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1.
  • Arnrup, K, et al. (author)
  • Classification of dental behavior management problems among children.
  • 2007
  • In: Poster presentation at the 85th General Session & Exhibition of the IADR, New Orleans, LA, USA, March 21-24, 2007..
  • Conference paper (other academic/artistic)abstract
    • Objectives: This study aimed to further investigate the heterogeneity within the group of children referred for specialist treatment because of dental behavior management problems (DBMP). A specific aim was to evaluate the validity of a previously reported cluster structure in another DBMP study group. Methods: 177 child dental patients, aged 4 to 12 at referral to a specialist pediatric dental clinic in Göteborg, Sweden, were classified into subgroups according to their personal characteristics. Cluster structure was described and compared to previously reported findings in a DBMP study group of same-aged child dental patients in Örebro, Sweden (n=74). Parental assessments of children's dental and general fear, temperament and behavior were made pre-treatment. The children also performed a vocabulary test. Data were analyzed mainly with a person-based approach using sequences of cluster analyses. Results: Classification into five different subgroups was judged the best representation of the Göteborg study group data, while four groups had been defined in Örebro. The new clusters partly paralleled the previous and were labeled (I) Extrovert, outgoing, (II) Highly fearful, multiple problems, (III) Highly fearful, (IV) Moderately fearful, externalizing, impulsive and (V) Moderately fearful, inhibited. Cluster profile II describes severe dental fear and general temperamental and behavioral problems of internalizing as well as externalizing character. Such combined problems were not clearly revealed in the Örebro cluster structure. Conclusion: The contention that children with dental behavior management problems (DBMP) comprise a heterogeneous group was strengthened. Similar, although not identical, clusters of children showing DBMP were identified in this replication study. Apart from different levels of dental fear, varying temperamental and behavioral characteristics need to be taken into consideration to better match treatment for these patients
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2.
  • Lundgren Elfström, Magnus, 1971, et al. (author)
  • Methodological assessment of behavioural problem dimensions in adults with dental fear.
  • 2007
  • In: Community Dent Oral Epidemiol. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:3, s. 186-194
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: In the assessment and treatment of persons with dental fear, there may be other psychological/behavioural factors than fear itself and traditional measures of psychopathology that should be considered. Longitudinal natural history studies are needed to find such variables. The present study investigated whether the same behavioural problem dimensions (internalizing, externalizing, attention) found among children and adolescents with behaviour management problems and/or dental fear could also be found among severely fearful adult patients. METHODS: The participants were 230 consecutive adult patients applying for treatment for severe dental anxiety at a specialized clinic. Patients completed a version of the Rutter behaviour questionnaire that was adapted for adults. Comparison data were the Hospital Anxiety and Depression scale and self-rated anger evoked by dental fear. Background data, including dental fear, were also collected. Descriptive statistics, principal components analyses, group comparisons and correlations were calculated. RESULTS: Of the three behaviour problems scales we adapted for adults, two (Internalizing and Attention) had acceptable psychometric properties and meaningful relations with the comparison variables. In contrast, the third problem scale (Externalizing) proved to have less satisfactory properties and relations, especially for men. Patients with severe phobia had higher levels of problem behaviours than patients with less severe phobia. CONCLUSIONS: Internalizing and Attention scales for adults seem promising for use in future prospective studies of the natural history of dental fear. The Externalizing scale, however, needs to be studied with a wider range of comparison variables and measures of social desirability.
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3.
  • Lundgren, Jesper, 1970, et al. (author)
  • The relationship between temperament and fearfulness in adult dental phobic patients.
  • 2007
  • In: Int J Paediatr Dent. - 0960-7439 .- 1365-263X. ; 17:6, s. 460-468
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Temperament has been associated with dental fear (DF) and dental behavioural management problems (DBMP) in children, but little is known about what role temperament plays in the aetiology of DF. Thus, measures of temperament suitable for use among children, adolescents, and adults would be of value for longitudinal and family studies of DF, where relations between children's and parent's ratings are investigated. AIM: Our aim was to explore the adapted EASI (emotionality, activity, sociability, and impulsivity) in adult patients, and to evaluate the instrument in comparison with established measures of DF and general emotional reactions in adults. DESIGN: The subjects were 230 adult patients applying for treatment for DF and 41 nonfearful patients (reference group). Questionnaires investigated temperament (general and DF) and general anxiety and depression. RESULTS: The previously described factor structure of the EASI among children was confirmed and the adapted EASI had acceptable psychometric qualities. Emotionality correlated with DF and with measures of general psychological distress. No differences were found in mean scores of EASI dimensions between DF group and the reference group, which was in contrast with studies in children. CONCLUSIONS: The adapted EASI seem promising for use in future longitudinal and familial studies of development of DF and DBMP.
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4.
  • Wide Boman, Ulla, 1964, et al. (author)
  • Common use of a Fear Survey Schedule for assessment of dental fear among children and adults.
  • 2008
  • In: International journal of paediatric dentistry. - 0960-7439 .- 1365-263X. ; 18:1, s. 70-6
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Little is known about children with dental fear (DF) in a long-term perspective. Measures of DF suitable for use among children, adolescents, and adults would be of value for longitudinal and family studies. AIM: Our aim was to explore the DF subscale of the Children's Fear Survey Schedule (CFSS-DS) in highly fearful adult dental patients. DESIGN: The subjects were 230 adult patients applying for treatment for severe DF at a specialized DF clinic. Questionnaires investigated background data, general fear and DF, and general anxiety and depression. Reference data were obtained from 36 nonfearful patients on a subset of questionnaires. RESULTS: The fearful group reported high levels of DF on all measures and at a level similar to children with severe DF. The DF measures clearly differed between the fearful and reference groups. A factor analysis revealed a three-factor structure (fear of dental treatment, medical treatment, and of strangers and choking), which explained 68% of the variance. CONCLUSION: The CFSS-DS appears suitable for use in studies of adult populations. The results indicated that some areas of DF (physiology, avoidant behaviour, anticipatory anxiety), areas of importance among adult patients, are not assessed by the CFSS-DS. Studies of adults should therefore also include established adult measures of DF.
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5.
  • Axelsson, Malin, 1964-, et al. (author)
  • Motivational foci and asthma medication tactics directed towards a functional day
  • 2011
  • In: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 11, s. 809-
  • Journal article (peer-reviewed)abstract
    • Background:There appears to be an obvious gap between a medical and patient adherence perspective.Deviating from a medication prescription could be regarded as fairly irrational, but with respect to patients' goals and/or concerns it could be seen as understandable. Thus, the aim was to elucidate adherence reasoning in relation to asthma medication.Methods:This was a qualitative study; data collection and analysis procedures were conducted according to Grounded Theory methodology. Eighteen persons, aged 22 with asthma and regular asthma medication treatment, were interviewed.Results:The emerged theoretical model illustrated that adherence to asthma medication was motivated by three foci, all directed towards a desired outcome in terms of a functional day as desired by the patient. Apromotive focus was associated with the ambition to achieve a positive asthma outcome by being adherent either to the received prescription or to a self-adjusted dosage. A preventive focuswas intended to ensure avoidance of a negative asthma outcome either by sticking to the prescription or by preventively overusing the medication. A permissive focus was associated with unstructured adherence behaviour in which medication intake was primarily triggered by asthma symptoms.Conclusions:As all participants had consciously adopted functioning medication tactics that directed themtowards the desired goal of a functional day. In an effort to bridge the gap between a patient- and a medical adherence perspective, patients need support in defining their desired functionality and guidance in developing a person-based medication tactic.
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6.
  • Axelsson, Malin, 1964-, et al. (author)
  • Personality, adherence, asthma control and health-related quality of life in young adult asthmatics
  • 2009
  • In: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 103:7, s. 1033-1040
  • Journal article (peer-reviewed)abstract
    • BackgroundStriving for improved adherence and asthma control is of vital concern in today's asthma management. Several influential factors have been identified, but the importance of personality traits has been insufficiently explored. The aim was first to determine whether personality traits in young adult asthmatics are related to asthma control and health-related quality of life (HRQL), and second to examine the influences of personality traits on adherence to regular asthma medication treatment.MethodsYoung adult asthmatics, 22 years of age (n = 268) completed questionnaires. Statistical analyses were performed.ResultsThe personality traits Negative Affectivity and Impulsivity correlated negatively with asthma control, whereas in women Hedonic Capacity correlated positively with asthma control. Negative Affectivity, Impulsivity, Hedonic Capacity, Alexithymia and asthma control predicted the mental dimension of HRQL. Asthma control and physical activity predicted the physical dimension of HRQL. Among respondents with regular asthma medication (n = 109), Impulsivity correlated negatively with adherence. In men, Antagonism and Alexithymia were associated with low adherence. Additionally, Alexithymia, Hedonic Capacity and Negative Affectivity showed non-linear relationships with adherence, meaning that initially increased scores on these personality traits scales were associated with increased adherence but higher scores did not increase adherence. Respondents who were prescribed a single inhaler combining ICS and LABA reported higher adherence than those with monotherapies.ConclusionThese data suggest that personality can influence how asthma patients adhere to asthma medication treatment, and report their control and HRQL. Tools determining personality traits may be useful in the future in individualizing management of asthma patients.
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7.
  • Axelsson, Malin, 1964, et al. (author)
  • Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life.
  • 2013
  • In: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. - : Springer Science and Business Media LLC. - 1573-2649 .- 0962-9343. ; 22:3, s. 567-575
  • Journal article (peer-reviewed)abstract
    • PURPOSE: Personality traits are rather stable dispositions in adulthood, while self-efficacy and adherence may be modified through targeted interventions. Health-related quality of life (HRQL) serves as a vital outcome measure. The present aim was to explore the function of self-efficacy and adherence as mediators for the influencing effect of personality traits on HRQL in people with chronic disease. METHODS: An epidemiological sample of 786 persons completed questionnaires on personality, general self-efficacy, adherence behaviour and HRQL. Data were statistically analysed using descriptive statistics, correlation analyses and path models. RESULTS: Self-efficacy mediated the effect of Extraversion and Conscientiousness on mental HRQL. Neuroticism had a direct effect on both physical and mental HRQL. Adherence partially mediated the effect of both Agreeableness and Conscientiousness on mental HRQL. CONCLUSIONS: The mental HRQL in people scoring low on Extraversion or low on Conscientiousness could be improved by strengthening general self-efficacy. Increasing adherence in people scoring low on Agreeableness or Conscientiousness could improve their mental HRQL, but the improvement was small and may be of lesser clinical relevance. These results argue for personalized interventions intended to positively affect health outcomes in people with chronic disease.
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8.
  • Axelsson, Malin, 1964-, et al. (author)
  • The influence of personality traits on reported adherence to medication in individuals with chronic disease : An Epidemiological study in West Sweden
  • 2011
  • In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3
  • Journal article (peer-reviewed)abstract
    • Background: Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease. Methodology/Principal Findings: Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30-70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences. Conclusions: This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence. © 2011 Axelsson et al.
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10.
  • Brahm, Carl-Otto, 1974, et al. (author)
  • Dentists' skills with fearful patients: education and treatment.
  • 2013
  • In: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 283-291
  • Journal article (peer-reviewed)abstract
    • The aims were to explore dentists' skills in dental fear, current strategies when treating fearful adult patients, and the possible need for additional education among dentists working in Sweden. A sample of 1,293 members of the Association of Public Health Dentists in Sweden were asked to respond to a Web survey concerning dental fear. The response rate was 69% (n = 889); 91% trained in Sweden and 9% trained in another country. The most frequently used pharmacological anxiety-reducing techniques were medication with a midazolame mixture (72%) and benzodiazepine tablets (77%), and the most commonly used psychological techniques were relaxation (68%), distraction (66%), and Tell-Show-Do (86%). A larger proportion of dentists trained in Sweden, compared with dentists who were trained in other countries, reported that they had received undergraduate training in dental fear. Dentists trained in Sweden more often reported competence in pharmacological and psychological anxiety-reducing techniques, compared with dentists who were trained in other countries. Higher levels of self-rated efficacy in treating fearful patients accompanied additional education in dental fear after graduation. In conclusion, Swedish dentists use a variety of techniques to meet the needs of fearful dental patients. Competence in anxiety-reducing techniques is associated with self-efficacy and the site of education.
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11.
  • Brahm, Carl-Otto, 1974, et al. (author)
  • Dentists' views on fearful patients. Problems and promises.
  • 2012
  • In: Swedish Dental Journal. - 0347-9994. ; 36:2, s. 79-89
  • Journal article (peer-reviewed)abstract
    • Abstract A large number of patients treated in the general dental health service in Western countries report dental fear to some degree. Dentists' views of treating these fearful patients are not well described in the literature.Therefore, the aims of the study were to explore dentists' attitudes towards, experience of, and feelings about treating fearful patients. The sample consisted of 1293 members of the Association of Public Health Dentists in Sweden who were asked to respond to a web survey concerning dental fear. The response rate was 69% (n = 889).The majority of the responding dentists stated that dental fear is a problem in routine dental care,treating patients with dental fear is a positive challenge and they felt they were making a contribution.They also reported that treating patients with dental fear is associated with hard work, poor revenues, and little appreciation by employers. Female dentists reported a greater proportion of patients with dental fear and greater self-efficacy regarding the treatment of these patients, compared with their male colleagues. Dentists trained in other EU countries reported stress more often and less perceived contribution when treating fearful patients, compared with colleagues trained in Sweden. CONCLUSION: Dentists' views of treating fearful patients are mainly positive; however, it is problematic that dentists feel stress and that dentists who treat many fearful patients feel their employers do not appreciate their efforts.
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12.
  • Brahm, Carl-Otto, et al. (author)
  • Development and evaluation of the Jönköping Dental Fear Coping Model : a health professional perspective
  • 2018
  • In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 76:5, s. 320-330
  • Journal article (peer-reviewed)abstract
    • Objective: The purpose of this study was to design a structured treatment model focusing on all levels of adult’s dental fear, the Jönköping Dental Fear Coping Model (DFCM). The aim was to study the DFCM from a dental health professional perspective.Material and methods: The DFCM was studied by means of quantitative and qualitative analyses. Nine dental clinics participated in Period I (pre-intervention/standard care), and 133 dental health professionals (dentists, dental hygienists, dental assistants) and 3088 patients were included. After completion of Period I, four of the clinics were randomized to Period II (intervention), beginning with the professionals undergoing DFCM training. Following that, 51 dental health professionals treated 1417 patients according to the DFCM. The other five clinics served as controls.Results: Half or more of the dental health professionals assessed the model as better than standard care, regarding anamnesis and diagnostics, communication and contact, and understanding of patients and dental fear. The dental health professionals reported higher tension in their fearful patients in Period II compared with Period I, possibly due to their increased awareness of dental fear.Conclusions: The qualitative data suggest that dental health professionals find the DFCM beneficial in routine dental care. The model promotes a holistic approach to the treatment of adult patients. However, stress among the professionals was not reduced when measured, neither quantitatively nor qualitatively. It is important to evaluate the model in further studies to make it possible to draw generalizable conclusions. 
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13.
  • Brahm, Carl-Otto, et al. (author)
  • Evaluation of the Jönköping dental fear coping model : a patient perspective
  • 2019
  • In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:3, s. 238-247
  • Journal article (peer-reviewed)abstract
    • Objective: This study is a part of a project with the aim to construct and evaluate a structured treatment model (the Jönköping Dental Fear Coping Model, DFCM) for the treatment of dental patients. The aim of the present study was to evaluate the DFCM from a patient perspective.Material and methods: The study was performed at four Public Dental Clinics, with the same 13 dentists and 14 dental hygienists participating in two treatment periods. In Period I, 1351 patients were included and in Period II, 1417. Standard care was used in Period I, and in Period II the professionals had been trained in and worked according to the DFCM. In the evaluation, the outcome measures were self-rated discomfort, pain and tension, and satisfaction with the professionals.Results: In comparison with standard care, less tension was reported among patients treated according to the DFCM, (p =.041), which was also found among female patients in a subgroup analysis (p =.028). Additional subgroup analyses revealed that patients expecting dental treatment (as opposed to examination only) reported less discomfort (p =.033), pain (p =.016) and tension (p =.012) in Period II than in Period I. Patients with low to moderate dental fear reported less pain in Period II than in Period I (p =.014).Conclusions: The DFCM has several positive effects on adult patients in routine dental care. In a Swedish context, the differences between standard care and treatment according to the model were small but, in part, statistically significant. However, it is important to evaluate the model in further studies to allow generalization to other settings. 
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14.
  • Carlsson, Sven G., 1935, et al. (author)
  • Dental anxiety - a joint interest for dentists and psychologists.
  • 2013
  • In: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 221-224
  • Journal article (peer-reviewed)abstract
    • This introductory article to the Symposium on Behavioral and Community Dentistry aims to describe the development of research and clinical work on dental anxiety, and includes a discussion of the historical background and the evolution since the 1970s. In view of its pioneering activities in this regard, special focus is placed on research and development at the Institute of Odontology of the University of Gothenburg, Sweden.
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15.
  • Dimenäs, Sandra L., 1989, et al. (author)
  • A person-centred, theory-based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study
  • 2022
  • In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:4, s. 237-387
  • Journal article (peer-reviewed)abstract
    • Aim: To test the effectiveness of a person-centred and theory-based educational intervention to increase adolescents′ adherence to adequate oral hygiene behaviour, that is, self-performed periodontal infection control. Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study in which treatment was performed by dental hygienists (DHs) within the Public Dental Service, Västra Götaland, Sweden. Adolescents with poor oral hygiene conditions were invited to participate. The test intervention was based on cognitive behavioural theory and principles, and the DHs used a collaborative communicative approach, inspired by motivational interviewing. The control intervention consisted of conventional information/instruction. Clinical assessments and oral hygiene behaviours were evaluated at 6months. Results: Three-hundred and twelve adolescents were enrolled, of whom 274 followed the treatment to 6-month follow-up. There were significant improvements in gingival bleeding and plaque scores for both treatment groups at 6months, with significantly greater improvements in the test group. Adolescents in the test group brushed their teeth and used interdental cleaning aids more frequently compared to participants in the control group at 6months. Conclusion: A person-centred and theory-based oral health education programme ismore effective than conventional oral health education in improving adolescents' oral hygiene behaviour and periodontal infection control. ClinicalTrials.gov (NCT02906098). © 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.
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16.
  • Dimenäs, Sandra L., 1989, et al. (author)
  • Adolescents' experiences of a theory-based behavioural intervention for improved oral hygiene: A qualitative interview study
  • 2022
  • In: International journal of dental hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 20:4, s. 609-619
  • Journal article (peer-reviewed)abstract
    • Objectives Adequate oral hygiene, that is self-performed infection control, is crucial to prevent periodontal disease. Epidemiological studies reveal poor oral hygiene conditions among Swedish adolescents and indicate a need for more effective prevention programs. The aim of the current study was to analyse adolescents' experiences of a person-centred, theory-based, oral health education program for improved oral hygiene. Methods Data were obtained by interviewing 19 adolescents treated by dental hygienists in accord with the person-centred education program in a preceding clinical field study ( NCT02906098). Study participants were selected to reflect a variation of male and female adolescents, treated at clinics in areas with various socio-demographic profiles within Region Vastra Gotaland, Sweden. Interviews were audio-taped, transcribed verbatim and analysed with qualitative content analysis. Results A main theme was identified: 'Adolescents on a guided and challenging journey towards beneficial oral hygiene behavior'. The results elucidate the importance of a person-centred approach in therapy. The adolescents described insight on a personal level about the importance of improved oral hygiene as fundamental for behavioural change. Planning and monitoring of the behaviour, with guidance and support by the dental hygienist, was considered to facilitate change and encouraged further behavioural efforts. However, the adolescents expressed a need of reminders and support to keep up oral hygiene routines over time. Conclusions The study brings knowledge on factors of importance in educational interventions to increase beneficial health behaviours among adolescents and emphasize areas for further improvements of such interventions.
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17.
  • Dimenäs, Sandra L., 1989, et al. (author)
  • Adolescents' self-reported experiences following a person-centred, theory-based educational intervention versus conventional education for improved oral hygiene: Analysis of secondary outcomes of a randomized field study
  • 2023
  • In: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979. ; 51:1, s. 63-73
  • Journal article (peer-reviewed)abstract
    • Aim: To analyse adolescents' self-reported experiences and behavioural outcomes of a person-centred, theory-based intervention in comparison with conventional information/instruction for improved oral hygiene.Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study focusing on the effectiveness of educational interventions for improved oral hygiene. Dental hygienists working within the Public Dental Service, Vastra Gotaland, Sweden, provided treatments, and adolescents with poor oral hygiene conditions were eligible for participation. The person-centred test intervention was based on social cognitive constructs, and motivational interviewing was used as an approach in communication. The control intervention included conventional information/instructions. Clinical examinations were performed, and questionnaires were distributed at baseline and at 6 months. Three-hundred and twelve patients were enrolled, and data from 276 patients, following treatment per protocol, were analysed.Results: The test group was more satisfied with the education about gingivitis (very good: 61% vs. 37%) and communication during therapy (very good: 69% vs. 50%) and reported to a larger extent that they were much more careful regarding their oral hygiene after the treatment (30% vs. 15%) and had higher confidence about keeping up healthy gingival conditions, in comparison with the control group (all p < .01).Conclusions: The person-centred, theory-based intervention was superior in terms of adolescents' experiences of education and communication during therapy and self-reported oral hygiene behavioural outcomes at 6 months, in comparison with conventional information/instruction.
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18.
  • Dimenäs, Sandra L., 1989, et al. (author)
  • Changing from disease-centred to person-centred – Swedish dental hygienists' views on a theory-based behavioural intervention for improved oral hygiene among adolescents
  • 2024
  • In: International Journal of Dental Hygiene. - 1601-5029 .- 1601-5037.
  • Journal article (peer-reviewed)abstract
    • Objectives: To explore dental hygienists' (DHs') views on (i) a person-centred, theory-based, behavioural intervention for improving oral hygiene among adolescents and (ii) professional and organizational factors to consider in the implementation of such an intervention in daily dental practice. Methods: Semi-structured interviews were conducted with 13 DHs who had applied the person-centred, theory-based, behavioural intervention directed at adolescents with poor oral hygiene in a field study within the Public Dental Service, Region Västra Götaland, Sweden. The interviews were audio-taped, transcribed verbatim and analysed using qualitative content analysis. Results: The main theme ‘From individual experts to partners – DHs changing direction from a disease-centred towards a person-centred approach’ illustrated a changed professional approach among DHs, from exerting their roles as experts to encouraging partnership in treatment by supporting the adolescents in taking health behavioural decisions and responsibility for their oral health. The DHs considered the changed approach as challenging, but also more enjoyable, compared to conventional information/instruction. Adequate knowledge and skills, personal interest and willingness for a change as well as support from colleagues and clinic management were identified as prerequisites for implementing the person-centred, theory-based, behavioural intervention in daily practice, while the expenditure of time needed in relation to economic demands in care were seen as barriers. Conclusions: The findings elucidate that DHs considered the application of a person-centred, theory-based, behavioural intervention to be challenging but also enjoyable. For such an intervention to be implemented in daily practice, prerequisites and barriers need to be considered on both personal/professional and organizational levels.
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19.
  • Eék, Niels, 1980, et al. (author)
  • High- versus low-intensity internet interventions for alcohol use disorders (AUD) : A two-year follow-up of a single-blind randomized controlled trial
  • 2023
  • In: Internet Interventions. - : Elsevier. - 2214-7829. ; 33
  • Journal article (peer-reviewed)abstract
    • Alcohol Use Disorders (AUD) are widespread and have serious consequences, but are among the most undertreated mental disorders. Internet interventions have been found effective in treating AUD, but we know little about long-term outcomes, two years or more after treatment. This study explored 12- and 24-month outcomes in alcohol consumption following initial 6-month improvements after a therapist-guided high-intensity internet intervention and an unguided low-intensity internet intervention among individuals with alcohol use disorder. Between-group comparisons were analyzed, as well as within-group comparisons with (1) pre-treatment measurements (2) post-treatment measurements. Participants consisted of a general population sample of internet help-seekers in Sweden. A total of 143 adults (47% men) with a score of 14 (women)/16 (men) or more on the Alcohol Use Disorders Identification Test, alcohol consumption of 11 (women)/14 (men) or more standard drinks the preceding week and & GE; 2 DSM-5 alcohol use disorder (AUD) criteria based on a diagnostic interview were included. The high- and low-intensity internet interventions (n = 72 and n = 71 respectively) consisted of modules based on relapse prevention and cognitive-behavioral therapy. The primary outcome was self-reported alcohol consumption in the preceding week measured as (1) number of standard drinks and (2) number of heavy drinking days. Attrition from self-reported questionnaires was 36% at the 12-month follow-up and 53% at the 24month follow-up. No significant between-group differences occurred in outcomes at either long-term follow-up. Regarding within-group differences, compared to pre-treatment, alcohol consumption was lower in both highand low-intensity interventions at both long-term follow-ups [within-group standard drinks effect sizes varied between g = 0.38-1.04 and heavy drinking days effect sizes varied between g = 0.65-0.94]. Compared to posttreatment, within-group alcohol consumption in the high intensity intervention increased at both follow-ups; for the low-intensity intervention, within-group consumption decreased at 12-month follow-up, but did not differ compared to post-treatment at 24 months. Both high- and low-intensity internet interventions for AUD were thus associated with overall reductions in alcohol consumption at long term follow-ups, with no significant differences between the two. However, conclusions are hampered by differential and non-differential attrition.
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20.
  • Elfström, Magnus, et al. (author)
  • Validation of the Swedish version of the clinical outcomes in routine evaluation outcome measure (CORE-OM)
  • 2013
  • In: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 20:5, s. 447-455
  • Journal article (peer-reviewed)abstract
    • The purpose of this study was to perform an initial validation of a Swedish translation of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). The CORE-OM is a broad self-report instrument of psychological problems, designed as an outcome measure for evaluating the effects of psychological therapy. Participants included a non-clinical group of 229 university students and a clinical group of 619 persons from four primary care sites. The Swedish CORE-OM showed excellent acceptability, high internal consistency and test-retest reliability, as well as acceptable convergent validity. There was strong differentiation of the clinical and non-clinical samples, with the clinical group scoring significantly more psychological problems than the non-clinical group. Sensitivity to change was demonstrated in psychological treatments in primary care. Overall, the psychometric characteristics of the Swedish CORE-OM were very similar to the original UK data. Nevertheless, the validity of the Swedish version needs to be examined more in detail, in larger and more diverse samples. Our results so far, however, provide support for using the Swedish CORE-OM as a psychological problems measure. To our knowledge, there are few other relatively short measures in Swedish that are free to reprint that meet the demands for psychometric properties and utility in primary care settings in which patients typically present a broad range of psychological problems.
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21.
  • Emilsson, Maria, 1966-, et al. (author)
  • The Influence of personality traits and beliefs about medicines on adherence to asthma treatment
  • 2011
  • In: Primary Care Respiratory Journal. - : Strategic Medical Pub. - 1471-4418 .- 1475-1534. ; 20:2, s. 141-147
  • Research review (peer-reviewed)abstract
    • Aim:To explore the influence of personality traits and beliefs about medicines on adherence to treatment with asthma medication.Methods:Respondents were 35 asthmatic adults prescribed controller medication. They answered questionnaires about medication adherence, personality traits, and beliefs about medicines.Results:In gender comparisons, the personality traits “Neuroticism” in men and “adherence to medication” were associated with lower adherent behaviour. Associations between personality traits and beliefs in the necessity of medication for controlling the illness were identified. Beliefs about the necessity of medication were positively associated with adherent behaviour in women. In the total sample, a positive “necessity-concern” differential predicted adherent behaviour.Conclusion:The results imply that personality and beliefs about medicines may influence how well adults with asthma adhere to treatment with asthma medication.
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22.
  • Eriksson, Maria, et al. (author)
  • Association between low internal health locus of control, psychological distress and insulin resistance. An exploratory study
  • 2023
  • In: Plos One. - 1932-6203. ; 18:5
  • Journal article (peer-reviewed)abstract
    • AimTo assess the hypothesis that low internal health locus of control (IHLC) and psychological distress (PD) are associated with insulin resistance. Materials and methodsIn 2002-2005, a random population sample of 2,816 men and women aged 30-74 years participated (76%) in two municipalities in southwestern Sweden. This study included 2,439 participants without previously known diabetes or cardiovascular disease. IHLC was measured by a global scale and PD was measured by the 12-item General Health Questionnaire. Insulin resistance was estimated using HOMA-ir. General linear models were used to estimate differences in HOMA-ir between groups with low IHLC, PD, and both low IHLC and PD, respectively. ResultsFive per cent (n = 138) had both PD and low IHLC, 62 per cent of participants (n = 1509) had neither low IHLC nor PD, 18 per cent (n = 432) had PD, and 15 per cent (n = 360) low IHLC. Participants with both low IHLC and PD had significantly higher HOMA-ir than participants with neither low IHLC nor PD (Delta = 24.8%, 95%CI: 12.0-38.9), also in the fully adjusted model (Delta = 11.8%, 95%CI: 1.5-23.0). Participants with PD had significantly higher HOMA-ir (Delta = 12%, 95%CI: 5.7-18.7), but the significance was lost when BMI was included in the model (Delta = 5.3%, 95%CI:0.0-10.8). Similarly, participants with low IHLC had significantly higher HOMA-ir (Delta = 10.1%, 95%CI: 3.5-17.0) but the significance was lost in the fully adjusted model (Delta = 3.5%, 95%CI: -1.9-9.3). ConclusionsInternal health locus of control (IHLC) and psychological distress (PD) were associated with insulin resistance. Especially individuals with both PD and low IHLC may need special attention.
  •  
23.
  • Eriksson, Maria Christina, 1981, et al. (author)
  • Validation of a single question to measure internal health locus of control in Swedish primary care
  • 2023
  • In: Scandinavian Journal of Psychology. - 0036-5564 .- 1467-9450. ; 64:5, s. 674-678
  • Journal article (peer-reviewed)abstract
    • BackgroundBehavioral risk factors are highlighted in the prevention of diabetes and cardiovascular disease. Screening for health locus of control could be a feasible way to better identify individuals who could benefit from preventive behavioral change interventions. The aim of the study was to investigate the correlation between a single question measuring internal health locus of control (IHLC) and the Multidimensional Health Locus of Control Scale (MHLC) and to assess how IHLC relates to the General Self-Efficacy scale (GSE) in a primary care setting. MethodsPrimary care patients, aged 18 and older, attending three primary care centers in southwest Sweden were consecutively asked to anonymously participate in the study. The patients were given a questionnaire and instructed to return the questionnaire in a sealed box in the waiting room. ResultsIn all, 519 patients were included. The correlation between MHLC Internality and IHLC was weak (r = 0.21, p < 0.001). An increase of one point on the internality scale of the MHLC gave an odds ratio of 1.19 (95% CI 1.11-1.28) for reporting high IHLC, and thus a five-point increase gave a doubled likelihood, OR = 2.40, CI 1.67-3.46. The results for the other scales of the MHLC and GSE were similar. ConclusionIn this study, we found weak but statistically significant support for the single-question IHLC as a measure of internal health locus of control. Given that the correlation was weak, we recommend using the MHLC when possible.
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24.
  • Fägerstad, Anida, 1978-, et al. (author)
  • Barriers and facilitators for adolescent girls to take on adult responsibility for dental care ? a qualitative study
  • 2019
  • In: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 14:1
  • Journal article (peer-reviewed)abstract
    • Purpose: This study aims to explore and describe experiences of the dental care system among adolescent dental patients with a recent history of missed dental appointments at public dental clinics (PDCs) in a Swedish county. Methods: Twelve adolescent girls participated in the study. Data were collected by individual, semi-structured, open-ended interviews and analysed with qualitative content analysis. Results: The study findings could be summed into the theme ?Triggers for adolescent girls to take on or not take on adult responsibility for dental care?. The experience of free dental care could be summarized in five main categories: Pain and discomfort; Attractive and healthy teeth; Feeling safe and secure; Taking on the responsibility; and Free of charge. These five categories consisted of 15 subcategories. Conclusions: The results of this study should increase the knowledge on how to meet and treat adolescent girls in dental care. Knowing what will happen during the dental visit was highlighted by the participants as decisive to whether or not they would attend their dental appointments. Therefore, we should as far as possible ensure that our patients feel safe at their dental visits and by trying to avoid painful treatments.
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25.
  • Fägerstad, Anida, 1978-, et al. (author)
  • Dental avoidance among adolescents : a retrospective case–control study based on dental records in the public dental service in a Swedish county
  • 2019
  • In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:1, s. 1-8
  • Journal article (peer-reviewed)abstract
    • Objective: This study aimed to investigate the occurrence of missed dental appointments among 16–19-year-old adolescents in a Swedish county. A second aim was to explore associations between background and concomitant factors and missed appointments and to investigate if these associations differed between areas with different sociodemographic profiles.Materials and methods: A list of booked, and missed, appointments for 10,158 individuals during 2012 was used for assessments. Based on the total sample, 522 cases with, and 522 matched controls without, dental avoidance behavior in 2012 were identified. Data on previous missed and cancelled appointments, oral health status, dental treatment, fear or behavior problems, and medical, and, where available, psychosocial or lifestyle factors were extracted from the dental records using a preset protocol covering the period 2009–2012.Results: In 2012, 13.1% of 23,522 booked appointments were missed, with a higher proportion of missed appointments among boys than girls. Cases with avoidance behavior more often had a record of sociodemographic load and dental fear or behavior management problems. They also had more oral health problems, more invasive dental treatments, and, in the past, more missed and canceled appointments.Conclusion: To enable good oral health and continued regular dental care, we need to pay more attention to adolescents’ individual situation and be observant of early signs of avoidance.
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26.
  • Fägerstad, Anida, et al. (author)
  • Dental fear among children and adolescents in a multicultural population – a cross-sectional study : Dental fear in a multicultural population
  • 2015
  • In: Swedish Dental Journal. - 0347-9994. ; 39, s. 109-120
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to explore dental fear in a multicultural population of child and adolescent dental patients, with background, gender, age, and socioeconomic status taken into account. A specific aim was to investigate whether the level of DF differed between patients with a non- Swedish background and patients with a Swedish background. In conjunction with a routine visit to the dental clinic, 301 patients (8–19 years old) assessed their dental fear on the Children’s Fear Survey Schedule – Dental Subscale, using self-ratings. Following an interview protocol, patients’ and their parents’ country of birth, and parents’ education and occupation/employment were registered. An interpreter was present when needed. Self-rated dental fear was almost equal among patients coming from a non-Swedish background and patients with a Swedish background. Girls scored higher than boys and younger children scored slightly higher compared to older children, but the pattern of dental fear variation was inconsistent. Socioeconomic status differed between the groups with a non- Swedish vs. a Swedish background, but no impact on dental fear was revealed. When children and adolescents with a non-Swedish vs. a Swedish background were modelled separately, female gender and younger age had an impact on dental fear only in the group with a Swedish background. No differences in dental fear were found between children and adolescents from non-Swedish vs. Swedish backgrounds. Dental fear variations according to gender and age were more pronounced in the group with a Swedish background compared to the group with a non-Swedish background. No impact of socioeconomic status could be revealed.
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27.
  • Hakeberg, Magnus, 1954, et al. (author)
  • Symptoms, Clinical Characteristics and Consequences
  • 2013
  • In: Cognitive Behavioral Therapy for Dental Phobia and Anxiety. Eds. L.-G. Öst and E. Skaret. - Oxford : Wiley. - 9781119960713 ; , s. 1-19
  • Book chapter (peer-reviewed)abstract
    • Description The first book to describe evidence-based treatment of dental phobia using brief CBT, based on the pioneering single-session treatment for specific phobias developed by Lars-Göran Öst. Brings together research, experience and techniques from clinical psychology and dentistry to describe evidence-based treatment of dental phobia in clinical and dental contexts Chapters describe epidemiology, diagnosis and differential diagnosis, symptoms, clinical characteristics and consequences, and aetiology of dental phobia Also covers related issues including intra-oral injection phobia, dental treatment of fearful children, and the use of medication to supplement psychological treatment of fear
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28.
  • Hultvall, Majlis Morhed, et al. (author)
  • Factors of importance to maintaining regular dental care after a behavioural intervention for adults with dental fear : a qualitative study
  • 2010
  • In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 68:6, s. 335-343
  • Journal article (peer-reviewed)abstract
    • Objective. Dental phobia is prevalent in the general population and can be successfully treated through cognitive behavioural therapy, which results in patients being able to cope with dental treatments. The aim of this study was to increase the understanding of factors of importance for maintaining regular dental care after completion of a cognitive behavioural therapy programme. Material and methods. A qualitative study design was used. Fourteen individuals who had successfully completed the programme and had thereafter been referred to a general dental practitioner were interviewed. An interview guide with open-ended questions was used. The interviews were tape-recorded and transcribed verbatim. The texts were analysed using descriptive and qualitative content analysis ( Grounded Theory). Results. The manifest analysis identified four content areas: experience of dental care, content of the behavioural therapy programme, perception of therapy and impact on quality of life. The latent analysis identified influence on quality of life, security, activity and barriers to dental care as categories. Although all informants had successfully completed the dental fear treatment programme, only a few stated that they had an uncomplicated relation to dental care afterwards. Barriers to dental care were lack of money and fear. A sense of security was conclusive to coping with dental care, and a respectful approach on the part of the dental care personnel was essential to development of this sense. Conclusions. Confidence in one's own ability to cope with dental care and the right to guide the treatment were important. Thus the theme in the present study was self-efficacy and respectful dental care personnel.
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29.
  • Hägglin, Catharina, 1955, et al. (author)
  • A Swedish version of the GOHAI index. Psychometric properties and validation.
  • 2005
  • In: Swedish dental journal. - 0347-9994. ; 29:3, s. 113-24
  • Journal article (peer-reviewed)abstract
    • This study investigated a Swedish version of the 12 item General Oral Health Assessment Index (GOHAI). The aim was to validate the translated instrument, and to investigate factors that may influence the GOHAI score. Consecutive samples at eight dental clinics in Göteborg, Sweden were asked to answer the GOHAI, the short form of Oral Health Impact Profile (OHIP-14) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 yrs old) out of 237 (65%) returned the questionnaires. The most commonly reported problem (GOHAI) was 'worried or concerned' due to problems related to oral health (48%), followed by 'unhappy with the appearance of teeth, gums, or dentures' (36%) and 'teeth sensitive to hot, cold, or sweets' (33%). The Cronbach's Alpha (0.86) indicated a high degree of internal consistency and homogeneity between items. Item-scale correlations varied between 0.50 and 0.83. Strong relations were found between depressed GOHAI-scores and dental problems (mobile teeth, number of teeth, dentures). The correlation between the GOHAI score and the OHIP-14 was high (-0.83) indicating good construct validity. Also 'perceived general health' and 'satisfaction with life-situation' and dental status were significantly, but less strongly, correlated with the patient's GOHAI score. In a linear regression analysis, age,'perceived general health' and dental status (number of teeth in lower jaw and mobile teeth) were found to have a significant effect on the GOHAI score. Factor analysis of GOHAI indicated a two-factor solution and did not support the theoretical construction reported of the index. The test-re-test reliability was assessed in a separate sample (members of a physical handicap organization, n = 47) and the correlation coefficient for the GOHAI was 0.64. For individual items, the weighted kappa coefficient varied between 0.25 and 0.80. In conclusion, the Swedish version of the GOHAI showed acceptable reliability and validity.
  •  
30.
  •  
31.
  • Kemani, Mike K, et al. (author)
  • Factor structure and internal consistency of a Swedish version of the Pain Catastrophizing Scale.
  • 2019
  • In: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 63:2, s. 259-266
  • Journal article (peer-reviewed)abstract
    • Pain catastrophizing is highly relevant to assess in the context of long-standing pain. The Pain Catastrophizing Scale (PCS) is a well-established questionnaire used to measure catastrophizing in individuals with long-standing pain. So far, no Swedish translation has been evaluated in regard to validity and reliability. The aims of this study were to translate the PCS questionnaire from English to Swedish, and to investigate its construct validity (face, content, and structural validity) and reliability (internal consistency).We translated the original English version of the PCS to Swedish and collected item responses from 194 persons suffering from primarily long-standing musculoskeletal pain. We used confirmatory factor analysis to evaluate structural validity, and tested the model fit of a one-factor model, an oblique two-factor model, and an oblique three-factor model. We evaluated the measure's reliability in regard to internal consistency calculated with Cronbach's alpha.A three-factor model comprising a four-item rumination factor, a three-item magnification factor, and a six-item helplessness factor provided the best fit to the data. Internal consistency was adequate and Cronbach's α was 0.92 for the entire scale, 0.84 for the rumination subscale; 0.69 for the magnification subscale, and 0.89 for the helplessness subscale.The results indicated adequacy of a three-factor solution and the questionnaire's internal consistency, and provide initial support for the structural validity and internal consistency of a Swedish version of the PCS. Future studies should replicate the study in larger samples and extend the current evaluation in regard to validity and reliability.
  •  
32.
  • Korpe, Lena, et al. (author)
  • Psychometric evaluation of a Swedish version of the Functional Outcomes of Sleep Questionnaire, FOSQ.
  • 2013
  • In: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 71:5, s. 1077-1084
  • Journal article (peer-reviewed)abstract
    • Abstract Objective. The Functional Outcomes of Sleep Questionnaire, FOSQ, is a self-administered 30 item questionnaire, designed to assess the impact of disorders of excessive sleepiness on activities of daily living. The aim was to evaluate the psychometric properties of a Swedish translation of the English original. Materials and methods. A Swedish version of the FOSQ was answered by 75 consecutive patients, diagnosed with obstructive sleep apnea syndrome and in need of treatment. The Short Form Health Survey (SF-36) and Epworth Sleepiness Scale (ESS) were also answered at the same time to evaluate validity. The first 25 patients answered the FOSQ a second time, 3 weeks later, to assess reliability. Results. The test-re-test reliability and intra-class correlation of the different sub-scales in the FOSQ varied between 0.71-0.92 and was 0.92 for the total scale, all statistically significant. Cronbach's alpha, calculated as a measure of internal consistency, varied between 0.84-0.92 for FOSQ sub-scales and was 0.96 for the total score. Statistically significant correlations between FOSQ sub-scales and the eight sub-scales in the SF-36 supported the validity. Discriminant validity, calculated by splitting responders with high and low ESS scores, revealed that FOSQs scores differed significantly between the groups. Conclusions. The results suggest that the Swedish version of the FOSQ has psychometric qualities in line with the original. It might, therefore, be a potentially useful, reliable and valid instrument for clinicians and researchers when measuring variables related to quality-of-life in sleep disorders in this language area.
  •  
33.
  • Lopes, David, et al. (author)
  • Validating the dental subscale of the children's fear survey schedule using Rasch analysis
  • 2013
  • In: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 121:3, s. 277-282
  • Journal article (peer-reviewed)abstract
    • Rasch analysis was used to examine the validity of the Children's Fear Survey Schedule Dental Subscale (CFSS-DS). Data were collected from parents of children in regular dental care (n=240) and from parents of children referred to a specialized pediatric dental clinic (n=200). The Rasch model is a probabilistic model in which estimations are based on the relationship between person ability and item difficulty, and the present study investigated the validity of the CFSS-DS through analysis of person and item fit, dimensionality, ordering of thresholds, local dependency, and differential item functioning. The results show multidimensionality of the original scale, and an adjusted version consisting of six items with good fit to the model is suggested. The adjusted scale makes interval-level analysis possible, and time efficiency and elimination of previously criticized items argue in favor of the adjusted scale.
  •  
34.
  •  
35.
  • Lundgren, Jesper, 1970, et al. (author)
  • Multimodal Cognitive Behavioural Treatment
  • 2013
  • In: Cognitive behaviour therapy for dental phobia and anxiety / edited by Lars-Göran Öst and Erik Skaret.. - Chichester : Wiley-Blackwell. - 9781118499825 ; , s. 109-118
  • Book chapter (other academic/artistic)abstract
    • This chapter contains sections titled: * Historical Background * The First Treatment Method * The Revised Treatment * The Current Treatment * References
  •  
36.
  • Lundgren, Jesper, 1970, et al. (author)
  • Psychophysiological reactions in dental phobic patients during video stimulation.
  • 2001
  • In: European journal of oral sciences. - : Wiley. - 0909-8836. ; 109:3, s. 172-7
  • Journal article (peer-reviewed)abstract
    • Electromyography (EMG) reflecting forehead muscle tension, heart rate (HR) and skin conductance (SC) were continuously recorded in dental phobic subjects (n = 126) and controls (n = 25) during exposure of dental and neutral video scenes in order to explore the relationship between dental fear and psychophysiological responses. This relationship is far from well established, and the present investigation was performed to contribute to the understanding of the psychophysiology of dental fear. Dental phobics had a mean anxiety level of 17.3 as measured by Corah's Dental Anxiety Scale (DAS) and refused conventional dental treatment. Control subjects reported regular dental treatment and a DAS score below population average (DAS < 8). Psychophysiological data was reduced to level (mean) and reactivity (means of intraindividual variations). Results showed that physiologic reactions to fear-relevant conditions measured by HR and EMG reflected degree of dental fear, and that neutral conditions, when presented for the second and third time, induced lower psychophysiologic reactions in phobics than in controls. Recordings of SC indicated that dental phobics may differ from individuals suffering from other types of specific phobia by showing weakened autonomic responsiveness to threat.
  •  
37.
  • Lundgren, Jesper, 1970, et al. (author)
  • Psychophysiological reactions in dental phobic patients with direct vs. indirect fear acquisition
  • 2004
  • In: JOURNAL OF BEHAVIOR THERAPY AND EXPERIMENTAL PSYCHIATRY. - : Elsevier BV. - 0005-7916. ; 35:1, s. 3-12
  • Journal article (peer-reviewed)abstract
    • Dental phobic patients with reported traumatic experiences at onset of dental anxiety were compared to subjects with an indirect fear acquisition in their psychophysiological responses to video scenes showing dental procedures. It has been suggested that individuals with conditioned fear would respond with higher levels of physiological arousal in response to threat compared to subjects with indirect fear acquisition. Although the overall pattern indicates support for this hypothesis, subjects grouped on the basis of their reported fear-etiology did not statistically differ in recorded muscle tension, heart rate or skin conductance reactions to fear-provoking conditions.
  •  
38.
  • Lundgren, Jesper, 1970, et al. (author)
  • Relaxation versus cognitive therapies for dental fear--a psychophysiological approach.
  • 2006
  • In: Health Psychol. - : American Psychological Association (APA). - 0278-6133 .- 1930-7810. ; 25:3, s. 267-273
  • Journal article (peer-reviewed)abstract
    • By separating 127 adult dental-phobic patients according to fear etiology and psychophysiologic response style, the authors investigated the outcome of 2 dental fear treatments. Before and after either relaxation or cognitively oriented treatment, subjects were exposed to neutral and fear-relevant video sequences while the subjects' forehead muscle tension, heart rate, and skin conductance were recorded. Pre- to postintervention differences in self-reported dental fear, general fear, and trait anxiety were analyzed together with psychophysiological data. Both treatments resulted in a significant reduction of dental fear. Despite significant interaction effects of Treatment Modality × Psychophysiological Response Style, it could not be concluded that patients with different fear etiologies or response styles benefit differentially from the 2 treatments given. (PsycINFO Database Record (c) 2007 APA, all rights reserved)
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39.
  •  
40.
  • Melin, Lisa, et al. (author)
  • XRMA and ToF-SIMS Analysis of Normal and Hypomineralized Enamel.
  • 2015
  • In: Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada. - 1435-8115 .- 1431-9276. ; 21:2, s. 407-21
  • Journal article (peer-reviewed)abstract
    • Molar incisor hypomineralization (MIH) is a developmental disturbance of the enamel. This study presents analyses of hypomineralized and normal enamel in first molar teeth diagnosed with MIH, utilizing time-of-flight secondary ion mass spectrometry area analyses and X-ray microanalysis of area and spot profiles in uncoated samples between gold lines which provide electrical conductivity. Statistical analysis of mean values allows discrimination of normal from MIH enamel, which has higher Mg and lower Na and P. Inductive analysis using complete data sets for profiles from the enamel surface to the enamel-dentin junction found that Mg, Cl and position in the profile provide useful discrimination criteria. Element profiles provide a visual complement to the inductive analysis and several elements also provide insight into the development of both normal and MIH enamel. The higher Mg content and different Cl profiles of hypomineralized enamel compared with normal enamel are probably related to a relatively short period during the development of ameloblasts between birth and the 1st year of life.
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41.
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42.
  • Oldin, Anna, et al. (author)
  • Individual risk factors associated with general unintentional injuries and the relationship to traumatic dental injuries among children aged 0-15 years in the Swedish BITA study
  • 2016
  • In: Dental Traumatology. - : Wiley. - 1600-4469. ; 32:4, s. 296-305
  • Journal article (peer-reviewed)abstract
    • AimTo investigate general unintentional injuries (GUI) and traumatic dental injuries (TDI) in relation to behavioral and psychosocial strengths and difficulties among Swedish children aged 0-17 years, and to investigate general unintentional injuries in relation to temperament and socioeconomic status among the same children. Subjects and methodsThe study included 2363 children in four different age cohorts aged 3, 7, 11, and 15 years at the study start. Twelve Public Dental Service clinics in Sweden participated, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview, questionnaires, and dental records. ResultsTwenty-four percentage (24%) of the children had experienced a serious general unintentional injury (GUI) at some point during their lifetime up until 3 months prior to the study start. Children who were regarded by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Most general unintentional injuries occurred at home. Children with incidents of general unintentional injuries had occasions with TDI to a greater extent than children without general unintentional injury. Children, whose mothers had 11 years of school/education or less, were involved in more general unintentional injuries during the 3-month period prior to the study start, compared to children of mothers with higher education level. ConclusionsChildren with general unintentional injuries had more traumatic dental injuries. Children who were assessed by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Temperament, behavioral and psychosocial strengths and difficulties had different impacts at different ages for experiencing a general unintentional injury.
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43.
  • Oldin, Anna, et al. (author)
  • Temperamental and socioeconomic factors associated with traumatic dental injuries among children aged 0-17 years in the Swedish BITA study
  • 2015
  • In: Dental Traumatology. - : Wiley. - 1600-4469. ; 31:5, s. 361-367
  • Journal article (peer-reviewed)abstract
    • Aim: The aim of the study was to identify individual risk factors for traumatic dental injuries (TDI) among Swedish children aged 0-17 years. The studied risk factors were temperamental reactivity of the child, family structure, parent's country of birth, and the socioeconomic status of the family represented by parental education and occupation. Subjects and methods: The study included 2363 children in four different age cohorts at 12 public dental service clinics in Sweden, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview and questionnaires. Results: The more social and active children in the two older age cohorts showed less occasions of TDI. Having one parent/guardian protected the child from dental injury just as well as two parents/guardians. Parents born outside of the Nordic countries showed children with less TDI. Low parental education was related to more occasions of TDI among the children. Conclusions: This study has increased the knowledge on certain individual risk factors for TDI. To prevent dental injuries, information could be given to families and children at risk.
  •  
44.
  • Oldin, Anna, et al. (author)
  • Traumatic dental injuries among children aged 0–17 years in the BITA study – A longitudinal Swedish multicenter study
  • 2015
  • In: Dental Traumatology. - : Wiley. - 1600-4469 .- 1600-9657. ; 31:1, s. 9-17
  • Journal article (peer-reviewed)abstract
    • Abstract BACKGROUND/AIM: To prevent traumatic dental injuries (TDI), there is a need for vital information. This information could be reached using certain specific variables. The aim of this study, therefore, was to investigate TDI in different age groups, their etiology, and differences by gender, in Swedish children aged 0-17 years. SUBJECTS AND METHODS: The study included 2363 children in four different age cohorts from 12 Public Dental Service clinics in Sweden. The design was a 5-year longitudinal study including yearly clinical examinations, retrospective and prospective data compiled from dental records and interviews regarding TDI. RESULTS: The prevalence for TDI was 37.6% (889) with no gender differences. Boys suffered more injuries during the spring and fall compared to girls. The incidence of 2.8% varied between the age groups where preschool children presented the highest incidence. No changes in prevalence for TDI were found for the years included in the study. The most common reason for TDI was Falling (42.1%). The frequencies for the etiological factors varied between the ages. CONCLUSIONS: The TDI prevalence showed to be stable at a high level in spite of great efforts in Sweden and worldwide to reduce it. Knowledge in why, where, and when TDI appears is therefore essential for dental personnel who will work to reduce TDI.
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45.
  • Peterson, Leif, 1943, et al. (author)
  • A multi-facet pain survey of psychosocial complaints among patients with long-standing non-malignant pain
  • 2017
  • In: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 17, s. 68-76
  • Journal article (peer-reviewed)abstract
    • © 2017 Scandinavian Association for the Study of Pain Background and aims Psychometric inventories and scales intended to measure cognitive, emotional and behavioural concomitants of pain are typically constructed by deducting items from theoretically derived concepts related to pain states, e.g. social support, perceived control, depressiveness, and catastrophizing. The aim of this study was to design a clinically useful, generic pain distress inventory – The Multi-Facet Pain Survey (MFPS) – inductively derived from psychological and social complaints reported by a study group of individuals with severe chronic nonmalignant pain. Methods Extensive clinical interviews with hospitalized chronic pain patients were made by clinical psychologists. The purpose was to highlight the patients’ pain histories and their beliefs and feelings about the pain, and to determine factors possibly influencing their rehabilitation potential. The types of distress reported were sorted into categories with a procedure similar to content analysis. Distress reports were converted to statements, forming items in a questionnaire, the Multi-Facet Pain Survey. Results Our analyses supported a distress structure including 15 categories, or “facets”, comprising in all 190 types of psychosocial distress. Ten of the facets denote beliefs about the present condition and aspects of distress experienced in daily life (e.g. cognitive problems); three facets reflect the illness history, and two the patient's views on future prospects. To improve the clinical utility, we shortened the scale into a 53 items inventory. A factor analysis of these 53 items revealed four clinically meaningful factors: (1) stress-related exhaustion; (2) impact of pain on daily life; (3) self-inefficacy in regard to future prospects; and (4) negative experiences of health care. While the second factor represents distress directly related to the pain, the first factor reflects long-term exhaustion effects of the pain condition similar to those seen in individuals exposed to long periods of stress. Items loading in the third factor reflect a pessimistic outlook on the future. The content validity of the scale was explored by predicting and testing correlations between the 15 MFPS facets, and the Symptom Checklist (SCL-90) and the West Haven Yale Multidimensional Pain Inventory (MPI). Some of the MFPS facets showed little or no agreement with any of the subscales of the comparison measures. The homogeneity was satisfactory both for facets and factors. Conclusions The Multi-Facet Pain Survey (MFPS) facets cover a broad array of experienced psychosocial distress in patients with severe, longstanding pain. Some facets of psychosocial impact of longstanding pain states shown in the qualitatively derived distress facets, or by the latent factors found in the factor analysis, may complement our understanding of the long-term impact of pain. Consequently, MFPS may improve the assessment of psychological and social complaints and complications in patients with chronic pain. Implications The MFPS will hopefully be an assessment tool supporting the psychological contribution to a biopsychosocial evaluation of patients with severe, longstanding pain. By exposing a broad range of suffering, MFPS may contribute to alternative treatment options and a better prognosis of future rehabilitation.
  •  
46.
  •  
47.
  • Wide Boman, Ulla, 1964, et al. (author)
  • Psychosocial and dental factors in the maintenance of severe dental fear
  • 2010
  • In: Swedish dental journal. - 0347-9994. ; 34:3, s. 121-127
  • Journal article (peer-reviewed)abstract
    • The aim was to study the relationship between psychosocial factors and dental status in adult subjects with severe dental fear (DF). A consecutive sample of 148 adults (mean age 36.1 yrs, range 21-69 yrs) referred for dental fear treatment was investigated using an intake questionnaire on dental attendance and history, psychometric questionnaires on dental fear, general anxiety and depression and a radiographic examination. The subjects had a mean DFMT (Decayed, Filled, Missed Teeth) score of 18.6 (SD = 5.6). A deterioration in dental status defined as the presence of root remnants was present in 57% of the subjects and was related to the negative consequences of dental fear, general anxiety and depression. Most subjects (84%) reported clinical levels of general anxiety and 46% reported clinical levels of depression. In conclusion, subjects with severe DF often suffer from psychosocial consequences and distress.This is even more marked if their dental status has deteriorated.The findings support a biopsychosocial vicious circle understanding of the maintenance of DF.
  •  
48.
  • Wide Boman, Ulla, 1964, et al. (author)
  • Translation and psychometric properties of the Swedish version of the Index of Dental Anxiety and Fear (IDAF-4C+)
  • 2015
  • In: European Journal of Oral Sciences. - : Wiley. - 0909-8836. ; 123:6, s. 453-459
  • Journal article (peer-reviewed)abstract
    • Dental anxiety (DA) is a common condition, with significant medical, psychological, and social consequences. High-quality psychometric tools for the assessment of dental anxiety are necessary for clinical and research purposes. The aim of this study was to adapt the Index of Dental Anxiety and Fear (IDAF-4C+) to the Swedish language and to explore the psychometric properties of the translated version. The study included a clinical sample (n = 414; 17-91 yr of age) and a non-clinical sample (n = 51; 19-47 yr of age). The scales used were the IDAF-4C+, the Single-Question Assessment of Dental Anxiety (SQDA), the Dental Fear Survey (DFS), and the Internal Health Locus of Control (IHLOC). The Swedish IDAF anxiety module showed a clear, one-dimensional structure, good internal consistency (Cronbach's alpha = 0.95), and adequate validity, as evidenced by strong correlations with the other DA measures (SQDA and DFS) and weak correlations with the IHLOC. In addition, the IDAF phobia module and the IDAF stimulus module were strongly correlated with the other DA measures. To conclude, the study shows promising findings for the reliability and validity of the Swedish translation of the IDAF-4C+, as a useful measure of dental anxiety in research and clinical practice. © 2015 European Journal of Oral Sciences.
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