. Results Six qualitative studies related to PODS were found in the literature search. These studies addressed different aspects in PODS women including their womanhood, lived experience, information need, and experience of treatment with acupuncture. Five of these six studies used phenomenology as guiding theory. Conclusion Quantitative research has been the dominant approach in the field so far, qualitative research is relevant to the advancement of PODS.
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| 24. |
- Seferiadis, Aris, et al.
(författare)
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Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:5, s. 442-451
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Chronic whiplash-associated disorders (WAD) incur both costs and suffering. Treatments that can relieve chronic WAD are therefore needed. Exercise therapy (ET) has been shown to provide pain relief. Another often used treatment for chronic pain in Scandinavia is basic body awareness therapy (BAT). We compared the effectiveness of 10 weeks of twice-weekly, 90-min sessions of either ET or BAT in a randomized comparative trial. Method: We recruited 113 patients suffering from chronic WAD grades I–III and several years’ duration of symptoms in a primary health care setting. 57 were allocated to ET and 56 to BAT. Primary outcome measures were Neck Disability Index and SF-36 v.2. Results: From baseline to post-treatment, the BAT group increased their physical functioning (median 5, IQR=15) more than the ET group (median=0, IQR=15), p=0.032, effect size −0.54. Three months after the end of treatment, the BAT group had less bodily pain (m=17.5, 95% CI 6.9–17.6) than the ET group (m =4.9, 95% CI −0.1 to 9.8), p=0.044, effect size −0.4. The BAT group had also increased their social functioning (m=13.3, 95% CI 6.6–19.9) more than the ET group (m=3.5, 95% CI −3 to 9.9), p=0.037, effect size −0.41. No statistically significant differences between groups were found for the change of other outcomes. No serious adverse effects were found in either groups. Conclusions: The present trial indicates that BAT led to greater improvements than ET for the patients with chronic WAD. Implications for Rehabilation Chronic whiplash-associated disorders are disabling and incur great costs to society often through inability to work. Exercise therapy (ET) may alleviate symptoms of chronic WAD. Basic body awareness therapy (BAT) is often a component of multimodal pain rehabilitation programs. In this randomized comparative trial, BAT increased physical functioning and led to greater pain reduction and social functioning 3 months after the end of treatment.
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| 25. |
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| 26. |
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| 27. |
- von Below, Bernhard, 1952, et al.
(författare)
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"I couldn't do this with opposition from my colleagues": A qualitative study of physicians' experiences as clinical tutors
- 2011
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 11:79, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors. Methods Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method. Results In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: (a) Pleasure and stimulation. Informants appreciated tutorship and meeting both students and fellow tutors, (b) Disappointment and stagnation. Occasionally, tutors were frustrated and expressed negative feelings, (c) Demands and duty. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, (d) Impact of workplace relations. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and (e) Multitasking difficulties. Combining several duties with those of a tutorship was often reported as difficult. Conclusions It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.
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| 28. |
- Wachsmann, S., et al.
(författare)
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Tobacco impact on quality of life, a cross-sectional study of smokers, snuff-users and non-users of tobacco
- 2023
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Ingår i: BMC Public Health. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTobacco smoking is a major public health issue, and also affects health-related quality of life. There has been considerable debate as to whether oral moist snuff, a form of tobacco placed in the oral cavity between the upper lip and gum as in sublabial administration, can be considered a safe alternative to smoking. The aim of this study was to investigate the association between health-related quality of life and smoking, snuff use, gender and age.MethodThis cross-sectional study included 674 women and 605 men aged 18 to 65 recruited through a Swedish population database. Subjects completed a questionnaire about tobacco use and the 36-item Short Form Health Survey (SF-36). Multivariable logistic regression analyses were performed for the association between health-related quality of life and tobacco use, gender and age. The median perceived health-related quality of life (SF-36) for an age-matched Swedish population was used as the cutoff: above the cutoff indicated better-than-average health coded as 1, or otherwise coded as 0. The independent variables were smoking (pack-decades), snuff-use (box-decades), gender and age in decades. The outcome was presented as the Odds Ratio (OR) with a 95% confidence interval (CI) for each independent variable.ResultsThe experience of cigarette smoking is associated with decreased physical functioning (PF), general health (GH), vitality (VT), social functioning (SF) and mental health (MH) as well as both lower physical component summary (PCS) and mental component summary (MCS). Further, the experience of snuff use is associated with bodily pain (BP), lower VT, and lower PCS. In the study population older age is associated with lower PF,GH, VT, MH, PCS and MCS. Female gender is associated with lower PF and VT.ConclusionThis study shows that smoking is associated with lower health-related quality of life. The results also illuminate the detrimental health effects of using snuff, implying that snuff too is a health hazard. As studies on the bodily effects of snuff are relatively scarce, it is imperative that we continue to address and investigate the impact on the population using snuff on a regular basis.
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| 29. |
- Wolmesjo, Maria, et al.
(författare)
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Co-production for shared value-based care to increase the quality of life of older persons in Swedish eldercare
- 2022
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 22
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- According to national values in the Swedish social service act, the older person, who receive social service and care, should, as far as possible, be part of the decisions made on the caregiving. The older person should be given preconditions to live a life in dignity and maintain their independency and autonomy. The care provided should be of good quality and the older person and her/his relatives should be met with a good approach.Former studies on eldercare have shown shortcomings in the way the work was organized and lack of routines for staff members. Research on first line managers in eldercare showed, person centred care is depending on a good working environment and a low level of stress. User participation is valued as important but organisational issues, lack of formal education and a need of administrative support is needed to work with a value-based leadership. There is a need to find new solutions on how managers can work through a value-based leadership to increase the quality of life of older persons.Aim of this study therefore was to inspire, follow and evaluate the implementation of a person-centered approach in two municipal eldercare organizations in the south part of Sweden. Focus was on values and organizational changes towards an increased quality of life of older persons in need of social care. Further on focus was to develop an attractive work and healthy work environment and a sustainable leadership.Study design was based on participatory research, where managers, staff members and older persons from different eldercare organizations took part in developing the research questions and participated in questionnaire-studies, individual and focus groups interviews and Future workshops, which were followed up in reflection groups. Booth qualitative and quantitative methods thereby were used. A reference group with representatives from the different organisations and external representatives from eldercare and researchers was created and took an active part in the project process from the early beginning. Due to the restrictions during Covid-19-pandemic, follow up meetings were done digitally.Results point out important factor which hindered versus made the implementation of person-centred care possible, can be related to the organisational structure and the organisational culture. Important was, a clear value needed to be expressed at all organisational levels. This was shown by support from politicians and high managers to first line managers, which made their work with the implementation easier. Further on, reflection groups and an ongoing dialogue on values and ethical dilemmas among staff-members was important. Together the staff-members expressed a common will to include the older people in different decision of the daily work and care-giving activities. Further on results point out the Future workshop supported a creative process where staff members were able to come up with “own” ides and solutions to increase a value-based and co-creative care with high quality, which was able to fulfil in the different organisations.
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