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- Annersten Gershater, Magdalena, et al.
(författare)
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Changes in daily nursing needs and self‐care capability of people with diabetes after in‐hospital treatment for foot complications : A descriptive study
- 2024
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Aim: A limited number of studies discuss the changes in patients' self-care skills and needs for assisted self-care after discharge from in-patient treatment due to diabetes foot ulcer-related complications. The aim of this study was to examine the ability to perform self-care and needs for assisted nursing interventions at hospital discharge, compared to pre-admission, for people with diabetes admitted and treated for foot ulcer-related complications.Design: Retrospective patient record study.Methods: A retrospective assessment was done on the medical records of a total of 134 patients with diabetes consecutively admitted to a specialist in-patient unit due to foot ulcer complications, between 1 November 2017 and 30 August 2018. Data on daily self-care needs and home situations at admission and discharge were recorded.Results: The median age was 72 years (38-94), 103 (76.9%) were men and 101 (73.7%) had diabetes type 2. The median length of admission was 10 days (2-39). Infection was the most common cause of admission (51%), with severe ischaemia in 6%, and a combination of both in 20% of patients. Surgical treatment was performed in 22% and vascular intervention in 19% of patients. The percentage of patients discharged to their home without assistance was 48.1% compared to 57.5% before admission, discharge to home with assistance was 27.4% versus 22.4% before admission and 9.2% were discharged to short-term nursing accommodation versus 6% before admission. Three patients died during their stay in hospital. The need for help with medications increased from 14.9% of patients at admission to 26.7% at discharge and for mobility assistance from 23.1% to 35.9%. Social services at home were increased in 21.4% of patients at discharge.
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| 2. |
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| 3. |
- Annersten Gershater, Magdalena, et al.
(författare)
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Diabetes type 2 prevalence is rising among young residents in Malmö, Sweden.
- 2024
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Ingår i: Primary Care Diabetes. - : Elsevier. - 1751-9918 .- 1878-0210. ; 18:4, s. 409-413
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Type 2 diabetes is becoming more prevalent in many parts of the world. Malmö's population has increased in recent years mainly because of migration from other parts of Sweden and the world in addition to increased birth rates. We aimed to explore diabetes prevalence in Malmö in 2011-2018 as well as the achieved treatment targets for selected diabetes-related outcomes.Method: The current study is a part of the Cities Changing Diabetes Malmö project. Prevalence data were retrieved from the region's primary care and hospital diagnosis register, and data on treatment targets were collected from the National Diabetes Register. The inclusion criteria were either being a resident of Malmö or using a primary healthcare centre located in Malmö.Results: The prevalence of type 2 diabetes in 2018 doubled from 2011 in the entire Malmö population. During the same period, the prevalence of type 1 diabetes remained stable at 0.49 %. In 2011, the type 2 diabetes prevalence was 2.46 % (2.76 % for males and 2.28 % for females), and in 2018, it was 4.26 % (4.84 % for males and 3.82 % for females). The increase was 139 % for residents aged 0-29 years, 119.6 % for residents aged 30-39 years, 96.2 % for residents aged 40-49 years, 102 % for residents aged 50-59 years, 98.2 % for residents aged 60-69 years, and 115.5 % for those aged 70-79 years. Finally, the increase was 60.9 % for those aged 80-84 years and 90.7 % for residents 90 years of age and older. The National Diabetes Register reported that during 2019, 58 % of all patients with diabetes using primary care in Malmö reached HbA1c <52 mmol/mol, 20 % had albuminuria, 36 % had retinopathy, and 21 % had not had their feet inspected by a healthcare professional during the last year. The median HbA1c was 52.6 mmol/mol, and 17 % were registered as active smokers.Conclusion: Diabetes prevalence in Malmö has increased markedly in recent years, exacerbated by a rise in type 2 diabetes mainly in the younger population. Targets regarding p-glucose lowering treatments were not met by 42 %. One patient out of three had microvascular complications in the eye, one out of five had impaired kidney function, one out of five had not had their feet inspected, and one out of five was an active smoker. Active diabetes treatments need to be improved to reduce the number of younger patients developing microvascular complications. Preventive activities need to target younger populations to counteract even more residents developing type 2 diabetes.
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| 4. |
- Bragason, K., et al.
(författare)
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Secondary prevention after myocardial infarction widens health disparities between Swedish and immigrant patients
- 2015
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 36:Suppl 1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and introduction: Immigrants bear a disproportionate burden of poor cardiovascular health. Secondary prevention programs are essential for patients who have suffered from myocardial infarction (MI) as modification of risk factors favorably impacts their health. However, little is known about whether disparities in cardiovascular health are influenced by secondary prevention. Purpose: The purpose of this study was to determine if secondary prevention influences disparities in cardiovascular health between Swedish and immigrant MI patients. Methods: A cohort of 400 MI patients (58.6±8 years) was followed for two years, 292 Swedish and 108 immigrants (71% men). During the first year after MI patients participated in a secondary prevention program. The average number of six selected risk factors, before and two years post MI was evaluated and the mean change in risk burden from baseline calculated. The risk factors were current smoking, BMI >30 kg/m2, total cholesterol >4,5 or LDL >2,5 mmol/l (in accordance with reference values at the time of the study), HDL >1.0/1.2 (men/women) mmol/l, blood pressure >140/90 mmHg and HbA1c >45 mmol/mol (>52 mmol/mol for diabetic patients). Results: There were significant differences in risk factor exposure between Swedes and immigrants among men (p=0.045) and women (p=0.003) two years after MI. After adjustments for age, marital status and socio-economic status significance was lost among men. Swedish women reduced their exposure by 1.51 risk factors, while immigrant women only reduced theirs by 0.74 (p=0.007). No significant differences were observed for males, with Swedish men reducing their risk factors by 1.25 compared to 1.17 for immigrant men (p=0.593). Conclusion(s): The results indicate that while benefitting patients in general, secondary prevention did not benefit all groups equally. Immigrant women were less likely to reduce their risk than Swedish women, which could not be explained by age, marital status and socioeconomic status. No differences were found between immigrant and Swedish men.
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| 6. |
- Carlzén, Katarina, et al.
(författare)
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PROMOTING REFUGEES’ RIGHT TO HEALTH AND SOCIAL INCLUSION : A SYSTEMATIC APPROACH
- 2016
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Ingår i: Public health panorama. - : World health organization. - 2412-544X. ; 2:4, s. 442-448
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Tidskriftsartikel (refereegranskat)abstract
- The societal effects of forced migration are a burning topic of current political debate in Europe. There is an obvious absence of sustainable approaches to deal with this issue. We describe a collaborative and systemic regional effort, involving some 50 partners, towards a health-promoting and inclusive integration process designed to reach all refugees who settle in the southern region of Sweden. The main components of this process are now being disseminated to other regions in Sweden, which is contributing to national capacity-building. In addition, a national educational programme is being developed for those engaged in conveying civic and health information to asylum seekers and refugees. This work involves stakeholders in collaboration with six universities from different geographical areas of Sweden. The effort we describe in this report is expected to greatly contribute to providing better opportunities for all refugees in Sweden, and to empower them to control their own adaptation to a new life, thus reducing the risk of health deterioration often seen among them.
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| 7. |
- Dalingwater, Louise, et al.
(författare)
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Policies on marginalized migrant communities during Covid-19 : migration management prioritized over population health
- 2023
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Ingår i: Critical Policy Studies. - : Routledge. - 1946-0171 .- 1946-018X. ; 17:2, s. 316-336
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Tidskriftsartikel (refereegranskat)abstract
- Migration management policies in many states have marginalized significant numbers of individuals on the basis of their precarious residency status, negatively impacting their health. This article looks at how three European states with high levels of contagion - France, Sweden, and the United Kingdom - adapted their migration management policies to the changed circumstances during the Covid 19 pandemic in which there was new pressure for prioritizing population health over other concerns. The analysis compares globally-recognized 'best practices' for migrant health during the pandemic with policies adopted by France, Sweden, and the UK - selected as prominent migrant-hosting states and that experienced high rates of Covid-19. The article draws on supplementary evidence through interviews with civil society organizations working directly with migrants living on the margins of society - what are termed here 'marginalized migrants' (MMs). As the article concludes, the national policies often fell below international 'best practices' such that migration management was often prioritized over population health despite the crisis. The perspective developed in this paper is important for understanding where migration control policies have been prioritized over public health.
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| 8. |
- Dalingwater, Louise, et al.
(författare)
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The well-being of marginalized migrants in Europe duing the Covid-19 epidemic: evidence from France, Sweden, and the UK
- 2022
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Ingår i: The Unequal Costs of Covid-19 on Well-being in Europe. - Cham : Springer Nature. ; , s. 177-202
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Bokkapitel (refereegranskat)abstract
- International guidance set forth recommendations to protect marginalized migrant populations during Covid-19 given the significant inequalities in terms of social and economic well-being reported in the literature. However, a cross-country study of three European countries with high rates of Covid-19 infections and deaths has shown that migrant well-being has significantly decreased since the outbreak of Covid-19 in Europe from March 2020 and that policy measures to help those marginalized populations have been insufficient. The conclusions on migrant well-being during Covid-19 draw on interviews with prominent civil society organizations in all three countries that work specifically on migrant health and welfare. All interviews were semi-structured and conducted between October and November 2020. The analysis mainly focuses on objective/material measures of well-being related to access to health care, information on prevention of infection, housing and exclusion by host population.
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| 9. |
- Hansen, Michael Ulrich, et al.
(författare)
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Ambulance nurses' experiences of using prehospital guidelines for patients with acute chest pain - A qualitative study.
- 2022
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 63, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ambulance nurses have an important role in early recognition and treatment often being the first medical contact for patients with acute chest pain. However, there is sparse knowledge on the experiences of ambulance nurses with regard to use of Prehospital Guidelines for patients with Acute Chest Pain.AIM: To explore ambulance nurses' experiences of using prehospital guidelines for patients with acute coronary syndrome.METHOD: A qualitative descriptive study design. Semi-structured interviews with 22 ambulance nurses recruited through purposive sampling strategy. The material was transcribed and analysed using content analysis.RESULTS: Two main categories emerged from the results. The first category Sense of professional obligation included experiences of having an important role in caring for patients with acute chest pain. Understanding this role and the collaboration in the chain of care prompted ambulance nurses to adhere to the guidelines. However, not receiving enough feedback on the provided care made them uncertain whether to use guidelines. The second category Clinical difficulties using guidelines consisted of experiences of being surrounded by practical challenges while using guidelines. Ambulance nurses meet these challenges by relying on their clinical experience, which sometimes led to them deviating from the guidelines.CONCLUSIONS: The ambulance nurses experienced a mixture of feeling secure and insecure when using the guidelines. Foremost, when encountering patients with unspecific chest pain, they felt a lack of feedback and an insufficient collaboration within the chain of care, which made them deviate from guidelines. To increase adherence in guidelines, post-registration education to update the knowledge and skills about guidelines for acute chest pain is needed followed by formal inter-disciplinary feedback on the care provided.
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| 10. |
- Håkansson, Peter Gladoic, 1964-, et al.
(författare)
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Kvantitativa studier bland nyanlända ungdomar och ensamkommande : Tillvägagångssätt och utmaningar
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns ett flertal tillfällen då det är svårt att hitta respondenter via traditionella register eller insamlingsmetoder. Att undersöka nyanlända ungdomars hälsa är ett sådant tillfälle. Projektet MILSA 2.0 är en forskningsbaserad stöd- och utvecklingsplattform och ett av projektets mål har varit att utveckla metoder för att samla in kunskap om nyanländas hälsa. I delprojektet MILSA 2.3 undersöks barn och ungdomars hälsosituation framförallt med fokus på social kapital, riskbeteenden och framtidstro. Den metod som utvecklades i projektet byggde på att samla in enkätsvar via skolorna i Skånes kommuner. Metoden förutsatte ett nära samarbete med kontaktpersoner i kommunerna. Enkäterna var översatta av MILSA-projektet till arabiska, dari och pashto, men även en version på svenska erbjöds respondenterna. Trots vissa brister utifrån ett traditionellt obundet slumpmässigt urval (OSU), menar vi att urvalet kan svara på frågor som vi inte annars hade kunnat få svar på. Vi bör naturligtvis vara medvetna om de brister som finns i urvalet, men samtidigt kan det bidra till ny kunskap om en grupp där det finns väldigt begränsat med data. För framtida studier av liknande grupper bör mer resurser avsättas för ett närmare samarbete med kommunerna och studien måste tydligare förankras med skolor och kommuner utifrån den metod som ska användas.
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