| 1. |
- 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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| 2. |
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| 3. |
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| 4. |
- Ahlén, Gerd, 1951, et al.
(författare)
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Physician patient questionnaire to assess physician patient agreement at the consultation.
- 2007
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Ingår i: Family practice. ; 24:5, s. 498-503
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to validate an instrument of physician-patient agreement in the consultation. A secondary aim was to assess this agreement. METHOD: The setting was a county in the southwest of Sweden with a cross-sectional survey of primary care patients and physicians using separate coded questionnaires. Forty-six physicians and 316 patients aged 16 or more with a new complaint lasting 1 week or more. Thirteen items were evaluated and index of proportional agreement for the dichotomized answers agree (P(pos)) and disagree (P(neg)) was calculated. RESULTS: In 10 of the 13 items, a high level of agreement between physician and patient was seen. Discussion. Index of proportional agreement was useful in finding statements in a questionnaire on agreement for both physicians and patients that could be used for educational purposes and as a check-up for the GP in daily practice.
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| 5. |
- 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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| 6. |
- Fatahi, Nabi, 1961, et al.
(författare)
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Experiences of Kurdish war-wounded refugees in communication with Swedish authorities through interpreter
- 2010
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 78:2, s. 160-5
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study experiences of war-wounded Kurdish refugees with respect to cross-cultural communication through interpreters. Method Semi-structured interviews were conducted with ten men, aged 31–42. Content analysis was used for analysis and interpretation of data. Result War-wounded Kurdish refugees experienced a number of difficulties regarding communication through interpreters, mainly related to the insufficient language link to the Swedish authorities, particularly health care personnel. In many instances, interpreters were selected based on the immigrant's citizenship rather than mother tongue, leading to a more complex, tri-lingual interpretation situation. Differences in cultural background, fear, suspicion and lack of confidence in interpreters were addressed as other problems by the participants. Conclusion Interpreter competence and patient confidence in the interpreter are essential for an adequate cross-cultural health communication. Assignment of interpreters should be based on knowledge of the patient's/client's mother tongue, rather than citizenship, and the outcome is improved by a common ethnic and cultural background of interpreter and patient/client. Our study should be considered as a pilot study, and the results should be validated in larger cohorts as well as in other ethnic and language groups.
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| 7. |
- Fatahi, Nabi, 1961, et al.
(författare)
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General practitioners' views on consultations with interpreters: a triad situation with complex issues.
- 2008
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:1, s. 40-5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study a group of general practitioners' (GPs) views on cross-cultural consultations through interpreters in primary healthcare in Sweden. DESIGN: Two group interviews and three personal interviews with experienced GPs regarding clinical consultation through interpreters were carried out. The interviews were transcribed and analysed and the text was categorized according to content analysis. SETTING: Primary healthcare. SUBJECTS: Eight GPs were interviewed. MAIN OUTCOME MEASURES: The response and opinions of the GPs. RESULTS: In the analysis it appeared that an optimal clinical encounter demands an active role by all participants involved in the consultation. The interpreter has to strive after being a stable neutral information bridge, and has a balancing role between the GP and the patient. The GP has to be open to cultural inequalities and recognize consultation through an interpreter as a part of her/his job. The patient needs to be an active and visible participant, not hiding behind the interpreter. Common obstacles and imperfections to reach the best possible triad were discussed. Additionally, practical assets in the encounter were delineated. Accurate physical placing of the persons in the room, adequate length of consultation time, and using the same interpreter from one visit to another were mentioned as factors influencing the outcome of the consultation. CONCLUSION: Barriers in cross-cultural communications could originate from all persons involved, the interpreter, the GP, and the patient, as well as from tangible factors. Ways to reduce misunderstandings in GP-patient encounters through interpreters are suggested.
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| 8. |
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| 9. |
- Fatahi, Nabi, 1961, et al.
(författare)
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Interpreters' experiences of general practitioner-patient encounters.
- 2005
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 23:3, s. 159-63
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study interpreters' experiences of problems in cross-cultural communication with special regard to the general practitioner (GP)-patient encounter. DESIGN: A focus-group interview with authorized interpreters was carried out. A phenomenographic method was used in the analysis. SETTING: Primary health care. RESULTS: The interpreters displayed a number of problems mainly related to the difficulty in balancing the triad relation (GP-patient-interpreter), the role of the interpreter in relation to other healthcare staff, the time aspects of the translation procedure, and the problems of diverse health beliefs and cultural inequalities. CONCLUSION: The interpreters notice a set of difficulties that need to be highlighted in order to improve consultations with cross-cultural GP-patient encounters.
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| 10. |
- Fatahi, Nabi, 1961, et al.
(författare)
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Nurse radiographers' experiences of communication with patients who do not speak the native language
- 2010
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Ingår i: Journal of Advanced Nursing. - 1365-2648. ; 66:4, s. 774-783
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study exploring nurse radiographers' experiences of examining patients who do not speak the native language. Background. The increased number of immigrant patients in Western countries poses a challenge to healthcare staff, as mutual understanding is needed in encounters with patients who do not speak the language of the host country. In particular, little is known about the quality of communication in the setting of radiological examinations, i.e. short encounters with demanding technical and caring components. Methods. Three focus group interviews with experienced nurse radiographers (n = 11) were carried out in 2007. The interviews were audiotaped and transcribed. A qualitative content analysis method was applied to analyse the interview texts. Findings. Four main categories emerged in the analysis: modes, needs, quality and improvements of interpreting. The need for an interpreter is strongly associated with the type of examination. For interventional procedures and contrast-enhanced examinations, a professional interpreter is required to inform the patient and to identify and handle side effects and complications. Friends, relatives, particularly children, and staff as interpreters were not considered ideal as an alternative. Shortage of time and lack of specific knowledge about radiological procedures were identified as problems with professional interpreters. Interpreter training and checklists specific for radiology department routines were suggested, as well as improved nurse radiographers' education on intercultural communication. Conclusion. The need for an interpreter, and the native tongue of the patient, should be clearly stated on the radiology request form, to allow timely scheduling of an interpreter. Intercultural communication in nurse radiographers' education should be enhanced.
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| 11. |
- Fatahi, Nabi, 1961, et al.
(författare)
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Nurse radiographers’ experiences of communication with patients who do not speak the native language
- 2009
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Ingår i: Australian Journal of Advanced Nursing. - 0813-0531 .- 1447-4328. ; 66:4, s. 774-783
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Tidskriftsartikel (refereegranskat)abstract
- Improvements are needed in order to give satisfactory healthcare to patients with limited language abilities. These include improved education of interpreters, especially about cultural diversity, medical terminology and radiology methods. Early identification of the need for an interpreter, preferably stated on the radiology request form, and sufficient on-site time for radiological examinations are needed. Employment by the healthcare system of professional interpreters in the most frequent foreign languages seems warranted. Finally, inter-cultural communication skills and issues should be emphasized in nurse radiographers’ and other healthcare professionals’ educational programmes
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| 12. |
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| 13. |
- Hagström, Bertil, 1947, et al.
(författare)
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More illness and less disease? A 20-year perspective on chronic disease and medication.
- 2006
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:6, s. 584-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The implication of medication is that a drug is given against an illness. Over the last few decades an expanding number of drugs have appeared that focus on reducing risk factors and lifestyle conditions. Aims: To investigate the apprehension in respect of chronic disease among the working population in a Swedish community in 2000 compared with 1980. METHODS: In 1980 and 2000 an analogous questionnaire assessing chronic diseases and medication was mailed to 250 randomly selected persons from a local population between 25 and 70 years of age. RESULTS: Some 80% of the persons (n = 201) replied in 1980 and 78% (n = 195) in 2000. Individuals declaring a chronic disease increased from 23% (46/201) in 1980 to 39.5% in 2000 (p = 0.0005). Corresponding figures for men were 20.6% (20/97) in 1980 and 40.8% (40/98) in 2000 (p = 0,004) and for women 25.0% (26/104) in 1980 and 38.1% (37/97) in 2000 (p = 0.064). Persons who regularly see a doctor increased from 13% to 26% (p = 0.002) and the use of drugs for chronic diseases increased from 19% to 33% (p = 0.002). In 2000 an average of 2.3 drugs per person were used among those with a chronic disease, an increase of 53% since 1980. CONCLUSION: Stated chronic diseases and use of drugs for such diseases increased greatly between1980 and 2000. Prescribing drugs for a "risk" with no apparent illness may be confused with the remedy for an illness.
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| 14. |
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| 15. |
- Hansson, Anders, 1953-, et al.
(författare)
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Balancing - an equilibrium act between different positions : an exploratory study on general practitioners' comprehension of their professional role
- 2007
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 25:2, s. 80-85
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Tidskriftsartikel (refereegranskat)abstract
- Objective. There is a call to make the duties and working conditions of the GP more transparent. The aim of this study was to explore practising GPs’ personal experiences of their professional role and what they regard to be its salient characteristics. Design. An exploratory and descriptive study was undertaken by interviewing GPs and by performing a focus-group study of experienced GPs. The interviews were transcribed and analysed, and the text was categorized according to content analysis. Setting. The practice of the interviewed GPs. Subjects. Seven GPs in individual interviews and a focus group of experienced GPs. Results. A major theme, Balancing, was identified. It was derived from a number of opposing concepts to which different features were related. “The good shepherd” versus “The medical expert”; “Curing” versus “Caring”; “Short visits” versus “Long consultations”; “The personal doctor” versus “The society's doctor”. In many consultations the GP has to contemplate how to stay in focus between these diverse roles. Conclusion.General practice requires a balance to be achieved between a number of opposing conditions. In their clinical work GPs have to adjust to and integrate alternative perspectives. Problems of recruiting new GPs might be associated with dilemmas in this balancing act.
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| 16. |
- Hansson, Anders, 1953-, et al.
(författare)
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Medical students' attitudes toward collaboration between doctors and nurses - a comparison between two Swedish universities.
- 2010
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Ingår i: Journal of interprofessional care. - : Informa UK Limited. - 1469-9567 .- 1356-1820. ; 24:3, s. 242-50
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate differences in attitudes towards collaboration between doctors and nurses among medical students in two medical schools: Gothenburg University (GU), which did not offer interprofessional education, and Linköping University (LiU), with a curriculum containing an interprofessional education programme; between male and female students; and between those with previous working experience in medical care and those without. A questionnaire, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, was distributed to 314 first year and final year students at GU and LiU: 261 (82%) answers were received. There was no significant difference in attitudes toward collaboration, between first students at GU and LiU, between final year students at the two universities; and between those who had or did not have earlier experience of working in health care. There was a significant difference between male and female students (p = 0.0017) implying a more positive attitude among female students. Females were in majority among final year students (females 80 and males 46) final year, yet, students at both universities did not show a more positive attitude towards collaboration, than did first year students. It was concluded that students who had an interprofessional thread within their medical curriculum did not show different attitudes towards collaboration. The impact of the interprofessional teaching and training programme is discussed and further, especially longitudinal, studies are advocated.
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| 17. |
- Hansson, Anders, 1953-, et al.
(författare)
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Two sides of the coin - general practitioners' experience of working in multidisciplinary teams.
- 2008
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Ingår i: Journal of interprofessional care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 22:1, s. 5-16
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Tidskriftsartikel (refereegranskat)abstract
- Multidisciplinary teamwork, defined as the collaboration between different professional groups to achieve a common purpose, is commonly regarded as a means to meet the complex tasks that medicine has to deal with today. However, many attempts to introduce the method in primary care have failed and this is supposed to be partly due to the fact that general practitioners (GPs) did not participate in the implementation of the method. The aim of this investigation was to get a deeper understanding of their attitude to teamwork by interviewing nine GPs at four Swedish health care centres, where successful teamwork had been ongoing since 1997. Themes and categories in the interviews were identified according to content analysis. Although the attitude in general was in favour of teamwork, four major themes: time-consuming versus time-saving; shared responsibility versus main responsibility; medical expert versus generalist; shared knowledge versus all knowing, could be identified, which all revealed ambivalence towards teamwork among the interviewees. It was concluded that, if teamwork is to be successfully introduced into primary care, the GPs' self-perception has to be taken into consideration as has the prestige and status associated with their traditional role and the benefits of teamwork to the profession of medicine. Apart from time, teamwork requires, professional supervision and doctors need to be trained in this method as early as in medical school.
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| 18. |
- 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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| 19. |
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| 20. |
- Håkanson, Margareta, 1950, et al.
(författare)
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The horse as the healer-a study of riding in patients with back pain.
- 2009
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Ingår i: Journal of bodywork and movement therapies. - Amsterdam : Elsevier BV. - 1532-9283 .- 1360-8592. ; 13:1, s. 43-52
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Tidskriftsartikel (refereegranskat)abstract
- A total of 24 patients, considerably disabled in daily activities by back pain, participated in an Equine Assisted Therapy (EAT) programme. The patients also had several health problems in addition to their current pain. The programme emphasised the principles of body awareness. The study is aimed at investigating not only whether symptom reduction would be achieved, but also at identifying qualities of EAT that were particularly beneficial for the patients' well being. The study was performed according to action research principles. The treatment reduced the pain and lessened other symptoms. The EAT also had an influence on the patients' self-image and a positive chain of effects was observed. The consequences were described according to four dimensions; the dimension of body awareness, competence, emotion and environment. The dimensions were interrelated having the simultaneous influence of a transition process and symptom reduction towards health.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Karlsson, Ann-Kristin, 1953, et al.
(författare)
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Well-being in patients and relatives after open-heart surgery from the perspective of health care professionals
- 2010
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Ingår i: Journal of Clinical Nursing. - Oxford : Wiley. - 1365-2702 .- 0962-1067. ; 19:5-6, s. 840-846
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to explore how health care professionals perceive the well-being of patients and relatives following open-heart surgery. BACKGROUND: Open-heart surgery is an extraordinary life event associated with hope and fear among both patients and relatives, thus they require attention from health care professionals. Patients' short stay in hospital after surgery and the workload of health care professionals increase the risk that reduced well-being will be overlooked. Health care professionals need to become familiar with the signs of reduced well-being. DESIGN: The study has an observational design and was performed using a qualitative method. METHOD: Health care professionals working with patients who have undergone open-heart surgery participated in focus group discussions. The data were analysed by means of content analysis. RESULTS: Two categories emerged: signs of vulnerability and signs of insecurity. The latent meaning of the study was interpreted as awareness of an exposed position. CONCLUSION: The health care professionals were aware of patients' and relatives' exposed position following open-heart surgery. Reduced well-being was communicated by bodily and emotional signs, which were captured using direct communication or intuition. RELEVANCE TO CLINICAL PRACTICE: Developing the ability to recognise signs of reduced well-being is important for minimising the negative influences associated with open-heart surgery for patients and relatives. Increased awareness that both anger and avoidance can mask depression is important. Patients and their relatives, particularly younger ones, should be observed to ensure early detection of a life crisis provoked by the heart disease. Furthermore, staff should invite patients and their partners to talk about sexuality. Changes aimed at increasing patients' and relatives' well-being would be facilitated by interdisciplinary teamwork, 'reflection groups' for a greater exchange of knowledge and the implementation of a patient/family perspective. The latter would lead to greater interest in the relatives' situation and position in cardiac care.
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| 25. |
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| 26. |
- Kleizen, Karijn, et al.
(författare)
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Motives and Experiences of the Competent Supervisor in General Practice - A Qualitative Study
- 2010
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Ingår i: The Open Medical Education Journal. - 1876-519X. ; :3, s. 18-22
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Tidskriftsartikel (refereegranskat)abstract
- At the Sahlgrenska Academy, University of Gothenburg, Sweden, general practitioners (GPs) teach undergraduate medical students in three stages of the curriculum. Not much is known about the GPs’ motives for teaching, neither about their experiences in this process. Qualitative interviews were carried out with GPs who were known to have a positive attitude towards and interest in teaching and student supervision and assessed by the teaching-staff as skilled. The interviews were tape-recorded and transcribed. In the transcripts themes, categories and meaning units were identified according to a content analysis method. Two main themes were related to GPs’ interest in teaching activities; personal issues and organizational issues. The personal issues constituted the reasons the GPs have for their positive inclination towards teaching, and consisted of early private experiences, an interest in the future, an interest in the students’ development of clinical skills, and pleasure taken in teaching and personal growth. The organizational issues were the facilitating and impairing factors in the teaching process: the workload, health centre conditions and university conditions. The positive GPs who were interviewed experienced many benefits from their teaching. However, conditions could be improved regarding time and workload. Support from the health centre is an important factor in this field. The implementation of the findings to other health care systems is discussed.
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| 27. |
- Komitova, Mila, 1974, et al.
(författare)
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Enriched environment after focal cortical ischemia enhances the generation of astroglia and NG2 positive polydendrocytes in adult rat neocortex
- 2006
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Ingår i: EXPERIMENTAL NEUROLOGY. - : Elsevier BV. - 0014-4886. ; 199:1, s. 113-121
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Tidskriftsartikel (refereegranskat)abstract
- Environmental enrichment (EE) alleviates sensorimotor deficits after brain infarcts but the cellular correlates are not well-known. This study aimed to test the effects of postischemic EE on neocortical cell genesis. A neocortical infarct was caused by distal ligation of the middle cerebral artery in adult spontaneously hypertensive rats, subsequently housed in standard environment or EE. Bromodeoxyuridine (BrdU) was administered during the first postischemic week to label proliferating cells and BrdU incorporation was quantified 4 weeks later in the periinfarct, ipsilateral medial and contralateral cortex. Immunohistochemistry and confocal microscopy were used to analyze co-localization of BrdU with neuronal (calbindin D28k, calretinin, parvalbumin, glutamic acid decarboxylase, tyrosine hydroxylase), astrocytic (glial fibrillary acidic protein, glutamine synthetase, vimentin, nestin), microglia/macrophage (CD11b/Ox-42, CD68/ED-1), oligodendrocyte progenitor/polydendrocyte (NG2, platelet-derived growth factor alpha receptor) or mature oligodendrocyte (myelin basic protein) markers. BrdU positive cells were increased in all analyzed cortical regions in stroke EE rats compared with stroke standard environment rats. Newly born cells in the periinfarct cortex were mostly reactive astroglia. Occasionally, BrdU positive cells in the periinfarct cortex that were negative for glial or microglia/macrophage markers co-expressed markers typical for interneurons but did not express appropriate functional markers. The majority of BrdU positive cells in intact cortical regions, ipsi- and contralaterally, were identified as NG2 positive polydendrocytes. Perineuronally situated newly born cells and polydendrocytes were found to be brain-derived neurotrophic factor immunoreactive. In conclusion, EE enhanced newborn glial scar astroglia and NG2+ polydendrocytes in the postischemic neocortex which might be beneficial for brain repair and poststroke plasticity.
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| 28. |
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| 29. |
- Landström, Björn, 1954, et al.
(författare)
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A qualitative study of final-year medical students' perspectives of general practitioners' competencies
- 2011
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Ingår i: International Journal of Medical Education. - : International Journal of Medical Education. - 2042-6372. ; 2, s. 102-109
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objectives To investigate final-year medical students' perspectives of general practitioners' competencies. A further aim of the study was to investigate which type of clinical problems is properly managed by GPs according to students. Methods We conducted a qualitative study of 49 final year medical students from two programmes. Reflective writing statements were used to collect data. Qualitative content analysis was employed to analyse data. Results Three themes were identified to explain the conditions of a general practitioner (GP). They are: 'prerequisites', 'patients´ problems' and 'competence and clinical judgment' which reflect the specific features of primary care, presentation of symptoms by patient and the way that GPs approach an actual encounter. Conclusions The students valued the importance of unselected patient problems, straightforwardness in contact and care as the characteristics of a competent GP. They viewed patients with different approaches and related their observations to problems of fragmentation within this large area of medical care. This is a period in the training of students in which students' views of general practice are formed.
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| 30. |
- Landström, Björn, 1954, et al.
(författare)
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Attributes of competence -- on GPs' work performance in daily practice.
- 2009
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:6, s. 598-603
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The core competencies of general practitioners (GP) are ordinarily formulated by professional bodies and international organisations, like the World Organization of Family Doctors (Wonca). Official documents are sometimes questioned as being too comprehensive and products of the drawing board. The aim was to explore clinically oriented GPs own description of the proficiency used in everyday practice. The study could be essential both for GPs and other professionals who work with consultations. METHOD: Group interviews with GPs selected by regional supervisors and with substantial clinical competence were carried out. The verbatim transcribed sessions were analyzed with a qualitative content analysis approach. RESULTS: Two main categories emerged reflecting the competence: ''Professional readiness'' and ''Working behaviour''. Professional readiness comprises the inclination of understanding and acting based on the subcategories: medical knowledge modified by experience, knowing the patient, involvement and uncertainty. Working behaviour describes in a more concrete way the doctoring approach and is formed by the subcategories: preparation, the current problem, use of time, body attention, cooperation with other professionals, and record keeping as a work aid. CONCLUSIONS: The attributes of competence of GPs empirically have two components: professional readiness and working behaviour. Together they compose a comprehensive picture of the GP's everyday clinical setting.
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| 31. |
- Landström, Björn, 1954, et al.
(författare)
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The characteristics of general practice and the attractiveness of working as a GP: medical students' views
- 2014
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Ingår i: International Journal of Medical Education. - : International Journal of Medical Education. - 2042-6372. ; 5, s. 51-55
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to investigate medical students' views on general practice based on their experiences in training, and to find out whether there were certain views associated with the intention to become a GP. METHODS: A questionnaire, based on our earlier studies about GP working behaviour, was handed out to medical students in terms 1, 3, 5, 7, 10 and 11 of undergraduate studies in Gothenburg, Sweden. The analysis comprised statistical descriptions and comparisons. RESULTS: The students regarded general practice positively. They found the work environment good, the GP's awareness of patients' living conditions necessary, and that GP work requires medical breadth. The status of the GP in the medical profession was not considered high. One-fourth of the students strongly agreed with the possibility of a future as a GP. This attitude was statistically associated with support to the statements that general practice offers a good work environment and should be a major component in undergraduate training. Students with a negative attitude to working as GPs were also negative to having a major component of general practice in undergraduate training. CONCLUSIONS: Medical students with a positive stated attitude towards becoming GPs support changes in undergraduate training to include more general practice. The risk of increasing a negative attitude should be considered when changes are discussed.
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| 32. |
- Landström, Björn, 1954, et al.
(författare)
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Working behaviour of competent general practitioners: personal styles and deliberate strategies.
- 2006
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 24:2, s. 122-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study how competent GPs perform their work within the consultation and in relation to the team and practice organization. DESIGN: Ethnographic study with thick description. A participant observation of the GP was followed by a personal interview. A substantial description was elaborated that was analysed qualitatively. SETTING: Primary care surgeries in Sweden. SUBJECTS: A number of competent GPs. RESULTS: Two main categories emerged, deliberated strategy and personal style. These categories set up the individual pattern of working behaviour for each GP. A behaviour that is a deliberate strategy for one GP for the other belongs to his or her personal style. Common denominators in the overall working behaviour were attention to the patient as a person, practising patient-centred medicine, saving the consultations from disturbances, rejecting taking over responsibilities from the patients, and safeguarding own autonomy. CONCLUSION: The transition of deliberate, favourable strategies into one's personal style is an important aspect of professional development. A well-developed personal style is necessary to obtain the spontaneous interchange between attentive listening and detachment characteristic of patient-centeredness.
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| 33. |
- Lehti, Arja, 1956-, et al.
(författare)
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Recognition of depression in people of different cultures: a qualitative study.
- 2009
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Ingår i: BMC family practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many minority group patients who attend primary health care are depressed. To identify a depressive state when GPs see patients from other cultures than their own can be difficult because of cultural and gender differences in expressions and problems of communication. The aim of this study was to explore and analyse how GPs think and deliberate when seeing and treating patients from foreign countries who display potential depressive features. METHODS: The data were collected in focus groups and through individual interviews with GPs in northern Sweden and analysed by qualitative content analysis. RESULTS: In the analysis three themes, based on various categories, emerged; "Realizing the background", "Struggling for clarity" and "Optimizing management". Patients' early life events of importance were often unknown which blurred the accuracy. Reactions to trauma, cultural frictions and conflicts between the new and old gender norms made the diagnostic process difficult. The patient-doctor encounter comprised misconceptions, and social roles in the meetings were sometimes confused. GPs based their judgement mainly on clinical intuition and the established classification of depressive disorders was discussed. Tools for management and adequate action were diffuse. CONCLUSION: Dialogue about patients' illness narratives and social context are crucial. There is a need for tools for multicultural, general practice care in the depressive spectrum. It is also essential to be aware of GPs' own conceptions in order to avoid stereotypes and not to under- or overestimate the occurrence of depressive symptoms.
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| 34. |
- Lindström, Eva, et al.
(författare)
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Schizofreni - läkemedelsbehandling, patientens delaktighet och vårdens organisation : En systematisk litteraturöversikt
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Schizofreni är i de flesta fall en kronisk och invalidiserande psykisk sjukdom. Antipsykotiska läkemedel (neuroleptika) är namnet på den grupp läkemedel som är avsedd att lindra de psykotiska symtomen som uppstår vid schizofreni. Antipsykotiska läkemedel kan indelas i första generationens antipsykotika och andra generationens antipsykotika. Denna litteraturöversikt kompletterar SBU:s systematiska översikt från år 1997 med en granskning av andra generationens antipsykotika. I översikten ingår också ett kapitel om den kunskap man idag har om hur personer med schizofreni upplever sin medverkan och sin delaktighet i behandling och vård. Dessutom ingår ett kapitel där man undersökt värdet av integrerade vårdformer för personer med olika psykiatriska tillstånd där huvuddelen av dem har schizofreni.
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| 35. |
- 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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- Mattsson, Bengt, 1941, et al.
(författare)
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["...always giving comfort". General practitioners and the everyday consolation] : "...och alltid trösta". Allmänläkaren och det dagliga tröstandet
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:49
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Tidskriftsartikel (refereegranskat)abstract
- Since the time of Hippocrates" ... to always comfort" has been regarded as a part of every physician's profession. However, this daily phenomenon of medical practice has not been studied very much so far. Consolation is sometimes emphasized when care is more prominent than cure, as in palliative or intensive care or when seeing family members during these circumstances. Six general practitioners in a focus-group interview presented narratives about their experience of consolation in the consultation. They also described the last time they managed to comfort a patient. The narratives were analysed by an empirical psychological phenomenological method. Four themes emerged that gave a meaning to consolation: "presence", "be in contact", "confirmation" and "restoration". The consultations were characterized by acceptance, freedom, respect and absence of demand. However, consolation could also be associated with negative features such as instrumental and ritual behaviour and a "top-down" attitude that inhibited the healing process. Consolation as an important element of medical practice needs to be further studied.
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