| 1. |
- Bybrant, Mara Cerqueiro, et al.
(författare)
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The prevalence of having coeliac disease in children with type 1 diabetes was not significantly higher during the Swedish coeliac epidemic
- 2023
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 112:10, s. 2175-2181
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Tidskriftsartikel (refereegranskat)abstract
- Aim: From 1986 to 1996, there was a four-fold increase in coeliac disease among young Swedish children, known as the Swedish coeliac epidemic. Children with type 1 diabetes have an increased risk of developing coeliac disease. We studied whether the prevalence of coeliac disease differed in children with type 1 diabetes born during and after this epidemic.Methods: We compared national birth cohorts of 240 844 children born in 1992–1993 during the coeliac disease epidemic and 179 530 children born in 1997–1998 after the epidemic. Children diagnosed with both type 1 diabetes and coeliac disease were identified by merging information from five national registers.Results: There was no statistically significant difference in the prevalence of coeliac disease among children with type 1 diabetes between the two cohorts: 176/1642 (10.7%, 95% confidence interval 9.2%–12.2%) in the cohort born during the coeliac disease epidemic versus 161/1380 (11.7%, 95% confidence interval 10.0%–13.5%) in the post-epidemic cohort.Conclusion: The prevalence of having both coeliac disease and type 1 diabetes was not significantly higher in children born during, than after, the Swedish coeliac epidemic. This may support a stronger genetic disposition in children who develop both conditions.
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| 2. |
- Degerlund Maldi, Kinza, et al.
(författare)
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Cost-utility analysis of esketamine and electroconvulsive therapy in adults with treatment-resistant depression
- 2021
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Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Electroconvulsive therapy (ECT) has long been used for treating individuals with treatment-resistant depression (TRD). Esketamine has recently emerged as a new treatment for TRD due to its rapid antidepressant effects. To further inform the decision regarding choice of treatment, this paper aims to evaluate whether ECT or esketamine is the more cost-effective option.METHODS: The cost-effectiveness was derived as cost per quality-adjusted life-year (QALY) using a Markov model from a societal and life-time perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Health states included different depression and remission states and death. Data to populate the model was derived from randomised controlled trials and other research. Various sensitivity analyses were carried out to test the robustness of the model.RESULTS: The base case scenario shows that ECT is cost-effective compared to esketamine and yields more QALYs at a lower cost. The sensitivity analysis shows that ECT is cost-effective in all scenarios and ECT dominates esketamine in 12 scenarios.CONCLUSIONS: This study found that, from a cost-effectiveness point of view, ECT should be the first-hand option for individuals with TRD, when other first line treatments have failed. Considering the lack of economic evaluation of ECT and esketamine, this study is of great value to decision makers.
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| 3. |
- Hambraeus, Johan, et al.
(författare)
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Cost-effectiveness of radiofrequency neurotomy to treat zygapophysial joint pain compared with pain rehabilitation programs
- 2022
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Ingår i: Interventional Pain Medicine. - : Elsevier. - 2772-5944. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pain is a widespread condition that causes much suffering and significant cost to society. Pain rehabilitation programs (REH) have dominated the treatment of chronic pain in Sweden in recent decades. Although radiofrequency neurotomy (RFN) was cost-effective in recent studies, the long-term health and economic effects of REH have not been comprehensively evaluated.Design: Observational study with propensity score weighting to compare RFN and REH.Methods: Patients assessed and treated between 2010 and 2016 were eligible; 15,357 underwent REH and 254 underwent RFN. Patient data were combined with linked data from national registers. We used propensity score weighting to mimic a randomized controlled trial using baseline gender, age, and baseline health-related quality of life as covariates.Results: Health-related quality of life improved significantly in both groups, by 0.164 and 0.352 quality-adjusted life years (QALYs) at 1 and 2 years after REH, and by 0.186 and 0.448 QALYs after RFN. The assessment and diagnostic procedures were slightly more expensive for RFN, but the treatment costs were greater for REH. Sick leave decreased after treatment in both groups, particularly after RFN. The cost per QALY gained 1 year after REH was ∼121,633 USD, which is considered "very expensive" according to the Swedish National Board of Health and Welfare. By comparison, the cost of RFN was ∼13,715 USD, in the "moderate" range. After 2 years the cost per QALY gained was in the "moderate" range for REH and "low" for RFN.Conclusions: RFN and REH improved health-related quality of life, with significantly greater improvement with RFN. The treatments were comparable based on propensity score weighting, and RFN was cost-effective in the moderate to low range, whereas REH was considered very expensive to moderate. Expanding RFN from 2% currently to 25% of the treatments given in Sweden could save ∼21.2 million USD annually in healthcare expenditure.
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| 4. |
- Hu, Xiao-Lei, et al.
(författare)
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Digital Graphic Follow-up Tool (Rehabkompassen) for Identifying Rehabilitation Needs among People after Stroke : Randomized Clinical Feasibility Study
- 2022
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Ingår i: JMIR Human Factors. - : JMIR Publications. - 2292-9495. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke is a leading cause of disability among adults, with heavy social and economic burden worldwide. A cost-effective solution is urgently needed to facilitate the identification of individual rehabilitation needs and thereby provide tailored rehabilitations to reduce disability among people who have had a stroke. A novel digital graphic follow-up tool Rehabkompassen has recently been developed to facilitate capturing the multidimensional rehabilitation needs of people who have had a stroke.Objective: The aim of this study was to evaluate the feasibility and acceptability of conducting a definitive trial to evaluate Rehabkompassen as a digital follow-up tool among people who have had a stroke in outpatient clinical settings.Methods: This pilot study of Rehabkompassen was a parallel, open-label, 2-arm prospective, proof-of-concept randomized controlled trial (RCT) with an allocation ratio of 1:1 in a single outpatient clinic. Patients who have had a stroke within the 3 previous months, aged ≥18 years, and living in the community were included. The trial compared usual outpatient visits with Rehabkompassen (intervention group) and without Rehabkompassen (control group) at the 3-month follow-up as well as usual outpatient visit with Rehabkompassen at the 12-month follow-up. Information on the recruitment rate, delivery, and uptake of Rehabkompassen; assessment and outcome measures completion rates; the frequency of withdrawals; the loss of follow-up; and satisfaction scores were obtained. The key outcomes were evaluated in both groups.Results: In total, 28 patients (14 control, 14 Rehabkompassen) participated in this study, with 100 patients screened. The overall recruitment rate was 28% (28/100). Retention in the trial was 86% (24/28) at the 12-month follow-up. All participants used the tool as planned during their follow-ups, which provided a 100% (24/24) task completion rate of using Rehabkompassen and suggested excellent feasibility. Both patient- and physician-participants reported satisfaction with the instrument (19/24, 79% and 2/2, 100%, respectively). In all, 2 (N=2, 100%) physicians and 18 (N=24, 75%) patients were willing to use the tool in the future. Furthermore, modified Rankin Scale as the primary outcome and various stroke impacts as secondary outcomes were both successfully collected and compared in this study.Conclusions: This study demonstrated the high feasibility and adherence of the study protocol as well as the high acceptability of Rehabkompassen among patients who have had a stroke and physicians in an outpatient setting in comparison to the predefined criterion. The information collected in this feasibility study combined with the amendments of the study protocol may improve the future definitive RCT. The results of this trial support the feasibility and acceptability of conducting a large definitive RCT.
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| 5. |
- Hu, Xiao-Lei, et al.
(författare)
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Study protocol for a randomized, controlled, multicentre, pragmatic trial with Rehabkompassen®-a digital structured follow-up tool for facilitating patient-tailored rehabilitation in persons after stroke
- 2023
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Ingår i: Trials. - : BioMed Central (BMC). - 1745-6215. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStroke is a leading cause of disability among adults worldwide. A timely structured follow-up tool to identify patients' rehabilitation needs and develop patient-tailored rehabilitation regimens to decrease disability is largely lacking in current stroke care. The overall purpose of this study is to evaluate the effectiveness of a novel digital follow-up tool, Rehabkompassen (R), among persons discharged from acute care settings after a stroke.MethodsThis multicentre, parallel, open-label, two-arm pragmatic randomized controlled trial with an allocation ratio of 1:1 will be conducted in Sweden. A total of 1106 adult stroke patients will have follow-up visits in usual care settings at 3 and 12 months after stroke onset. At the 3-month follow-up, participants will have a usual outpatient visit without (control group, n = 553) or with (intervention group, n = 553) the Rehabkompassen (R) tool. All participants will receive the intervention at the 12-month follow-up visit. Feedback from the end-users (patient and health care practitioners) will be collected after the visits. The primary outcomes will be the patients' independence and social participation at the 12-month visits. Secondary outcomes will include end-users' satisfaction, barriers and facilitators for adopting the instrument, other stroke impacts, health-related quality of life and the cost-effectiveness of the instrument, calculated by incremental cost per quality-adjusted life year (QALY).DiscussionThe outcomes of this trial will inform clinical practice and health care policy on the role of the Rehabkompassen (R) digital follow-up tool in the post-acute continuum of care after stroke.Trial registrationClinicalTrials.gov NCT04915027. Registered on 4 June 2021. ISRCTN registry ISRCTN63166587. Registered on 21 August 2023.
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| 6. |
- Johansson, Katarina, et al.
(författare)
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Celiac disease and upper secondary school achievement in Sweden : A retrospective cohort study
- 2022
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Ingår i: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Both undiagnosed celiac disease and some chronic childhood diseases are associated with lower academic achievement. However, there is little knowledge of achievements in those diagnosed with celiac disease. Our aim was to investigate school achievements in upper secondary school among Swedish adolescents with celiac disease.METHODS: We performed a retrospective cohort study using register data. We analyzed choice of upper secondary school program, completion of upper secondary school including achievements of basic eligibility for college/university, and final grade in individuals with celiac disease diagnosed before 15 years of age, born 1991-97. We compared with the Swedish population of the same birth years. Analyses were adjusted for sex, year of birth, living region at 17 years of age, and parental education as well as income.RESULTS: The cohort included 734 074 individuals, whereof 3 257 (62% females) with celiac disease. There was no significant difference in choice of upper secondary school program. No significant difference was found in completion or achieving basic eligibility for college/university in adjusted analyses. The mean final grade in the celiac disease group was 13.34 (standard deviation 4.85) compared to 12.78 (standard deviation 5.01) in the reference population (p < 0.001), out of a maximum of 20. The effect of celiac disease on final grade remained in adjusted analyses (p = 0.012).CONCLUSIONS: We found that diagnosed celiac disease does not negatively affect school achievements in upper secondary school. This finding suggests the diagnosis, treatment and follow-up programs of celiac disease could reverse potential deleterious academic processes.
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| 7. |
- Kallerhult Hermansson, Stina, 1979-, et al.
(författare)
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Experiences of being a mentor for newly qualified nurses : An interview study
- 2022
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Ingår i: 8th International Nurse Education Conference, Sitges, October 19-22, 2022.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Challenges of retaining registered nurses in the profession is a global issue[1]. Support is an important factor for retaining nurses[2], and even though mentorship have been found to reduce turnover rate for nurses[3], it is still not a fully integrated routine in all health care units. To fill the knowledge gap, the aim of this study is to describe registered nurses’ experiences of being a mentor for newly qualified nurses.Methods: Members of the collaborative project Becoming a Professional Nurse performed individual interviews in health care units in Sweden and Norway. Participants were registered nurses (n=21) who had mentored at least one newly qualified nurse. Transcribed interview data were analysed using qualitative content analysis[4]. Preliminary results: To be a mentor were described as; being a role model for the mentees, creating an inclusive and open environment, and developing as a professional. To be successful mentors, they described a need of; scheduled time, support from colleagues, education about mentorship, arenas for exchange of experience, and attendant leaders. Conclusions: There is a need of a structured organization to promote mentorship. More research is needed to develop, test and evaluate evidence-based mentorship programs in the health care units. [1] World Health Organisation. (2020). State of the world's nursing 2020: investing in education, jobs and leadership. ISBN: 978-92-4-000327-9 [2] Akerjordet, K., Furunes, T., & Haver, A. (2018). Health-promoting leadership: An integrative review and future research agenda. Journal of Advanced Nursing, 74(7), 1505-1516. https://doi.org/10.1111/jan.13567 [3] Zhang, Y., Qian, Y., Wu, J., Wen, F., & Zhang, Y. (2016). The effectiveness and implementation of mentoring program for newly graduated nurses: A systematic review. Nurse Education Today, 37, 136-144. https://doi.org/10.1016/j.nedt.2015.11.027[4] Lindgren, Lundman, B., & Graneheim, U. H. (2020). Abstraction and interpretation during the qualitative content analysis process. International Journal of Nursing Studies, 108, 103632–103632. https://doi.org/10.1016/j.ijnurstu.2020.103632
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| 8. |
- Kallerhult Hermansson, Stina, 1979-, et al.
(författare)
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Exploring registered nurses’ perspectives as mentors for newly qualified nurses : a qualitative interview study
- 2024
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 14:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Existing research has focused mostly on mentees’ experiences of mentoring rather than mentors’ experiences. Therefore, this study describes registered nurses’ experiences of being a mentor for newly qualified nurses.Design: A qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis.Participants and setting: A purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%–100% as a registered nurse and to be able to communicate in Swedish or Norwegian.Results: Our study’s findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support.Conclusion: Being a mentor is a complicated role for registered nurses. The mentoring role is beneficial—ie, positive and rewarding—if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses’ perspectives and needs regarding being a mentor and the study’s findings make an important contribution to the field of nursing regarding the facilitation of mentoring.
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| 9. |
- Kallerhult Hermansson, Stina, 1979-, et al.
(författare)
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Job satisfaction, professional competence, and self-efficacy : a multicenter cross-sectional study among registered nurses in Sweden and Norway
- 2024
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare organizations worldwide face persistent challenges relating to turnover and intention to leave the nursing profession among registered nurses. Factors contributing to their retention and well-being at work include high job satisfaction, professional competence, and self-efficacy. Few multicenter studies have investigated these factors in relation to work experience in a Nordic context. Therefore, this study aimed to investigate job satisfaction, professional competence, and self-efficacy among registered nurses.Methods: This multicenter cross-sectional study survey was part of a larger overarching Swedish-Norwegian project, and was conducted among registered nurses (n = 1137) in September 2021. The participants worked in a variety of health care units, e.g., hospital units, primary health care, and home care. Data was subjected to descriptive and comparative statistical analysis; chi-square test, one-way between-groups analysis of variance (ANOVA) and Kruskal-Wallis test.Results: The findings show that job satisfaction is reported as lowest in registered nurses with medium-term work experience as compared to newly qualified and long-term work-experienced registered nurses. Professional competence and self-efficacy are reported as higher among registered nurses with long-term work experience as compared to those with medium-term work experience and newly qualified registered nurses. However, the participants reported their professional competence as highest in relation to the same factor – “Value-based nursing care” – regardless of their work experience.Conclusions and implications: This study underscores the need for continuous support and professional development for registered nurses throughout their careers. Proactive support for newly qualified nurses may improve job satisfaction as they progress to being registered nurses with medium-term work experience. Tailored interventions to address the distinct needs of both newly qualified and medium-term work-experienced registered nurses are crucial for nurturing a sustainable nursing workforce.
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| 10. |
- Kallerhult Hermansson, Stina, 1979-, et al.
(författare)
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The impact of a mentorship program with digital solutions : Mentors' experiences, self-reported self-efficacy, and clinical teaching behavior
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In 2021, a two-fold mentorship program was developed in collaboration with new and experienced registered nurses and leaders in healthcare units and municipalities in two regions in northern Sweden and northern Norway. The mentorship program aimed to support newly qualified nurses into working life as well as support mentors and was tested in intervention units from October-21 to April-22. The aim of this sub-study was to evaluate the mentors´ experiences, self-reported self-efficacy, and clinical teaching behavior.Methods: A mixed methods design was used where data was collected via focus-group interviews (n=5) directly after the intervention. A follow-up, self-reported questionnaire study was conducted at three different time points: pre-test, baseline, and post-test I, directly after the intervention, and post-test II, eight months after the intervention. Transcribed interview data will be analyzed using qualitative content analysis, and self-reported answers will be analyzed using suitable statistical methods.Results and conclusion: Preliminary results will be presented at the conference. The evaluation will highlight the potential effects and meaning of the mentorship program from the mentors´ perspective as well as what it means to be a mentor.
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