| 1. |
- de Vries, Claire E. E., et al.
(författare)
-
Outcomes of the first global multidisciplinary consensus meeting including persons living with obesity to standardize patient-reported outcome measurement in obesity treatment research
- 2022
-
Ingår i: Obesity Reviews. - : John Wiley & Sons. - 1467-7881 .- 1467-789X. ; 23:8
-
Tidskriftsartikel (refereegranskat)abstract
- Quality of life is a key outcome that is not rigorously measured in obesity treatment research due to the lack of standardization of patient-reported outcomes (PROs) and PRO measures (PROMs). The S.Q.O.T. initiative was founded to Standardize Quality of life measurement in Obesity Treatment. A first face-to-face, international, multidisciplinary consensus meeting was conducted to identify the key PROs and preferred PROMs for obesity treatment research. It comprised of 35 people living with obesity (PLWO) and healthcare providers (HCPs). Formal presentations, nominal group techniques, and modified Delphi exercises were used to develop consensus-based recommendations. The following eight PROs were considered important: self-esteem, physical health/functioning, mental/psychological health, social health, eating, stigma, body image, and excess skin. Self-esteem was considered the most important PRO, particularly for PLWO, while physical health was perceived to be the most important among HCPs. For each PRO, one or more PROMs were selected, except for stigma. This consensus meeting was a first step toward standardizing PROs (what to measure) and PROMs (how to measure) in obesity treatment research. It provides an overview of the key PROs and a first selection of the PROMs that can be used to evaluate these PROs.
|
|
| 2. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
-
Depicting the interplay between organisational tiers in the use of a national quality registry to develop quality of care in Sweden
- 2015
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With a pending need to identify potential means to improved quality of care, national quality registries (NQRs) are identified as a promising route. Yet, there is limited evidence with regards to what hinders and facilitates the NQR innovation, what signifies the contexts in which NQRs are applied and drive quality improvement. Supposedly, barriers and facilitators to NQR-driven quality improvement may be found in the healthcare context, in the politico-administrative context, as well as with an NQR itself. In this study, we investigated the potential variation with regards to if and how an NQR was applied by decision-makers and users in regions and clinical settings. The aim was to depict the interplay between the clinical and the politico-administrative tiers in the use of NQRs to develop quality of care, examining an established registry on stroke care as a case study.METHODS: We interviewed 44 individuals representing the clinical and the politico-administrative settings of 4 out of 21 regions strategically chosen for including stroke units representing a variety of outcomes in the NQR on stroke (Riksstroke) and a variety of settings. The transcribed interviews were analysed by applying The Consolidated Framework for Implementation Research (CFIR).RESULTS: In two regions, decision-makers and/or administrators had initiated healthcare process projects for stroke, engaging the health professionals in the local stroke units who contributed with, for example, local data from Riksstroke. The Riksstroke data was used for identifying improvement issues, for setting goals, and asserting that the stroke units achieved an equivalent standard of care and a certain level of quality of stroke care. Meanwhile, one region had more recently initiated such a project and the fourth region had no similar collaboration across tiers. Apart from these projects, there was limited joint communication across tiers and none that included all individuals and functions engaged in quality improvement with regards to stroke care.CONCLUSIONS: If NQRs are to provide for quality improvement and learning opportunities, advances must be made in the links between the structures and processes across all organisational tiers, including decision-makers, administrators and health professionals engaged in a particular healthcare process.
|
|
| 3. |
- Eldh, Ann Catrine, et al.
(författare)
-
Facilitators and barriers to applying a national quality registry for quality improvement in stroke care
- 2014
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14, s. 354-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. Results: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. Conclusion: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.
|
|
| 4. |
- Eldh, Ann Catrine, 1965-, et al.
(författare)
-
Factors facilitating a national quality registry to aid clinical quality improvement : findings of a national survey
- 2016
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:11
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement.Methods: Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression.Results: A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R2=0.76) with ‘Colleagues’ call for local results’ (p=<0.001), ‘Management Request of Registry data’ (p=<0.001), and it was said to be ‘Simple to explain the results to colleagues’ (p=0.02). Using stepwise regression, ‘Colleagues’ call for local results’ was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results.Conclusions: While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives.
|
|
| 5. |
|
|
| 6. |
- Fredriksson, Mio, 1976-, et al.
(författare)
-
Are data from national quality registries used in quality improvement at Swedish hospital clinics?
- 2017
-
Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 29:7, s. 909-915
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the use of data from national quality registries (NQRs) in local quality improvement as well as purported key factors for effective clinical use in Sweden. Comparative descriptive: a web survey of all Swedish hospitals participating in three NQRs with different levels of development (certification level). Heads of the clinics and physician(s) at clinics participating in the Swedish Stroke Register (Riksstroke), the Swedish National Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) and the Swedish Lung Cancer Registry (NLCR). Individual and unit level use of NQRs in local quality improvement, and perceptions on data quality, organizational conditions and user motivation. Riksstroke data were reported as most extensively used at individual and unit levels ((x) over bar 17.97 of 24 and (x) over bar 27.06 of 35). Data quality and usefulness was considered high for the two most developed NQRs ((x) over bar 19.86 for Riksstroke and (x) over bar 19.89 for GallRiks of 25). Organizational conditions were estimated at the same level for Riksstroke and GallRiks ((x) over bar 12.90 and (x) over bar 13.28 of 20) while the least developed registry, the NLCR, had lower estimates (x 10.32). In Riksstroke, the managers requested registry data more often ((x) over bar 15.17 of 20). While there were significant differences between registries in key factors such as management interest, use of NQR data in local quality improvement seems rather prevalent, at least for Riksstroke. The link between the registry's level of development and factors important for routinization of innovations such as NQRs needs investigation.
|
|
| 7. |
- Fredriksson, Mio, et al.
(författare)
-
Local politico-administrative perspectives on quality improvement based on national registry data in Sweden : a qualitative study using the Consolidated Framework for Implementation Research.
- 2014
-
Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement¿s intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and the like lead to quality improvement, and little is known about non-clinical use. The aim was therefore to investigate the perspectives of Swedish politicians and administrators on quality improvement based on national registry data.Methods. Politicians and administrators from four county councils were interviewed. A qualitative content analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed.Results. The politicians and administrators perspectives on the use of NQR data for quality improvement were mainly assigned to three of the five CFIR domains. In the domain of intervention characteristics, data reliability and access in reasonable time were not considered entirely satisfactory, making it difficult for the politico-administrative leaderships to initiate, monitor, and support timely QI efforts. Still, politicians and administrators trusted the idea of using the NQRs as a base for quality improvement. In the domain of inner setting, the organizational structures were not sufficiently developed to utilize the advantages of the NQRs, and readiness for implementation appeared to be inadequate for two reasons. Firstly, the resources for data analysis and quality improvement were not considered sufficient at politico-administrative or clinical level. Secondly, deficiencies in leadership engagement at multiple levels were described and there was a lack of consensus on the politicians¿ role and level of involvement. Regarding the domain of outer setting, there was a lack of communication and cooperation between the county councils and the national NQR organizations.Conclusions. The Swedish experiences show that a government-supported national system of well-funded, well-managed, and reputable national quality registries needs favorable local politico-administrative conditions to be used for quality improvement; such conditions are not yet in place according to local politicians and administrators.
|
|
| 8. |
- Halford, Christina, et al.
(författare)
-
A population-based study of nearly 15 000 observations among Swedish women and men during 1973-2003
- 2012
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 2:6
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives Global self-rated health (SRH) has become extensively used as an outcome measure in population health surveillance. The aim of this study was to analyse the effects of age and secular trend (year of investigation) on SRH.Design Prospective cohort study, using population-based data from eight ongoing cohort studies, with sampling performed between 1973 and 2003.Setting Sweden.Participants 11 880 women and men, aged 25–99 years, providing 14 470 observations.Primary outcome measure Global SRH.Results In multiple ordinal logistic regression analyses, adjusted for the effects of covariates, there were independent effects of age (p<0.0001) and of year of investigation (p<0.0001) on SRH. In women the association was linear, showing lower levels of SRH with increased age, and more recent year of investigation. In men the association was curvilinear, and thus more complex. The final model explained 76.2% of the SRH variance in women and 74.5% of the variance in men.Conclusions SRH was strongly and inversely associated with age in both sexes, after adjustment for other outcome-affecting variables. There was a strongly significant effect of year of investigation indicating a change in SRH, in women towards lower levels over calendar time, in men with fluctuations across time.
|
|
| 9. |
|
|
| 10. |
- Halford, Christina, et al.
(författare)
-
Effects of self-rated health on sick leave, disability pension, hospital admissions and mortality. A population-based longitudinal study of nearly 15,000 observations among Swedish women and men.
- 2012
-
Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Simple global self-ratings of health (SRH) have become increasingly used in national and international public health monitoring, and in recent decades recommended as a standard part of health surveys. Monitoring developments in population health requires identification and use of health measures, valid in relation to targets for population health. The aim of the present study was to investigate associations between SRH and sick leave, disability pension, hospital admissions, and mortality, adjusted for effects of significant covariates, in a large population-based cohort. The analyses were based on screening data from eight population-based cohorts in southern and central Sweden, and on official register data regarding sick-leave, disability pension, hospital admissions, and death, with little or no data loss. Sampling was performed 1973-2003. The study population consisted of 11,880 women and men, age 25-99 years, providing 14,470 observations. Information on SRH, socio-demographic data, lifestyle variables and somatic and psychological symptoms were obtained from questionnaires. There was a significant negative association between SRH and sick leave (Beta -13.2, p<0.0001, and -9.5, p<0.01, in women and men, respectively), disability pension (Hazard ratio 0.77, p<0.0001 and 0.76, p<0.0001, in women and men, respectively), and mortality, adjusted for covariates. SRH was also significantly associated with hospital admissions in men (Hazard ratio 0.87, p<0.0001), but not in women (Hazard ratio 0.96, p0.20). Associations between SRH on the one hand, and sick leave, disability pension, hospital admission, and mortality, on the other, were robust during the follow-up period. SRH had strong predictive validity in relation to use of social insurance facilities and health care services, and to mortality. Associations were strong and robust during follow-up.
|
|
| 11. |
- Halford, Christina, et al.
(författare)
-
Endocrine measures of stress and self-rated health : A longitudinal study
- 2003
-
Ingår i: Journal of Psychosomatic Research. - 0022-3999 .- 1879-1360. ; 55:4, s. 317-320
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Simple global self-ratings of health have been found to hold considerable predictive validity in relation to morbidity and mortality. Inverse associations between chronic stress and self-rated health (SRH) have been found and suggested to explain part of the predictive validity of SRH. Studies including biological data are, however, few. The purpose of this paper is to study the relationship between endocrine measures of stress and SRH.Methods: A longitudinal study of 102 healthy middle-aged men. Written questionnaires and blood samples were collected at baseline and at follow-up 1 year later.Results: A decrease in SRH below the level of good was associated with significantly increased s-prolactin and decreased s-testosterone. Poorer SRH and increased levels of s-prolactin were significantly associated with increased vital exhaustion at follow-up.Conclusion: Our study identifies a possible biological pathway, which might be of relevance in understanding the well-established association between SRH and health.
|
|
| 12. |
- Halford, Christina, et al.
(författare)
-
Perceived Stress, Psychological Resources and Salivary Cortisol
- 2012
-
Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608050710 - 9781608053421 ; , s. 67-86
-
Bokkapitel (refereegranskat)abstract
- The aim of this chapter was to analyze associations between measures of cortisol in saliva withmeasures of perceived stress, using the Perceived Stress Scale (PSS), and of psychological resources interms of mastery, locus of control, self-esteem and sense of coherence. Only studies on healthy individualswere included and cortisol measures were grouped into single time point measures, deviation measures,Area Under the Curve (AUC), laboratory test responses, and dexamethasone suppression. For bothPerceived Stress Scale (PSS) and for psychological resources, most results of associations with salivacortisol were nonsignificant particularly for single measures and for cortisol awakening response. For PSSthe largest proportion of significant findings (38%) was seen for morning AUC, however with conflictingresults. For psychological resource constructs, mastery and sense of coherence were related to lower cortisollevel at baseline in standardized rest and high mastery was related to steeper diurnal slope in two studies.For self-esteem, no associations showed significant results. Differences in findings may to a large extent bedependent on theoretical assumptions made and methods used
|
|
| 13. |
- Halford, Christina, et al.
(författare)
-
Self-rated health, life-style, and psychoendocrine measures of stress in healthy adult women
- 2010
-
Ingår i: Upsala Journal of Medical Sciences. - : Informa Healthcare. - 0300-9734 .- 2000-1967. ; 115:4, s. 266-274
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Self-rated health (SRH) is a robust predictor of subsequent health outcome, independent of objective health measures and life-style-related health risk factors. However, the determinants of SRH are as yet largely unknown. In accordance with the prevailing stress theory, we hypothesized that SRH is associated with personal coping resources, psychological strain, life-style variables, and endocrine variables. Methods. A total of 106 healthy women, 22-59 years of age, were followed for up to 3 years with annual blood sampling (cortisol, prolactin, testosterone) and written questionnaires in which information on SRH, psychological strain, coping resources, socio-economic and life-style variables was sought. Results. In bivariate, screening logistic regression analyses, intended to find candidate variables for a final analysis model, all coping resource variables (sense of coherence, mastery, and self-esteem) were significantly related to SRH, and so were two psychological strain variables (vital exhaustion, and sleep disturbances), one life-style variable (fitness), but none of the endocrine variables. In the final multivariate analysis model, including all candidate variables, only vital exhaustion (P < 0.0001), fitness (P = 0.0002), and sense of coherence (P = 0.0006) were independently associated with SRH, together explaining 74% of the SRH variance. Conclusion. Some elements of the hypothesis, i.e. the effects of coping resources, psychological strain, and life-style variables on SRH, were supported by the results, while others, i.e. effects of endocrine measures on SRH, were not, indicating a possible gender difference.
|
|
| 14. |
- Halford, Christina, 1960-
(författare)
-
Self-rated Health with special reference to Prevalence, Determinants and Consequences
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The overall aim was to investigate determinants and consequences of global non-comparative self-ratings of health (SRH). Concerning determinants, the aim was more specifically to investigate the association between age, year of investigation, stress-theory based psychobiological variables, and SRH.Materials and methods: Papers I and IV were based on eight ongoing population-based cohort studies, with sampling performed 1973-2003. The study-population consisted of 11,880 men and women, aged 25-99 years, providing 14,470 observations. Papers II and III were based on a longitudinal study of 212 adult, healthy, women and men.Results: In women, SRH declined linearly with age and year of investigation, after adjustment for influence of covariates, while in men the association was based on a third degree polynomial function. The most important covariates were complaint score, sick-leave or disability pension, and leisure time physical activity. The final model explained 76.2% of the variance in women and 74.5% in men. SRH was directly associated with psychological resources and inversely associated with psychological strain, in healthy, adult, women and men. In men with SRH which decreased to fair or poor, higher levels of prolactin and lower levels of testosterone were observed at follow-up as compared to baseline. There were no associations between endocrine variables and SRH in women. There was a significant inverse association between SRH and mortality, disability pension, and sick-leave during follow-up, in women and men, adjusted for covariates. Associations between SRH and mortality were robust during the follow-up period.Conclusions: Age and year of investigation were associated with SRH, but differently in women and men. Psychological resources and psychological strain were consistently associated with SRH, but there were no robust associations between endocrine measures and SRH. SRH was associated with mortality, disability pension, and sick-leave, during follow-up. The association between SRH and mortality was robust during the follow-up period
|
|
| 15. |
- Holmström, Inger, et al.
(författare)
-
Swedish health care professionals' diverse understandings of diabetes care
- 2003
-
Ingår i: Patient Education and Counseling. - 0738-3991 .- 1873-5134. ; 51:1, s. 53-58
-
Tidskriftsartikel (refereegranskat)abstract
- Knowledge of health care professionals’ different understandings of diabetes care is important when preparing such professionals in patient education. For patients to manage illness effectively, the actions of health care professionals are crucial. Patients’ understanding of their condition should be taken as the point of departure when creating a learning situation. The professionals’ understandings of diabetes care were mapped using a survey including 169 primary care doctors, nurses, assistant nurses and chiropodists in Stockholm, Sweden. The responses were analysed using a phenomenographic approach. Five understandings were identified: the professionals treat the patients, the professionals give information, the professionals focus relation and organisation, the professionals seek the patient’s agreement, and the professionals focus the patient’s understanding of the situation. Only 20 (12%) of the 169 professional caregivers focused the patient’s understanding. Professionals need to develop their understandings of health care and the professional–patient interaction in order to support the patients’ learning.
|
|
| 16. |
- Jonsdottir, Ingibjörg H., et al.
(författare)
-
Mental Health and Salivary Cortisol
- 2012
-
Ingår i: The Role of Saliva in Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608053421 ; , s. 129-166
-
Bokkapitel (refereegranskat)
|
|
| 17. |
- Jonsdottir, Ingibjörg H., et al.
(författare)
-
Mental Health and Salivary Cortisol
- 2012
-
Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608050710 - 9781608053421 ; , s. 129-166
-
Bokkapitel (refereegranskat)abstract
- Abstract: The aim of this chapter was to analyze associations between measures of cortisol in salivaand mental health and to see if divergent results were functions of the methods used. Measures ofmental health outcome included Major Depressive Disorder (MDD), symptoms of depression, andsymptoms of anxiety, Burnout (BO), and Vital Exhaustion (VE). Only studies on otherwise healthyindividuals were included. Cortisol measures were grouped into single time point measures, measuresof deviations, laboratory test responses, Area Under the Curve (AUC), and response to dexamethasone.Some consistency is seen for MDD, mainly higher mean levels. The results regarding single measuresand depressive mood are less consistent, but the overall picture for depression shows poorer diurnaldeviation and response to stress. Inconsistency among papers studying depression seems to be relatedmainly to the study population. Very few significant findings were found for anxiety, therefore cortisoldoes not seem to be strongly related to anxiety. Most of the statistical analysis does not show asignificant relationship between BO and cortisol, and when these are present, the results areinconsistent. One explanation seems to be the measures of BO used, probably due to the differentconceptual basis for BO. VE measured using the Maastricht Questionnaire seems to be related to apoorer cortisol response to stress and poorer diurnal deviation. The coexistence of BO and VE in manystudies does make it difficult to conclude how the different concepts are related to cortisol. However, aninteresting difference appeared between MDD and VE in response to dexamethasone administration,showing lower suppression in MDD patients and higher suppression in VE patients. A generalconclusion for all mental health measures is that a large proportion of non-significant findings are dueto low power and few sampling days combined with low contrasts between study groups and withinstudy populations. Generally, deviation measures such as diurnal deviation seem to be more validmeasures compared with single measures to capture possible changes in the hypothalamus-pituitaryadrenal axis, measured using salivary cortisol.
|
|
| 18. |
- Kelly, Bridget, et al.
(författare)
-
Television food advertising to children: a global perspective
- 2010
-
Ingår i: American Journal of Public Health.
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. We compared television food advertising to children in several countries. Methods. We undertook a collaboration among 13 research groups in Australia, Asia, Western Europe, and North and South America. Each group recorded programming for 2 weekdays and 2 weekend days between 6:00 and 22:00, for the 3 channels most watched by children, between October 2007 and March 2008. We classified food advertisements as core (nutrient dense, low in energy), noncore (high in undesirable nutrients or energy, as defined by dietary standards), or miscellaneous. We also categorized thematic content (promotional characters and premiums). Results. Food advertisements composed 11% to 29% of advertisements. Noncore foods were featured in 53% to 87% of food advertisements, and the rate of noncore food advertising was higher during children's peak viewing times. Most food advertisements containing persuasive marketing were for noncore products. Conclusions. Across all sampled countries, children were exposed to high volumes of television advertising for unhealthy foods, featuring child-oriented persuasive techniques. Because of the proven connections between food advertising, preferences, and consumption, our findings lend support to calls for regulation of food advertising during children's peak viewing times.
|
|
| 19. |
- Sanner, Margareta A., 1937-, et al.
(författare)
-
The dilemma of patient safety work : Perceptions of hospital middle managers
- 2018
-
Ingår i: Journal of Healthcare Risk Management. - : John Wiley & Sons. - 2040-0861 .- 1074-4797. ; 38:2, s. 47-55
-
Tidskriftsartikel (refereegranskat)abstract
- Patient safety continues to be a challenge for health care. Medical errors are not decreasing but continue to show roughly the same patterns in Sweden and other Western countries. This interview study aims to explore how 27 hospital middle managers responsible for patient safety work in a Swedish university hospital perceive this task. A qualitative analysis was performed. A code template was created, and each code was explored in depth and summarized into six categories. We conclude that patient safety work appears to have low priority; hospital top management does not seem to have any real interest in patient safety; incidents are underreported; and the organization of patient safety work seems to be insufficient and carried out insofar as resources are available. These parameters may explain why medical errors remain on a certain level and do not seem to decrease in spite of various support programs.
|
|
