| 11. |
- Olsson-Tall, Maivor, et al.
(författare)
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The Impact of Repeated Assessments by Patients and Professionals: A 4-Year Follow-Up of a Population With Schizophrenia
- 2019
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Ingår i: Journal of the American Psychiatric Nurses Association. - : SAGE Publications. - 1078-3903 .- 1532-5725. ; 25:3, s. 189-199
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Tidskriftsartikel (refereegranskat)abstract
- The needs of people with schizophrenia are great, and having extensive knowledge of this patient group is crucial for providing the right support. The aim of this study was to investigate, over 4 years, the importance of repeated assessments by patients with schizophrenia and by professionals. Data were collected from evidence-based assessment scales, interviews, and visual self-assessment scales. The data processing used descriptive statistics, correlation and regression analyses. The results showed that the relationships between several of the patients’ self-rating assessments were stronger at the 4-year follow-up than at baseline. In parallel, the concordance rate between patient assessments and case manager assessments increased. The conclusions drawn are that through repeated assessments the patients’ ability to assess their own situation improved over time and that case managers became better at understanding their patients’ situation. This, in turn, provides a safer basis for assessments and further treatment interventions, which may lead to more patients achieving remission, which can lead to less risk for hospitalization and too early death.
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| 12. |
- Rovner, Graciela, 1959, et al.
(författare)
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Chronic pain and sex-differences; women accept and move, while men feel blue.
- 2017
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation.1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p ≤.01.Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level.Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.
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| 13. |
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| 14. |
- Magnusson, Carl, 1976, et al.
(författare)
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The final assessment and its association with field assessment in patients who were transported by the emergency medical service
- 2018
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Ingår i: Scandinavian Journal of Trauma Resuscitation & Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn patients who call for the emergency medical service (EMS), there is a knowledge gap with regard to the final assessment after arriving at hospital and its association with field assessment.AimIn a representative population of patients who call for the EMS, to describe a) the final assessment at hospital discharge and b) the association between the assessment in the field and the assessment at hospital discharge.MethodsThirty randomly selected patients reached by a dispatched ambulance each month between 1 Jan and 31 Dec 2016 in one urban, one rural and one mixed ambulance organisation in Sweden took part in the study. The exclusion criteria were age<18years, dead on arrival, transport between health-care facilities and secondary missions. Each patient received a unique code based on the ICD code at hospital discharge and field assessment.ResultsIn all, 1080 patients took part in the study, of which 1076 (99.6%) had a field assessment code. A total of 894 patients (83%) were brought to a hospital and an ICD code (ICD-10-SE) was available in 814 patients (91% of these cases and 76% of all cases included in the study). According to these ICD codes, the most frequent conditions were infection (15%), trauma (15%) and vascular disease (9%). The most frequent body localisation of the condition was the thorax (24%), head (16%) and abdomen (13%). In 118 patients (14% of all ICD codes), the condition according to the ICD code was judged as time critical. Among these cases, field assessment was assessed as potentially appropriate in 75% and potentially inappropriate in 12%.ConclusionAmong patients reached by ambulance in Sweden, 83% were transported to hospital and, among them, 14% had a time-critical condition. In these cases, the majority were assessed in the field as potentially appropriate, but 12% had a potentially inappropriate field assessment. The consequences of these findings need to be further explored.
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| 15. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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In Hospital We Trust : Experiences of older peoples' decision to seek hospital care
- 2015
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 36:4, s. 306-311
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.
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| 16. |
- Hovlin, Lina, et al.
(författare)
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Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model : A qualitative interview study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.
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| 17. |
- Hovlin, Lina, et al.
(författare)
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The role of the home health care physician in mobile integrated care : a qualitative phenomenograpic study
- 2022
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318 .- 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as perceptions of participating in and forming health care.Methods: A phenomenographic qualitative study design, with semi-structured interviews using an interview guide.Results: Working within Mobile Integrated Care Model was a different way of working as a physician. The physicians’ role was to support the patient by making safe medical decisions. Physicians described themselves as a piece in the team puzzle, where the professional knowledge of others was crucial to give quality health care. Being in the patients’ homes was expressed as adding a unique dimension in the provision of health care, and the physicians learned more about the patients by meeting them in their homes than at an institution. This aided the physicians in respecting patient autonomy in medical decision making, even though the physicians sometimes disregarded patient autonomy in favor of their own medical experience. There was a divided view on next of kin participation among the home health care physicians, ranging from always including to total absence of involving next of kin in decision making.Conclusions: The home health care physicians described the Mobile Integrated Care Model as the best way to work, but there was still a need for additional resources and structure when working in different organizations. The need for full-time employment, additional time or hours, more equipment, access to each other’s medical records, and additional collaboration with other health care providers were expressed, which could contribute to increased work satisfaction and facilitate further development of person-centered care in the Mobile Integrated Care Model.
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| 18. |
- Munthe, Christian, 1962
(författare)
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A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal
- 2015
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Ingår i: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 29:1, s. 36-45
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Tidskriftsartikel (refereegranskat)abstract
- A new landscape of prenatal testing (PNT) is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development supports a radical individualization of how PNT screening is organized. This reformation is, at the same time, difficult to reconcile with responsible spending of resources in a publicly funded healthcare context. Thus, while the ethical imperative of individualization holds and applies to PNT, the new landscape of PNT provides reasons to start rolling back the type of mass-screening programmes currently established in many countries. Instead, more limited offers are suggested, based on considerations of severity of conditions and optimized to simultaneously serve reproductive autonomy and public health within an acceptable frame of priorities. The new landscape of PNT furthermore underscores the ethical importance of supporting and including people with disabilities. For the very same reason, no ban on what may be analysed using PNT in the new landscape should be applied, although private offers must, of course, conform to strict requirements of respecting reproductive autonomy and what that means in terms of counselling.
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| 19. |
- Munthe, Christian, 1962
(författare)
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Patient Collaboration and Person Centeredness in Forensic Psychiatric Care: An Ethical Map
- 2017
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Ingår i: 35th International Congress on Law and Mental Health, July 9-14, 2017, Prague. Abstracts of the XXX Vth International Congress on Law and Mental Health / David N. Weisstub Editor.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is increasing interest in applying ideas from person centred care (PCC) in forensic psychiatry, including increased room for patients to collaborate in the care design. However, standard ethical assumptions in PCC about capacities of patients, as well as a traditional health care ethical context, departs significantly from the forensic psychiatric situation. Forensic psychiatric care is beset with restrictions of personal freedom and motivated partly by patients' incapacity to take responsibility brought by mental ill-health, usually within limits from criminal law, public safety and court orders. The care is supposed to change patients to become more autonomous and responsible in order for the restrictions on freedom to be justifiably relaxed or removed. Doing so may involve some room for independent decision-making by patients, using their responsibility capacities, but PCC opens up for much more far-reaching empowerment of patients, e.g., regarding the goals of care and the acceptance of applied methods. Therefore, there is a manifold increase of the ethical complexity creating tensions for PCC already in standard health care. This presentation provides a map of these ethical complexities, focusing especially on the issue of how the central notions of patient empowerment and shared decision-making should imply within forensic psychiatric care.
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| 20. |
- Bonander, Carl, et al.
(författare)
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Estimating the effects of a studded footwear subsidy program on pedestrian falls among older adults in Gothenburg, Sweden
- 2019
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 132
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Tidskriftsartikel (refereegranskat)abstract
- We study the effects of a studded footwear subsidy program in Gothenburg, Sweden, where a free pair of anti-slip devices was distributed to all residents aged over 65 years as a pedestrian falls prevention measure. Using a difference-in-differences approach with internal age-based controls, we find evidence of a short-term effect on emergency department visits due to slips on snow and ice during the first year of the intervention ( -45% [95% CI: - 54, - 9] in 2013), which equates to 21.8 injuries prevented (95% CI: 3.34, 39.4). A cost-benefit analysis based on this result suggests that the short-term benefits outweigh the total costs of the intervention (benefit-cost ratio: 6.9 [95% CI: 1.05-12.46]), indicating that this type of subsidy program may be an important tool for the prevention of pedestrian falls among older adults during icy weather conditions. However, replication at other sites is recommended before drawing any strong and general conclusions.
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