| 1. |
- Landstad, Bodil J, 1965-, et al.
(författare)
-
Personal Perspectives on Vocational Rehabilitation in Singapore and Sweden
- 2010
-
Ingår i: The Asia Pacific Disability & Rehabilitation Journal. - Bangalore. ; 21:1, s. 3-25
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study is to describe and analyse personal reflections on vocational rehabilitation in Singapore and Sweden as described by employees who have been on sick leave. Further, the study investigates what similarities and differences can be discerned from the accounts provided by the participants in the different countries. Interviews were conducted with five Singaporeans and five Swedes undergoing rehabilitation due to musculoskeletal problems. The most significant result is that more differences than similarities were identified; e.g. the Singaporeans had fewer days of sickness absence, they were diagnosed more swiftly, treatment and the rehabilitation process began earlier and there were no queues for treatment. The conclusion is that the Singaporean system seems to be more effective with respect to returning people to work. However, the Swedish system creates more security for all groups of people.
|
|
| 2. |
- Olsson, Inger, 1954-, et al.
(författare)
-
Social welfare in Singapore and Sweden : Differences in organisational systems of health care, social security and rehabilitation.
- 2008
-
Ingår i: International Journal of Disability Mangement Research. - Brisbane : Australian Academic Press. - 1833-8550 .- 1834-4887. ; 2:3, s. 30-38
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study is to describe and compare the health care, social security and rehabilitation systems in Singapore and Sweden. Two fundamental differences can be identified. First, the system in Singapore are strongly oriented towards a free market system, while Sweden’s demonstrates strong public control. Second, following from how the systems are oriented, Singaporeans are expected to have a higher degree of independence and control over their health care, social security and rehabilitation. It appears that Singapore has had greater success in attaining and maintaining a system of health promotion, which influences the three systems. However, the Swedish welfare system provides greater security to those who are in need of health care, social security and rehabilitation.
|
|
| 3. |
|
|
| 4. |
- Dudas, Kerstin, 1963, et al.
(författare)
-
Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care
- 2013
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:6, s. 521-528
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Many patients with chronic heart failure (CHF) experience uncertainty regarding the treatment and characteristics of their illness. Person-centred care (PCC) emphasizes patient involvement in care. We have previously shown that PCC improved outcomes such as length of hospital stay and activities of daily living in patients with CHF. The impact of PCC on self-reported uncertainty in illness among patients hospitalized for CHF is still unknown.Aim:To evaluate whether PCC is associated with less self-reported uncertainty in illness compared with usual care in patients hospitalized for worsening CHF.Methods:Using a controlled before-and-after design, eligible CHF patients were assigned to either a usual care group or a PCC intervention group. Patient-reported uncertainty in illness was assessed at hospital discharge with the Cardiovascular Population Scale (CPS). The CPS consists of two domains: 1) Ambiguity (about illness severity); and 2) Complexity (of treatment and system of care).Results:Two hundred and forty-eight patients were included in the study; 123 in the usual care group and 125 in the PCC intervention. The PCC group had better scores than the usual care group in the CPS domains complexity (M=15.2, SD=4.7 vs. M=16.8, SD=4.7; p=0.020) and ambiguity (M=27.8, SD=6.6 vs. M=29.8, SD=6.9; p=0.041).Conclusion:Patients with CHF were less uncertain in their illness after PCC, which may help to equip and empower patients to manage their illness. Together with earlier findings of shortened hospital stay and improved activities of daily living, this indicates that PCC should be a standard approach for hospital care of patients with worsening CHF.
|
|
| 5. |
- Ekman, Inger, 1952, et al.
(författare)
-
Effects of person-centred care in patients with chronic heart failure: the PCC-HF study
- 2012
-
Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 33:9, s. 1112-1119
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Person-centred care (PCC), emphasizes a partnership in care between patients and health care professionals and is advocated by WHO as a key component of quality health care. We evaluated outcomes of PCC in hospitalized patients with chronic heart failure (CHF) with respect to length of hospital stay (LOS), activities of daily living (ADL), health-related quality of life (HRQL) and 6-month readmission rate. Methods and results: During 2008-2010, 248 consecutive patients hospitalized for symptoms of worsening CHF were enrolled in a controlled before and after designed study. A Usual care group (n=123) was recruited according to pre-defined criteria to map usual CHF care and assess outcomes at 5 designated hospital wards. Based on the mapping, a panel of in-house clinicians and researchers developed measures aimed at aligning usual care with basic PCC principles. These measures were incorporated into a study protocol to guide care procedures at the same 5 wards. PCC was then implemented at these wards and evaluated in 125 patients. LOS and 6-month readmission were extracted from patient records. ADL was evaluated at baseline and discharge and HRQL at baseline and after three months. In the analysis of all patients, LOS was reduced by one day (p=0.16) while retaining ADL (p=0.07). When PCC was fully implemented (per protocol analysis), LOS was reduced by 2.5 days (p=0.01) and ADL level better preserved (p=0.04). HRQL and time-to-first readmission did not differ. Conclusions: In this proof-of-concept study, our findings suggest that a fully implemented PCC approach shortens hospital stay and maintains functional performance in patients hospitalized for worsening CHF, without increasing risk for readmission or jeopardizing patients’ HRQL.
|
|
| 6. |
- Hansson, Elisabeth K, 1954, et al.
(författare)
-
Person-centred care for patients with chronic heart failure - a cost-utility analysis
- 2016
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Costs of care for patients with chronic heart failure have been estimated at between 1% and 2% of the total health care expenditure in Europe and North America. Two-thirds are for inpatient care. Person-centred care (PCC) asserts that patients are persons and should not be reduced to their diseases alone. Aims: The aim of this study was to estimate the cost–utility of PCC when compared with conventional care in patients hospitalized for worsening chronic heart failure. Methods and results: Data for the cost–utility analysis were collected alongside a prospective clinical intervention study with a controlled before and after design from 2008 to 2010. Patient-specific resources used and preference-based health status data were collected at an individual level. Only 63% received PCC as intended illustrating the difficulties of introducing new methods in established organizations. The group intended to have PCC yielded higher costs in comparison with the conventional care group. The incremental cost was estimated as €98. The costs for those who actually received PCC, per protocol (PP) (63%) were significantly (p=0.026) lower than for those in the conventional care group, with an incremental cost-saving of €863. For the first three months, patients in the conventional care group showed decreasing health-related quality of life, with a corresponding improvement in the PCC(PP) group. Conclusion: It must be emphasized, however, that these positive effects, both cheaper and somewhat better, were obtained only among those receiving the PCC intervention in its intended form, PCC(PP).
|
|
| 7. |
- Lehto, Arja, 1952-, et al.
(författare)
-
Jakten på en jämställd myndighet : Process- och måluppfyllelseanalys som utvärderingsmodell
- 2009. - 1:1
-
Ingår i: Lärande utvärdering genom följeforskning. - Lund : Studentlitteratur. - 9789144056173 ; , s. 223-243
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I kapitlet tas utgångspunkt i ett jämställdhetsprojekt som bedrevs inom en myndighet i Sverige. Projektet var ett förändringsarbete som pågick parallellt med en omfattande omorganisation av myndigheten. Jämställdhet skulle integreras i myndighetens organisation och verksamhet. Syftet med kapitlet är att beskriva hur köns- och organisationsforskning kan kombineras med en process- och måluppfyllelseanalysmodell i utvärdering av projekt.
|
|
| 8. |
- Lehto, Arja, 1952-, et al.
(författare)
-
The hunt for an equal authority : Process- and goal achivement analysis as evaluation model
- 2009. - 1:1
-
Ingår i: Learning through onging evaluation. - Lund : Studentlitteratur. - 9789144057491 ; , s. 231-252
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter is based on a gender equality project carried out within a police authority somwhere in Sweden. The project was a change management venture carried out in tandem with a radical re-organisation of the authority. Gender equality was to be integrated into the authority's organisation and activities. The aim is to describe how gender and organisational research have been combined with a process- and goal achivement model in the evaluation.
|
|
| 9. |
- Lindblom, Cecilia, Universitetslektor, 1979-, et al.
(författare)
-
Challenges to Interdisciplinary teaching for nutrition and health in Swedish compulsory schools
- 2020
-
Ingår i: International Journal of Home Economics. - Bonn : International Federation for Home Economics. - 1999-561X. ; 13:1, s. 15-29
-
Tidskriftsartikel (refereegranskat)abstract
- The Swedish National Agency for Education states that educational provision should involve pupil opportunities for interdisciplinary work and the experience of learning in different ways. In this context, the current study aimed to explore the actual operation of interdisciplinary teaching (IDT) in Swedish compulsory schools, i.e. from preschool (6 years) to grade 9 (16 years) regarding nutrition and health. To investigate this, two web-based nationwide questionnaires were sent out in 2014 to compulsory schools in Sweden. One questionnaire was aimed at teachers in five subjects: Home and Consumer Studies (HCS), Natural Science Subjects (NSS) (Biology, Chemistry, Physics), and Physical Education and Health (PEH). The second questionnaire was for school principals. A total of 388 teachers and 216 principals answered the respective questionnaire. The study showed that 40% of the teachers and 59% of the principals reported that their school worked in an interdisciplinary way regarding nutrition and health education. Practical scheduling problems and a lack of time for planning were seen as the main barriers by both teachers and principals, but to a much larger extent by teachers. A prerequisite for successful IDT is that teachers have a chance to meet and plan, and this study indicates that frame factors have a critical impact on what is possible regarding IDT in Swedish schools. It is crucial that principals appreciate their part in facilitating IDT. Increased interdisciplinary teaching for nutrition and health (IDT-NH) might increase school potential for the better integration of knowledge and understanding about the importance of lifestyle for health, the environment and society.
|
|
| 10. |
- Olsson, Lars-Eric, 1951, et al.
(författare)
-
A cost-effectiveness study of a patient-centred integrated care pathway
- 2009
-
Ingår i: Journal of Advanced Nursing. ; 65:8, s. 1626-35
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to compare costs and consequences for an integrated care pathway intervention group with those of a usual care group for patients admitted with hip fracture. BACKGROUND: Rehabilitation for patients with hip fracture consists of training in hospital and/or in a rehabilitation unit, and on their own at home with assistance from community care staff. It is important for hospitals to provide methods of care that can safeguard these older patients' physical function and potential for independent living. METHODS: A consecutive sample of 112 independently living participants, aged 65 years or older and admitted to hospital with a hip fracture, were included in the study. Data were collected over an 18-month period in 2003-2005. A cost-effectiveness analysis was performed to compare an integrated care pathway intervention (treatment A) with usual care (treatment B). RESULTS: There was a 40% reduction for each participant in the average total cost of treatment A of euro 9685 vs. euro 15,984 for treatment B. Moreover, clinical effectiveness was much improved. The cost-effectiveness ratio for treatment A was euro 14,840 vs. euro 31,908 for treatment B. In addition, 75% of the participants in treatment A were successfully rehabilitated vs. 55% in treatment B. CONCLUSIONS: The recovery trajectory for hip fracture surgery may be shortened if nurses pay more attention to the individual patient's resources and motivation for rehabilitation. The application of an integrated care pathway with individualized care appears to enhance both rehabilitation outcomes and cost-effectiveness
|
|
| 11. |
- Olsson, Lars-Eric, 1951, et al.
(författare)
-
Evaluation of person-centred care after hip replacement-A controlled before and after study on the effects of fear of movement and self-efficacy compared to standard care
- 2016
-
Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The goal of total hip arthroplasty (THA) is optimal pain relief and a normalized health-related quality of life. Anxious patients describe more pain and more difficulties than non-anxious patients during rehabilitation after THA. The aims of the present study were twofold: (1) to identify vulnerable patients using the general self-efficacy scale (GSES) and the Tampa scale for Kinesiophobia (TSK), and (2) to evaluate if person-centred care including the responses of the instruments made rehabilitation more effective in terms of shortening hospital length of stay. Methods: The design of the study was quasi-experimental. Patients scheduled for THA, a control group (n = 138) and an intervention group (n = 128) were consecutively recruited. The intervention was the provision of person-centred care which was designed to reduce the negative effects of low self-efficacy and high levels of pain-related fear of movement. Results: Patients with low GSES in the intervention group had shorter length of stay (LoS) by 1.6 days (95 % CI 0.16-3.15) p-value 0.03. Patients with high TSK in the intervention group had shorter LoS by 2.43 days (95 % CI 0.76-4.12) p-value 0.005. For patients who had both, the reduction of LoS was 2.15 days (95 % CI 0.24-4.04) p-value 0.028. Conclusions: The GSES and the TSK instrument were found useful as tools to provide information to support patients which reduced the LoS by 1.67 days in the whole intervention group (95 % CI 0.72-2.62) p-value 0.001. More importantly, vulnerable patients such as ASA group 3 probably gained the most from the extra support, they had a reduction with 6.78 days (95 % CI 2.94-10.62) p-value 0.001. © 2016 The Author(s).
|
|
| 12. |
- Saevarsdottir, S., et al.
(författare)
-
Multiomics analysis of rheumatoid arthritis yields sequence variants that have large effects on risk of the seropositive subset
- 2022
-
Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 81:8
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To find causal genes for rheumatoid arthritis (RA) and its seropositive (RF and/or ACPA positive) and seronegative subsets. Methods We performed a genome-wide association study (GWAS) of 31 313 RA cases (68% seropositive) and similar to 1 million controls from Northwestern Europe. We searched for causal genes outside the HLA-locus through effect on coding, mRNA expression in several tissues and/or levels of plasma proteins (SomaScan) and did network analysis (Qiagen). Results We found 25 sequence variants for RA overall, 33 for seropositive and 2 for seronegative RA, altogether 37 sequence variants at 34 non-HLA loci, of which 15 are novel. Genomic, transcriptomic and proteomic analysis of these yielded 25 causal genes in seropositive RA and additional two overall. Most encode proteins in the network of interferon-alpha/beta and IL-12/23 that signal through the JAK/STAT-pathway. Highlighting those with largest effect on seropositive RA, a rare missense variant in STAT4 (rs140675301-A) that is independent of reported non-coding STAT4-variants, increases the risk of seropositive RA 2.27-fold (p=2.1x10(-9)), more than the rs2476601-A missense variant in PTPN22 (OR=1.59, p=1.3x10(-160)). STAT4 rs140675301-A replaces hydrophilic glutamic acid with hydrophobic valine (Glu128Val) in a conserved, surface-exposed loop. A stop-mutation (rs76428106-C) in FLT3 increases seropositive RA risk (OR=1.35, p=6.6x10(-11)). Independent missense variants in TYK2 (rs34536443-C, rs12720356-C, rs35018800-A, latter two novel) associate with decreased risk of seropositive RA (ORs=0.63-0.87, p=10(-9)-10(-27)) and decreased plasma levels of interferon-alpha/beta receptor 1 that signals through TYK2/JAK1/STAT4. Conclusion Sequence variants pointing to causal genes in the JAK/STAT pathway have largest effect on seropositive RA, while associations with seronegative RA remain scarce.
|
|
| 13. |
- Öhlund, Karin, et al.
(författare)
-
Dietary shortcomings in children on a gluten-free diet
- 2010
-
Ingår i: Journal of human nutrition and dietetics (Print). - Oxford : Blackwell Scientific. - 0952-3871 .- 1365-277X. ; 23:3, s. 294-300
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Coeliac disease (CD), or permanent gluten intolerance, is one of the most common chronic food-related diseases among children in Europe and the USA. The treatment is lifelong gluten-free diet (GFD) (i.e. the exclusion of wheat, rye and barley from the diet, which are important sources particularly of iron, dietary fibre and vitamin B). The present study aimed to evaluate dietary intakes of energy and nutrients in children and adolescents on GFD and compare these with intake of comparable age groups on a normal diet as well as current recommendations. Methods: Thirty children, 4-17 years of age with confirmed CD and on GFD were agreed to participate in this study at the Department of Pediatrics, Umeå University Hospital. Weight and height were used to calculate individual energy requirement according to Nordic Nutrition Recommendations 2004 (NNR-04). Dietary intake was assessed using 5-day food records and household measures were used for quantities. Twenty-five children completed their dietary record. Results: Thirteen of the 25 children did not meet the recommended energy intake and the dietary intakes were inadequate regarding quality of macronutrients and quantity of minerals and vitamins. The mean intakes of sucrose and saturated fatty acids were above and the intakes of dietary fibre, vitamin D, magnesium and selenium below the NNR-04. High intakes of sucrose and saturated fat and a low intake of dietary fibre were also noted in a previous national survey on healthy children on a normal diet. The nutrient density of vitamin D, riboflavin, niacin, thiamine, magnesium and selenium were lower among CD children than healthy children but, for iron and calcium, it was higher in CD children. Conclusions: Children on GFD appear to follow the same trends as healthy children on a normal diet, with high intakes of saturated fat and sucrose and low intakes of dietary fibre, vitamin D and magnesium compared to recommendations.
|
|
