| 1. |
- Adolfsson, A., et al.
(författare)
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Prevalence of dry mouth in adult patients in primary health care
- 2022
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 80:8, s. 605-610
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To determine the prevalence and severity of dry mouth by age, gender, presence of disease, and medication intake for patients aged 18 years and over, seeking primary health care on the west coast of Sweden (Region of Vastra Gotaland, VGR). Materials and methods Cross-sectional study conducted among patients (n = 374, age >= 18) visiting primary health care providers (n = 4) in VGR for any medical reasons. Patients were invited to participate by answering a single-item question, 'Have you experienced dry mouth in the last six months?' Patients giving positive answers (n = 163) were asked to fill in the 11-item Xerostomia Inventory (XI) questionnaire to determine the variability and severity of xerostomia. Patients replying 'No' (n = 211) to the single-item question were considered not to have xerostomia and included in the non-xerostomia group. Results The overall prevalence of xerostomia was 43.6% with a female dominance (61.2%). The prevalence in different age groups among females and males was similar. The number of medications and/or diseases are positively associated with xerostomia. Medication was a significant predictor of the prevalence of xerostomia, regardless of age and gender (p < .001). Patients with five or more medications had the highest prevalence of xerostomia (71.2%). Conclusion Patients seeking primary care on the west coast of Sweden have a high prevalence of xerostomia. Factors associated with xerostomia were female gender and medications and/or diseases. Awareness is required to manage patients with xerostomia in medical and dental care.
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| 2. |
- Alvenfors, Adam, 1988, et al.
(författare)
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"Difficult" dental patients: a grounded theory study of dental staff's experiences.
- 2022
-
Ingår i: BDJ open. - : Springer Science and Business Media LLC. - 2056-807X. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- The "difficult" patient is a well-known and potentially negative character in various care contexts.This study aimed to generate a conceptual framework explaining the main concerns about "difficult" dental patients, and obtain a deeper understanding of their characteristics, how they affect the dental staff and how the staff think and act in order to manage these patients.Ten interviews were conducted with professional dental caregivers, including dentists, dental hygienists, and dental nurses. The audio-recorded interviews were transcribed and analyzed in accordance with the principles of grounded theory.The main concern regarding "difficult" dental patients generated a framework of seven descriptive interrelated lower-level categories grounded in the data, subsumed in the core category "balancing subjective difficulties". The informants perceived the possession of "showing interaction difficulties" and "having bio-psycho-social complexity", as characteristic features of "difficult" patients, who could further adversely affect the dental staff by "evoking negative emotions and behaviors", "hampering self-esteem and job satisfaction", and "impairing life and health in general". To manage the dental care of these patients, the staff used strategies aimed at "activating internal and external resources" and "creating adaptive treatment relations" with patients.The dental staff's meaning of the phenomenon of "difficult" dental patients points to specific characteristics, effects, and handling strategies. The core category captures the contradictory dynamics of characteristics and affects as these concepts seem interrelated to the caregivers' handling capacity. The dental staff's possibility of handling the main concern through balancing subjective difficulties depends on contextual conditions regarding time, to bring the patient and/or oneself at the center of attention. This indicates a need for further research regarding dental interactions and studies generalizing the outlook on "difficult" dental patients.
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| 3. |
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| 4. |
- Arvidsdotter, Tina, et al.
(författare)
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Quality of life, sense of coherence and experiences with three different treatments in patients with psychological distress in primary care: a mixed-methods study
- 2015
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Ingår i: BMC Complementary and Alternative Medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychological distress is associated with impaired health-related quality of life (HRQL) and poor sense of coherence (SOC). In a previous study, we found that therapeutic acupuncture (TA) and an integrative treatment that combined TA with person-centred approach in a salutogenic dialogue (IT) alleviated anxiety and depression significantly more than conventional treatment (CT) in primary care patients. Here, we report on secondary analyses regarding the HRQL and SOC from that previous pragmatic randomised controlled trial (RCT). Method: Quantitative and qualitative design. One hundred twenty patients were referred for psychological distress. Quantitative analyses were performed at baseline and after 8 weeks of treatment using the SF-36 mental component summary (MCS), physical component summary (PCS) and the Sense of Coherence-13 (SOC) questionnaires. Qualitative manifest content analyses were based on open-ended questions-"Have you experienced any changes since the start of the treatment? Will you describe these changes?" Results: No baseline differences were found. At 8 weeks, both the IT and TA groups had statistically better scores and greater improvement from baseline on the MCS and SOC than the CT group. The effect sizes were large. No significant differences were found between the IT and TA groups or in relation to the PCS. SOC was highly correlated with the MCS but not with the PCS. Dropout rates were low. The experiences of the intervention resulted in four categories: Being heading back; Status quo; Feeling confirmed; and Feeling abandoned, with 13 related subcategories. Conclusion: IT and TA seem to improve sense of coherence and mental health status in primary care patients with psychological distress, whereas CT appears to be less beneficial. IT and TA appear to be well-accepted and may serve as useful adjunct treatment modalities to standard primary care. Our results are consistent with much of the previous research in highlighting a strong relationship between SOC and mental health status. The written qualitative data described feeling confirmed and feeling increased self-efficacy, self-care and faith in the future. Those in the CT group, however, described feeling abandoned, missing treatment and experiencing increased emotional and physical problems. More research is needed.
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| 5. |
- Arvidsdotter, Tina, et al.
(författare)
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Six-month effects of integrative treatment, therapeutic acupuncture and conventional treatment in alleviating psychological distress in primary care patients - follow up from an open, pragmatic randomized controlled trial
- 2014
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Ingår i: Bmc Complementary and Alternative Medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 14:210
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Tidskriftsartikel (refereegranskat)abstract
- Background: To evaluate and compare 6-month effects of 8 weeks of an integrative treatment (IT), therapeutic acupuncture (TA), and conventional treatment (CT) in reducing symptoms of anxiety, depression and in improving health-related quality of life (HRQL) and sense of coherence (SOC) in psychologically distressed primary care patients. Methods: Patients who had participated in an open, pragmatic randomized controlled trial were followed up six months after treatment. The study sample consisted of 120 adults (40 per treatment arm) aged 20 to 55 years referred from four different primary health care centres in western Sweden for psychological distress. Assessments were made at baseline after eight weeks and after 24 weeks. Anxiety and depression were evaluated with the Hospital Anxiety and Depression scale (HADS), HRQL with the SF-36 Mental Component Summary scores (MCS) and SOC with the Sense of Coherence-13 questionnaire. Results: No baseline differences were found between groups on any outcome variable. At 24 weeks, IT and TA had significantly better values than CT on all variables. All three groups showed significant improvements from baseline on all variables, except HAD depression in CT; however, improvements were significantly greater in IT and TA than in CT. IT and TA did not differ on any outcome variable. Effect sizes were large in IT and TA for all variables and small or moderate in CT. Improvements on all variables seen after 8-weeks of IT and TA remained stable at 24 weeks and the CT group improved on HAD anxiety. Conclusions: IT and TA seem to be more beneficial than CT in reducing anxiety, depression, and in improving quality of life and sense of coherence after 24 weeks of follow up in patients with psychological distress. More research is needed to confirm these results.
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| 6. |
- Arvidsdotter, Tina, et al.
(författare)
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Understanding persons with psychological distress in primary health care
- 2016
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:4, s. 687-694
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being.
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| 7. |
- Baigi, Amir, et al.
(författare)
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The association between socio-economic status and chest pain, focusing on self-rated health in a primary health care area of Sweden
- 2001
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 11:4, s. 420-424
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: The study objective was to determine, first, the association between men's and women's chest pain and their socio-economic status (occupation, smoking) and, secondly, the association between their socio-economic status and self-rated health, in a primary health care area. Design and setting: A population-based cross-sectional survey was made in a primary health care area of Sweden. Primarily based on occupation according to Swedish standards, 4,238 men and women were divided into two socio-economic groups; blue-collar and white-collar workers. Methods: Odds ratios with 95% Cl were calculated by multivariate logistic regression, controlling for the variable age as confounding factor. Student's t-test was used to compare self-rated health, and the chi (2)-test to determine any difference in smoking habits between the two groups. Main results: Both male and female blue-collar workers showed significantly more chest pain when excited than white-collar workers. In six of eight health indices, they also reported significantly worse self-rated health than the white-collar workers. Conclusions: These findings show that there are socio-economic inequalities in self-reported chest pain. Furthermore, socio-economic status has a major influence on self-rated health, acting across the working life of both sexes.
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| 8. |
- Bergh, Håkan, 1958, et al.
(författare)
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Consultations for injuries by frequent attenders are found to be medically appropriate from general practitioners' perspective.
- 2005
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 33:3, s. 228-32
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: A study was carried out to determine whether frequent attenders' (FAs') consultations for injuries are medically appropriate or not. METHODS: A retrospective review was undertaken of medical records in a primary healthcare centre. All injury consultations by frequent attenders and controls during a period of one year were evaluated by two general practitioners (GPs). Outcome variables were: number of injuries, chronic diseases, type of injuries, and their treatments. The GPs made a comprehensive picture of each case and evaluated whether it was medically appropriate to consult a doctor or not. RESULTS: Injuries were 7.2 times more common among frequent attenders compared with the controls. Frequent attenders had significantly more chronic diseases. Mean number of injury consultations was the same for frequent attenders with or without chronic disease. There was no difference concerning medically appropriate consultations between frequent attenders and controls. CONCLUSIONS: Consultations for injuries with frequent attenders were considered medically appropriate. Chronic diseases did not explain the higher injury incidence among frequent attenders. These findings are interesting and contradict the opinion that increased healthcare consumption by FAs is a waste of resources. Our findings may suggest that FAs are more vulnerable individuals.
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| 9. |
- Bergh, Håkan, 1958, et al.
(författare)
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Life events, social support and sense of coherence among frequent attenders in primary health care.
- 2006
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Ingår i: Public health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 120, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this survey was to compare stressful life events, social support and sense of coherence (SOC) between frequent attenders (FAs) and normal attenders (controls) in primary health care. STUDY DESIGN: A cross-sectional study was conducted in a primary healthcare centre in the south-west of Sweden. METHODS: A postal questionnaire was sent to 263 frequent attenders and 703 normal attenders. The questionnaire comprised sociodemographic variables and scales of stressful life events, social support and SOC. The results from the questionnaire were compared between the groups, and the significance of the variables in terms of attendance was tested in a multiple regression analysis. RESULTS: More of the FAs were secondarily single, they had more chronic diseases and were more often living on a sickness/disablement pension than the controls. FAs did not report more stressful life events than the controls nor was their experience of events more negative. Social support was as strong among FAs as among controls, and it had no significant effect on their frequent attendance. FAs had a significantly weaker SOC compared with controls. The variables that significantly influenced frequent attendance were high age [odds ratio (OR) = 1.02], chronic disease (OR = 3.08), sickness/disablement pension (OR = 2.46) and SOC (OR = 0.97). CONCLUSIONS: SOC had a significant influence on frequent attendance in primary health care, but stressful life events and social support did not. FAs did not report more stressful life events. However, due to an inadequate coping strategy, indicated by a weak SOC, the life events probably caused them more symptoms and diseases, and thereby a higher consulting frequency.
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| 10. |
- Bergh, Håkan, 1958, et al.
(författare)
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Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years.
- 2007
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Ingår i: Public health. - : Elsevier BV. - 0033-3506. ; 121:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To find predictive factors for long-term sick leave (SL) and disability pension (DP) among frequent attenders (FAs) and normal attenders (NAs) in primary health care. STUDY DESIGN: A cohort study with follow-up over 5 years. METHODS: Groups of FAs and NAs were followed over 5 years. Information about background, situation, sociodemography, life events, social support and sense of coherence were gathered at baseline. Multiple logistic regression analysis was used to determine the influence of each variable on long-term SL and receipt of a DP. RESULTS: During the study period, 18.9% of FAs received long-term SL/DP compared with 6% of NAs. Chronic disease was a predictive factor for long-term SL/DP among FAs [odds ratio (OR) 7.0] and NAs (OR 3.4). Among FAs, a life event was also a predictive factor (OR 2.1). Each additional life event increased the ratio of FAs with long-term SL/DP by 110%. Conflicts and losses had the greatest negative effects on FAs. CONCLUSIONS: FAs are a high-risk group for long-term SL/DP. Besides chronic disease, a life event was the only predictive factor for long-term SL/DP among FAs. These findings indicate that FAs are a vulnerable group for stressful events. Consequently, healthcare personnel should take more notice of life events among FAs.
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| 11. |
- Brobeck, Elisabeth, et al.
(författare)
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Stress in children: how fifth-year pupils experience stress in everyday life.
- 2007
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- In many cases, stress in children takes the form of psychosomatic symptoms. The prevalence of headache in children has increased, as has stomach pain and self-reported psychological problems. Many children also experience stress without exhibiting any symptoms, as children perceive, understand and evaluate stress in a variety of different ways. The aim of this study was to describe how fifth-year pupils experience stress in everyday life. An explorative and descriptive design based on phenomenology was chosen to investigate children's lifeworld and lived experience of the phenomenon of stress. The data analysis was based on Giorgi's method. The study comprised 29 children, who were interviewed regarding their experience of stress in everyday life. The results revealed five key constituents: 'fear of being late', 'not having sufficient time', 'physical and mental consequences', 'both a negative and a positive feeling' and 'experiencing significant others' stress'. Together, these key constituents form the overall result. This study demonstrates that stress is a part of children's everyday life. The children described stress that was often acute and linked to situations that occur in everyday life. The results can assist in identifying the factors behind the stress experienced by children. This in turn will facilitate observation and intervention when a child exhibits stress symptoms.
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| 12. |
- Chin, Kuo Zhe, et al.
(författare)
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Extended prenatal and postnatal home visits in a vulnerable area in Sweden—a pilot study
- 2023
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Ingår i: Scandinavian Journal of Primary Health Care. - 1502-7724 .- 0281-3432. ; 41:4, s. 486-494
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Despite close to all-embracing access to child healthcare, health divides exist among children in Sweden. Home visits to families with new-born babies are a cost-effective way to identify and strengthen vulnerable families. An extended postnatal home visiting programme has been implemented in a disadvantaged suburb in Stockholm with positive results. Design: Longitudinal, prospective study and register study from medical records. Setting: A vulnerable rural area in Sweden. Intervention: A parent advisor from the social services and a midwife performed an extended home visiting programme during the end of pregnancy to mothers of children born between 1 May 2018 and 31 May 2019. During these children’s first 15 months, three additional home visits were made by a parent advisor and a child healthcare nurse. The aim of the study is to evaluate the effect of the intervention on the health of the children and the mothers. Subjects: All firstborn children at the study site (N = 30 study, N = 55 control group). Main outcome measures: The proportion participating in visits to the child and maternal healthcare services, children being breastfed and receiving childhood vaccinations. Results: There were fewer absentees in the study group during routine check-up visits (93 vs. 84%). More mothers in the study group attended the check-up with the midwives (90 vs. 80%). More children in the study group were breastfed (90 vs. 67%) and received all vaccinations (100 vs. 96%). Conclusion: Supplementing the extended home visiting programme with a visit at the end of pregnancy seems to contribute to fewer absentees at routine visits for both mothers and children; furthermore, more children were breastfed and vaccinated compared with the control group.
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| 13. |
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| 14. |
- Eriksson, Linn, 1982-, et al.
(författare)
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Obsession with diet among fitness center participants in relation to body ideal and social physique anxiety
- 2009
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Ingår i: 6th Eass Conference “Sports, Bodies, Identities” Rome, May 27th - 31st 2009.
-
Konferensbidrag (refereegranskat)abstract
- Several studies indicate that women are more likely than men to exercise for appearancerelated reasons, but today, even men have become more concerned about how they look. Exercise and/or diets are sometimes used in an attempt to develop a more attractive physique. Strict diets such as an obsession with healthy food, sometimes termed orthorexia nervosa (ON), are controversial and have been questioned by researchers. This study investigates how scores on the Social Physique Anxiety Scale (SPAS) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) relate to Bratman’s orthorexia test (BOT) scores with regard to age, sex, and self-reported exercise frequency and duration. The fitness participants (n=251, 166 women and 85 men, 21% dropout) were consecutively selected from five fitness centers in Sweden. They completed the BOT, SPAS, SATAQ, and a questionnaire focusing on exercise frequency and duration. Multiple stepwise regression analysis was used and the significance level set at 5%. In men, the results indicated that the SATAQ subdomain internalization could itself explain the variation in BOT results. In women, the results demonstrated that exercise frequency, in combination with the SPAS score and the SATAQ subdomains of internalization and awareness, could explain the variation in BOT results. Internalization of a slimness ideal (for women) and a muscular body (for men) can be a risk factor for obsession with diet. In the same way, higher exercise frequency, a higher level of social physique anxiety and awareness of Western body ideals seem to be predictors of obsession with diet among women. It is possible that the fitness center environment emphasizes a body ideal that leads to an increased obsession with diet. On the other hand, it may be that people who are aware of the body ideal and are obsessed with diet are the ones who engage in fitness center activities.
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| 15. |
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| 16. |
- Eriksson, Linn, 1982-, et al.
(författare)
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Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants
- 2008
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - Copenhagen : Munksgaard Forlag. - 0905-7188 .- 1600-0838. ; 18:3, s. 389-394
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates how scores on the Social Physique Anxiety Scale (SPAS) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) relate to Bratman's orthorexia test (BOT) scores with regard to age, sex, and self-reported exercise frequency and duration in a sample of Swedish participants in fitness center activities. A total of 251 participants (166 women and 85 men) completed the SPAS, the SATAQ, and a questionnaire focusing on exercise frequency and duration. The results indicated that the SATAQ subdomain internalization could itself explain the variation in BOT results. In women, the results indicated that exercise frequency, followed by SPAS score and the SATAQ subdomains internalization and awareness, could together explain the variation in BOT results. Fitness centers could make a point of emphasizing that some physical ideals are neither healthy nor realistic, thus strengthening member self-image and preventing social physique anxiety, eating disorders, and negative attitudes toward appearance.
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| 17. |
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| 18. |
- Göransson, Katarina, 1974-, et al.
(författare)
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Accuracy and concordance of nurses in emergency department triage.
- 2005
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 19:4, s. 432-8
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Tidskriftsartikel (refereegranskat)abstract
- In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. In Sweden, few studies on ED triage have been conducted and the organization of triage has been found to vary considerably with no common triage scale. The aim of this study was to investigate the accuracy and concordance of emergency nurses acuity ratings of patient scenarios in the ED setting. Totally, 423 RNs from 48 (62%) Swedish EDs each triaged 18 patient scenarios using the CTAS. Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.
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| 19. |
- Göransson, Katarina E., et al.
(författare)
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Emergency department triage : is there a link between nurses’ personal characteristics and accuracy in triage decisions?
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 14:2, s. 83-88
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A common task of registered nurses is to perform emergency department triage, often using an especially designed triage scale in their assessment. However, little information is available about the factors that promote the quality of these decisions. This study investigated personal characteristics of registered nurses and the accuracy in their acuity ratings of patient scenarios. Methods Using the Canadian Triage and Acuity Scale (CTAS), 423 registered nurses from 48 (62%) Swedish emergency departments individually triaged 18 patient scenarios. Results The registered nurses’ percentage of accurate acuity ratings was 58%, with a range from 22% to 89% accurate acuity ratings per registered nurse. In total, 60.3% of the registered nurses accurately triaged the scenarios in 50–69% of the cases. No relationship was found between personal characteristics of the registered nurses and their ability to triage. Discussion The lack of a relationship between personal characteristics of registered nurses and their ability to triage suggests that there might be intrapersonal characteristics, particularly the decision-making strategies used which can partly explain this dispersion. Future research that focuses on decision-making is likely to contribute in identifying and describing essential nursing characteristics for successful emergency department triage.
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| 20. |
- Hansson, Anders, 1953-, et al.
(författare)
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ST-läkare vill se praktisk nytta av FoU-kurser [ST-doctors believe scientific courses should relate more to everyday practice]
- 2013
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 110:22, s. 1098-1098
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Tidskriftsartikel (refereegranskat)abstract
- Enligt Socialstyrelsens målbeskrivning för läkarnas specialistutbildning ska ST-läkaren tillägna sig ett vetenskapligt förhållningssätt.Det är oklart vad målet innebär och hur det ska tolkas, vilket speglas i de olika specialistföreningarnas olika anvisningar och kursernas olika utformning.De traditionella FoU-kurser som erbjuds har inte alltid motsvarat ST-läkarnas förväntningar.Två fokusgruppsintervjuer med ST-läkare från olika specialiteter visar att ST-läkare anser att det är viktigt att tillägna sig ett vetenskapligt kritiskt tänkande för att kunna granska sina egna behandlingsmetoder och bemöta patienternas frågor.
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| 21. |
- Hansson, Anders, 1953-, et al.
(författare)
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Working together--primary care doctors' and nurses' attitudes to collaboration.
- 2010
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:1, s. 78-85
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Tidskriftsartikel (refereegranskat)abstract
- Multidisciplinary teamwork is recommended for various disorders and it has been suggested that it is a way to meet the new challenges and demands facing general practitioners (GPs) in modern society. Attempts to introduce the method in primary care have failed partly due to GPs' unwillingness to participate. The aim of this study was to measure attitudes towards collaboration among GPs and district nurses (DN) and to investigate whether there is a correlation between a positive attitude toward collaboration and high self-esteem in the professional role.
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| 22. |
- Haraldsson, Katarina, et al.
(författare)
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Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life : A grounded theory study
- 2011
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Ingår i: Stress and Health. - Chichester : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 27:2, s. E61-E70
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.
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| 23. |
- Haraldsson, Katarina, 1958, et al.
(författare)
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Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress.
- 2008
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Ingår i: Public health. - London : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress. STUDY DESIGN: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden. METHODS: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment. RESULTS: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls' sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls' sense of well-being was maintained in two areas and deteriorated in four areas. CONCLUSION: Massage and mental training helped to maintain adolescents' very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.
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| 24. |
- Haraldsson, K, et al.
(författare)
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The self-reported health condition of women after their participation in a stress management programme: a pilot study
- 2005
-
Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 13:3, s. 224-230
-
Tidskriftsartikel (refereegranskat)abstract
- From a public health perspective, it is important to develop effective measures to deal with stress which are based on the individual's participation, such as stress management provided in group sessions. Therefore, the aim of the present study was to compare and evaluate the self-reported health condition of women in terms of their general symptoms, stress and sense of coherence (SOC) after participation in a stress management programme. The intervention, which had a modified crossover design and involved 40 women divided into two groups (G1 and G2), comprised eight meetings, the content of which was both theoretical and practical, and included information about stress, stress management, massage and mental training. A questionnaire was filled in on three occasions: before and after the intervention (8 weeks later), and after another 8 weeks (16 weeks later). The questionnaire contained 60 items comprising background factors, general symptoms, stress and SOC. No significant differences existed between the groups at baseline. In favour of the intervention, significant differences were found between the groups with regard to fewer general symptoms (P = 0.035) as well as a tendency to stress reduction (P = 0.060). A comparison within groups showed that both groups had a significant reduction in symptoms after the intervention (G1, P = 0.002; and G2, P = 0.003) and in reduced stress (both P = 0.001). After a further 8 weeks, both groups still showed significantly fewer general symptoms and reduced stress, as well as significant improvements with regard to SOC (G1, P = 0.012; and G2, P = 0.026). These findings indicate that the combination of mental training and massage in this stress management programme had a positive influence on the women's health condition. The pilot study design could be used in a full-scale study with randomised groups.
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| 25. |
- Haraldsson, Katarina, et al.
(författare)
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What makes the everyday life of Swedish adolescent girls less stressful: a qualitative analysis
- 2010
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Ingår i: HEALTH PROMOTION INTERNATIONAL. - Oxford : Oxford University Press. - 0957-4824 .- 1460-2245. ; 25:2, s. 192-199
-
Tidskriftsartikel (refereegranskat)abstract
- Stress is a widespread phenomenon in society today, not least among children and adolescents. Stress-related ill-health has increased in this population and affects girls to a greater extent than boys. Against this background, it is important to acquire knowledge about measures that prevent stress, especially in girls. The aim of this study was therefore to illuminate adolescent girls' experiences and reflections about what makes everyday life less stressful. An explorative design, qualitative content analysis, was used. In-depth interviews were conducted with fifteen 17-year-old girls. The analysis comprised both manifest and latent content and revealed the girls' own experiences of and reflections about what makes everyday life less stressful. Three categories, ‘Enjoyment and Recovery’, ‘Trust’ and ‘Insight and Influence’, and nine subcategories emerged. The latent content of these categories is described by the theme ‘access to sources of strength’. It is essential that persons in the girls' surroundings are aware of all sources that provide the strength to resist and prevent stress in everyday life. A climate has to be created in all arenas of the girls' everyday life in which they can access these sources of strength. Utilizing the girls' experiences and views about what needs to be done is the first step towards a preventive and promotive mode of working on their own circumstances and wishes. This approach is consistent with the Ottawa Charter for Health Promotion, which emphasizes the importance of involving the target group.
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| 26. |
- Isaksson, P., et al.
(författare)
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Promoting mental health in Swedish preschool-teacher views
- 2017
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Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 32:1, s. 53-61
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Tidskriftsartikel (refereegranskat)abstract
- The promotion of childhood mental health is an important investment for the future. Many young children spend a large amount of time in preschool, which have unique opportunities to promote mental health at an early stage. The aim of this study was to illuminate teachers' views of what they do in ordinary work to promote mental health among preschool children. This qualitative study had a descriptive and exploratory design and qualitative content analysis was utilized. Six focus group interviews with preschool teachers, concerning families from different cultural, geographical and socioeconomic backgrounds, were conducted in a county in the southwest of Sweden. Both manifest and latent content appeared. Three categories, 'structured world', 'pleasant climate' and 'affirming the child' and 10 subcategories emerged. The latent content of these categories is described under the theme 'creating an atmosphere where each child can flourish in harmony with their environment'. The results show teachers different working approaches with mental health in preschool and together with previous research these results can provide a basis of knowledge for preschool teachers and inspire them to develop and maintain their health-promoting work. In future studies it should be particularly interesting to investigate how the promotive way to work can be transferred to strengthen mental health throughout the school years.
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| 27. |
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| 28. |
- Johansson, Minna, et al.
(författare)
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Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study
- 2018
-
Ingår i: Lancet. - 0140-6736. ; 391:10138, s. 2441-2447
-
Tidskriftsartikel (refereegranskat)abstract
- Background Large reductions in the incidence of abdominal aortic aneurysm (AAA) and AAA-related mortality mean that results from randomised trials of screening for the disorder might be out-dated. The aim of this study was to estimate the effect of AAA screening in Sweden on disease-specific mortality, incidence, and surgery. Methods Individual data on the incidence of AAA, AAA mortality, and surgery for AAA in a cohort of men aged 65 years who were invited to screening between 2006 and 2009, were compared with data from an age-matched contemporaneous cohort of men who were not invited for AAA screening. We also analysed national data for all men aged 40-99 years between Jan 1, 1987, and Dec 31, 2015, to explore background trends. Adjustment for confounding was done by weighting the analyses with a propensity score obtained from a logistic regression model on cohort year, marital status, educational level, income, and whether the patient already had an AAA diagnosis at baseline. Adjustment for differential attrition was also done by weighting the analyses with the inverse probability of still being in the cohort 6 years after screening. Generalised estimating equations were used to adjust the variance for repeated measurement and in response to the weighting. Findings AAA mortality in Swedish men has decreased from 36 to ten deaths per 100 000 men aged 65-74 years between the early 2000s and 2015. Mortality decreased at similar rates in all Swedish counties, irrespective of whether AAA screening was offered. After 6 years with screening, we found a non-significant reduction in AAA mortality associated with screening (adjusted odds ratio [aOR] 0.76, 95% CI 0.38-1.51), which means that two men (95% CI -3 to 7) avoid death from AAA for every 10 000 men offered screening. Screening was associated with increased odds of AAA diagnosis (aOR 1.52, 95% CI 1.16-1.99; p= 0.002) and an increased risk of elective surgery (aOR 1.59, 95% CI 1.20-2.10; p= 0.001), such that for every 10 000 men offered screening, 49 men (95% CI 25-73) were likely to be overdiagnosed, 19 of whom (95% CI 1-37) had avoidable surgery that increased their risk of mortality and morbidity. Interpretation AAA screening in Sweden did not contribute substantially to the large observed reductions in AAA mortality. The reductions were mostly caused by other factors, probably reduced smoking. The small benefit and substantially less favourable benefit-to-harm balance call the continued justification of the intervention into question. (c) 2018 Elsevier Ltd. All rights reserved.
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| 29. |
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| 30. |
- Jonasson, Inger, et al.
(författare)
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A new primary care model for the rehabilitation of strokepatients with impaired arm and hand function - a pilot study.
- 2012
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Ingår i: Vård i Norden. - 0107-4083. ; 32:2, s. 15-20
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT Background: A new treatment method, Constraint-Induced Movement Therapy (CIMT), has been tested by stroke patients in hospital but not in primary care. Reduced time in hospital increases primary care’s responsibility for rehabilitation and necessitates the development of new methods. Aim: To investigate the effect of CIMT on stroke patients in primary care. Method: Sixteen patients with stroke were offered a ten-day intensive group-training course, six hours per day. They were included in median value 17 months (range:7-120) after stroke. They were prevented from using their non-affected hand by wearing a glove for 90% of their waking hours. Measurements with 14 standardized instruments were performed up to three months after intervention. Findings: The results revealed a significant improvement in the patients’motor and everyday life functions. There was a marked recovery of lost capacity in ADL, which combined with the increase in the performance of meaningful tasks led to improved possibilities of living an independent life. The improvements in motor function and recovery of lost ADL functions were maintained at the three month follow-up. The training intervention was perceived as highly satisfactory. Conclusion: CIMT in a group setting in primary health care seems to be a successful rehabilitation model after stroke. KEY WORDS: ADL, constraint-induced movement therapy, occupational therapy, primary care, rehabilitation outcome
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| 31. |
- Jonasson, Inger, et al.
(författare)
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Working in a training garden : experiences of patients with neurological damage
- 2007
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Ingår i: Australian Occupational Therapy Journal. - : Blackwell Publishing. - 0045-0766 .- 1440-1630. ; 54:4, s. 266-272
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to describe patients’ experiences of working in a training garden after neurological damage. Methods: The study employs a qualitative method with a phenomenographic approach. Interviews with 14 patients attending outpatient rehabilitation were conducted. The interview consisted of open-ended questions based on an interview guide covering: the activity, the training, its value and the environment. Results: The study revealed that activities in a training garden were experienced as beneficial, productive, voluntary and complicated. Certain conditions are necessary for performance and for drawing benefit from the activities. Conclusions: The results of this study may be of benefit in clinical work and may also apply to other groups of patients. Further research is needed on training gardens to enhance knowledge of suitable activities for different groups of patients to be used in the design of intervention programs.
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| 32. |
- Jönsson, Eva, et al.
(författare)
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Psychosocial risk factors in families with infants: a municipality survey
- 2006
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Ingår i: Vård i Norden. - 0107-4083. ; 26:3, s. 9-9
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Tidskriftsartikel (refereegranskat)abstract
- Difficulties in a family's psychosocial situation during the period of infancy are associated with mental problems and behavioural disorders in children. The aim of the study was to identify the extent and type of psychosocial factors in families with infants, including social aspects, mental problems and substance abuse as well as circumstances surrounding the birth. All infants born between March 1st 2000 and August 31st 2001 whose parents had adequate knowledge of the Swedish language (N=576) were included. Data were collected by means of a questionnaire. Psychosocial risk factors were found in the families of 24% of infants whose mothers were of Swedish origin and in the families of 58% of infants whose mothers were of foreign origin. The most common risk factors were: unemployment, premature birth, and one or both parents exhibiting signs of great worry and anxiety in relation to their child and parenthood. The study also shows that mental problems and substance abuse were only present in a very small number of parents. Furthermore, the study indicates the need to review the strategies used within child health care to identify families at risk of developing mental problems and behavioural disorders as a result of dysfunctionality in their psychosocial situation during their child's infancy. It is important to study the professional network surrounding families in more detail, both in order to detect psychosocial risk factors and to develop and evaluate interventions.
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| 33. |
- Larsson, Lena Gunvor, et al.
(författare)
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A national study on collaboration in care planning for patients with complex needs
- 2019
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Ingår i: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 34:1, s. E646-E660
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The purpose of this study was to investigate inter-organisational collaboration on care planning for patients with complex care needs. Internationally, and in Sweden where the data for this study was collected, difficulties in care planning and transition of patients between the main health care providers, hospitals, municipal care, and primary care are well known.METHOD: A survey of a total population of care managers in hospitals, municipalities, and primary care in Sweden was conducted. The study assessed accessibility, willingness, trustworthiness, and collaboration between health care providers. Data were analysed with descriptive statistics, bivariate, and multivariate regressions.RESULTS: The results indicate that Swedish health care providers show strong self-awareness, but they describe each other's ability to collaborate as weak. Primary care stands out, displaying the highest discrepancy between self-awareness and displayed accessibility, willingness, trustworthiness, and collaboration.CONCLUSION: Inability to collaborate in patient care planning may be due to shortcomings in terms of trust between caregivers in the health care organisation at a national level. Organisations that experience difficulties in collaboration tend to defend themselves with arguments about their own excellence and insufficiency of others.
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| 34. |
- Larsson, Lena Gunvor, et al.
(författare)
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Primary care managers’ perceptions of their capability in providing care planning to patients with complex needs
- 2017
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 121:1, s. 58-65
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate primary care managers’ perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient's care needs and plan care interventions together. Methods Semi-structured interviews with 18 primary care managers in western Sweden were conducted using Westrin's theoretical cooperation model. Data were analysed using a qualitative deductive method. Main findings Results reveal that the managers’ approach to care planning was dominated by non-cooperation and separation. The managers were permeated by uncertainty about the meaning of the task of care planning as such. They did not seem to be familiar with the national legislation stipulating that every healthcare provider must meet patients’ need for care interventions and participate in the care planning. Implications for practice To accomplish care planning, the process needs to cross – and overcome – both professional and organisational boundaries. There is also a need for incentives to develop working methods that promote local cooperation in order to facilitate optimal care for patients with complex needs.
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| 35. |
- Lydell, Marie C, 1961, et al.
(författare)
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Predictive factors for work capacity in patients with musculoskeletal disorders.
- 2005
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - Oslo, Norway : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 37:5, s. 281-5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify predictive factors for work capacity in patients with musculoskeletal disorders. DESIGN: A descriptive, evaluative, quantitative study. SUBJECTS/PATIENTS: The study was based on 385 patients who participated in a rehabilitation programme. METHODS: Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. RESULTS: Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. CONCLUSION: Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.
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| 36. |
- Lydell, Marie C, 1961, et al.
(författare)
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Predictive factors of sustained return to work for persons with musculoskeletal disorders who participated in rehabilitation.
- 2009
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Ingår i: Work (Reading, Mass.). - Amsterdam : IOS Press. - 1051-9815 .- 1875-9270. ; 33:3, s. 317-328
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal disorders (MSD) account for the majority of total morbidity cases in the working-age Swedish population. These disorders are thought to be the reason given for one-third of total certified sick leave requests. In addition to the high cost to society, MSD involve both physical and emotional suffering, pain and financial and social problems for the injured persons. The aim of this study was to identify predictive multidimensional factors for sustainable return to work (RTW) in a long-term follow-up persons with MSD. During the period 1992-1999, 385 persons participated in a rehabilitation program. Ten years later, 354 of these took part in a prospective follow-up study. The average post-rehabilitation time was ten years (range=7-13 years) and 243 persons (69%) completed a questionnaire. The "working full-time" group (n=110) and the "sick-listed" group (n=73) were included in the study. The two groups were compared in terms of predictors for RTW. Multiple stepwise logistic regression and bivariate analysis, as well as parametric and non-parametric tests, were used to identify predictive factors. The number of sick-listed days before rehabilitation, age, self-rated pain, life events, gender, physical capacity, self-rated functional capacity, educational level and light physical labor were predictors of long-term RTW. Return to work an be facilitated by planning at an early stage of the certified sick leave period using instrument that take these predictors into account.
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| 37. |
- Lydell, Marie C, 1961, et al.
(författare)
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Return or no return - psychosocial factors related to sick leave in persons with musculoskeletal disorders: a prospective cohort study.
- 2011
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Ingår i: Disability and rehabilitation. - Abingdon : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 33:8, s. 661-666
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The aim of this study was to compare psychosocial factors between healthy persons and sick-listed persons with musculoskeletal disorders (MSD); both groups with MSD 10 years ago. Methods. This cohort study was prospective and 385 persons participated in a rehabilitation program 10 years ago, and 354 persons took part in the follow-up. Of these, 243 persons completed a questionnaire. Two groups were included in the study: a healthy group (not sick-listed) (n = 112) and a sick-listed group (n = 74). Psychosocial factors related to sick leave were compared between the groups. Results. In the 10-year follow-up, the healthy group showed a significantly higher quality of life, more control over the working situation, better sense of coherence and unexpectedly more life events. There was no significant difference in social integration and emotional support between the groups. Conclusions. Using the knowledge about the characteristics of the healthy group, adequate rehabilitation for every sick-listed person with a musculoskeletal disorder can be given and therefore facilitate the returning to work process. A multidimensional approach taking into account a person's physical condition and workplace related problems, as well as psychosocial factors, is of great importance for the person and for society.
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| 38. |
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| 39. |
- Lydell, Marie, 1961-, et al.
(författare)
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Thoughts and feelings of future working life as a predictor of return to work : a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders
- 2011
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Ingår i: Disability and Rehabilitation. - London : Taylor & Francis Group. - 0963-8288 .- 1464-5165. ; 33:13-14, s. 1262-1271
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The main aim of this study was to describe the thoughts and feelings of future working life related to return to work (RTW) in sick-listed persons due to musculoskeletal disorders (MSD). Further aim was to compare these descriptions with the person’s actual working situation 1, 5 and 10 years after a rehabilitation period.Methods. This study consisted of two parts. The first part had an explorative design, and qualitative content analysis was chosen in order to analyse the response to an open question regarding future working life answered before, persons sick-listed due to MSD (n = 320), took part in a rehabilitation programme 10 years ago. The second part had a prospective design and quantitative analysis was used to compare the results of the qualitative analysis with RTW and the working situation 1, 5 and 10 years after baseline.Results. Three categories emerged from the data with a total of nine subcategories. In the categories Motivation and optimism and Limitations to overcome, there were significantly more persons who had RTW 1 year after baseline when compared with the category Hindrance and hesitation. There were also some significant differences between the subcategories.Conclusions. The question, regarding thoughts and feelings of future working life, may be a simple screening method to predict RTW in persons sick-listed with MSD. This will guide the rehabilitation team to adjust the rehabilitation to each person’s needs and facilitating RTW.
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| 40. |
- Marklund, Bertil, et al.
(författare)
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A primary preventive coronary health survey among a finnish immigrant population in Sweden
- 1999
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Ingår i: Coronary Health Care. - Amsterdam : Elsevier. - 1362-3265 .- 1532-2025. ; 3:1, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- Primary prevention strategies aimed at immigrants are insufficiently documented in primary health care services and, in Sweden, this is especially true regarding coronary health care with a gender perspective. The aim of this study was to examine the coronary health condition among a Finnish immigrant population in Sweden in terms of gender differences. Immigrated Finns (256 men and women aged 25-64) belonging to one primary health care centre were invited to participate in a coronary health survey. The instruments used, comprising a well-established self-rated questionnaire as well as tests forming a coronary heart disease (CHD) risk index, were analysed using descriptive and inferential statistics. The findings show that 23% were at high risk; more men than women (P<0.015). Men indicated more problems in food (e.g. fibre intake P<0.012) and drink (e.g. alcohol use P<0.000) habits while women indicated more psychosocial problems (e.g. psychosocial strain P<0.020). Furthermore, male and female Finnish immigrants are at least at an equal risk of CHD compared to their Swedish and Finnish counterparts, due to a high smoking rate (42% and 43%). Both genders show higher body mass index and waist-hip ratio figures compared to Swedish people on average. Establishing permanent connections with immigrant organizations and finding key persons anchored both among the immigrants and in the primary health care are important tasks in order to reach compliance in coronary health care. An important research implication would be to implement a primary prevention clinical trial based partly on the general findings of risk indicators and partly on gender differences among the risk indicators with regard to language obstacles.
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| 41. |
- Marklund, Bertil, 1945, et al.
(författare)
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Computer-supported telephone nurse triage: an evaluation of medical quality and costs.
- 2007
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Ingår i: Journal of nursing management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 15:2, s. 180-7
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate a telephone nurse triage model in terms of appropriateness of referrals to the appropriate level of care, patient's compliance with given advice and costs. BACKGROUND: A key concern in each telephonic consultation is to evaluate if appropriate. METHOD: An evaluative design in primary health care with consecutive patients (N = 362) calling telephone nurse triage between November 2002 and February 2003. RESULTS: The advice was considered adequate in 325 (97.6%) cases. The patients' compliance with self-care was 81.3%, to primary health care 91.1% and to Accident and Emergency department 100%. The nurses referred self-care cases (64.7%) and Accident and Emergency cases (29.6%) from a less adequate to an appropriate level of care. The cost saving per call leading to a recommendation of self-care was euro 70.3, to primary health care euro 24.3 and to Accident and Emergency department euro 22.2. CONCLUSIONS: The telephone nurse triage model showed adequate guidance for the patients concerning level of care and released resources for the benefit of both patients and the health care system.
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| 42. |
- Marklund, Bertil, 1948-
(författare)
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Det milsvida skogsfolket : Skogssamernas samhälle i omvandling 1650-1800
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation shows that the forest Sami of Arvidsjaurbyn (the forest Sami community in Arvidsjaur) were actors on an economic, social and societal level. The parish of Arvidsjaur was founded by the Swedish state in the beginning of the 17th century. The dissertation is a source study. The primary area of investigation consists of the then existing Arvidsjaurbyn in Pite lappmark (the Sami region of Pite). With regard to economic and societal changes, comparative studies have been made of the forest Sami neighbours in the south, Uhmeåbyn (the forest Sami community in Ume lappmark), and the neighbours in the north, Jokkmokk and Sjokksjokk (forest Sami communities in Lule lappmark). Arvidsjaurbyn is unique as a research object, since the community consisted of no other Sami category but the forest Sami. They had cooperated under private management with each other and communicated with the state and the church for more than one hundred years before the first settler arrived (in 1757). Traditionally the forest Sami have been dependent on three industries, namely fishing, hunting and reindeer husbandry. In the 18th century the reindeer herding came to be dominant. The forest Sami showed that they could handle important issues in the encounter with the state and the church. Forest Sami lay assessors successfully defended the Sami community’s industries at the district court sessions. The economic differences among them were not great and the internal solidarity in the Sami community was strong. Arvidsjaurbyn was a Sami community with a considerable population increase 1750–1800. From the 1740s the Swedish state’s policy vis-à- vis the forest Sami became increasingly clear; they ought to pass on to the agricultural industry. The forest Sami were, however, not convinced to adhere to this state policy. Around 1800 the administration of lappskatteland (the taxation area of each forest Sami) came to be moved from the local district court to the county administrative boards, which was a considerable adversity for the forest Sami’s development potentialities. This dissertation is one of the few that problematizes the forest Sami in Sweden. It reveals a sustainable, cooperative, resilient and innovative society.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
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| 47. |
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| 48. |
- Marklund, Bertil, et al.
(författare)
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Promoting medical self-care : evaluation of a family intervention implemented in the primary health care by pharmacies
- 1999
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Ingår i: Family Practice. - : Oxford University Press. - 0263-2136 .- 1460-2229. ; 16:5, s. 522-527
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medical self-care is the range of behaviours undertaken by people to promote or restore health when dealing with a medical problem.Objectives: The aim of the study was to evaluate medical self-care effects of a family intervention implemented in primary health care by pharmacies, in terms of non-professional and professional involvement.Methods: The intervention was implemented in one of two primary health care areas during a 4-month period and involved consecutive families acting as an intervention (IG, n = 94) or a control (CG, n = 93) group. Eight telephone interviews were conducted with each family. The families were asked about complaints of illness, how long they prevailed and how they were treated.Results: The results showed (P < 0.05–0.0001) that the IG had more medical problems (931 versus 621) compared with the CG, were less hospitalized (4 versus 10), stayed at home more to take care of sick children (84 versus 40), read more medical brochures (121 versus 31), tried more non-medical treatments (228 versus 116), and had fewer visits to the department of paediatrics but more visits to primary health care (69 and 98 versus 90 and 68).Conclusions: Due to the non-randomization procedure, some caution with regard to generalization of the results must be taken, but they are in concordance with established knowledge of the usefulness of medical self-care. The results indicate that a brief intervention for families can change the use of health authorities. It therefore seems meaningful to implement the intervention in a more comprehensive way in the primary health care setting, while at the same time trying to implement it as a large-scale randomized experimental study, comprising aspects such as the individual's need for care, the use of the right organization level and the assessment of economic costs and savings.
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| 49. |
- Marklund, Bertil, 1945, et al.
(författare)
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Referrals of dyspeptic self-care patients from pharmacies to physicians, supported by clinical guidelines.
- 2003
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Ingår i: Pharmacy world & science : PWS. - 0928-1231. ; 25:4, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: It is important that self-medication customers with potentially serious diseases are correctly referred from pharmacies to physicians. The aim of this study was to determine the appropriateness of pharmacy practitioners in referring customers suffering from dyspepsia to a general practitioner (GP). METHOD: Practitioners in 12 pharmacies, supported by clinical guidelines and training, recorded information regarding the dyspeptic customers they referred to a physician on a data collection card. The card was sent to a GP participating in the study, who did a regular medical history of the referred customer over the phone and assessed whether the referral was appropriate or not. RESULTS: Out of 133 referred customers with dyspepsia, 132 completed the study. The GPs found that 119 (90%) needed a medical examination and/or prescription drugs and thus assessed these referrals as appropriate. In three cases (2%) the referral was doubtful and in ten cases (8%) not adequate, as the symptoms were more likely to come from an irritable bowel syndrome than dyspepsia. CONCLUSION: The results confirm the role of pharmacy practitioners as important members of the primary health care team. Provided with the appropriate referral guidelines and training, they are in a position to operate as 'filters', promoting the adequate use of other primary care services
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| 50. |
- Marklund, Bertil, 1948-
(författare)
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Skogssamernas ekonomiska rum
- 2008
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Ingår i: Människor i Norr. - Umeå : Centrum för samisk forskning, Umeå universitet. - 9789197730402 ; , s. 343-448
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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