| 1. |
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| 2. |
- Fagerlind, Hanna, et al.
(författare)
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Patient-physician communication during oncology consultations
- 2008
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 17:10, s. 975-985
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to characterize the content of patient-physician communication in standard oncology care. METHODS: The sample consisted of 19 patients with gastrointestinal cancer. The consultations were audio-recorded, transcribed verbatim, and analyzed according to qualitative content analysis. RESULTS: The analysis resulted in seven main categories: Disease and treatment, Healthcare planning, Everyday living, Psychological well-being, Coping with disease, Expressions of concerns and feelings, and Other aspects of communication. The main focus during the consultations was on disease and treatment. Physicians tended to concentrate on response to treatment and types and severity of side effects and how to treat them. More patient-centered subjects of psychosocial character like coping and psychological well-being were discussed only briefly, if at all. CONCLUSIONS: This study adds to the information given by the existing communication analysis systems, and hence we suggest a development of the psychosocial content categories of those systems to make them more valid.
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| 3. |
- Kettis, Åsa, et al.
(författare)
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Genetic research and donation of tissue samples to biobanks. What do potential sample donors in the Swedish general public think?
- 2006
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 16:4, s. 433-440
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to identify perceptions of the general public regarding research involving human tissues; to assess the public's willingness to donate samples to biobanks; and to identify factors associated with the willingness to donate samples. Methods: Cross-sectional survey. Postal questionnaires to a random sample of the general public in Sweden, 18-80 years of age (n = 6000) in October 2002 (response rate 49.4%; n = 2928). Results: A majority of the respondents had a positive attitude towards genetic research. Their trust in authorities' capability to evaluate the risks and benefits of genetic research varied. Individual university/hospital-based researchers received the greatest trust, while the county councils (health care providers), and the Swedish Parliament received the lowest trust. Most respondents (86.0%) would donate a linked blood sample for research purposes. Another 3.0% would provide an anonymous sample. In total, 78% of the respondents would agree to both donation and storage. The most common motive was benefit of future patients. The majority was indifferent to the funding source for the research and would delegate this judgment to the research ethics committee. After adjusting for covariates, those more likely to donate a sample were middle-aged, had children, had personal experience of genetic disease, were blood donors, had a positive attitude toward genetic research, and had trust in experts/institutions. Conclusions: The majority of the general public is willing to donate a sample to a biobank. The willingness is mainly driven by altruism, and depends on the public being well-informed and having trust in experts and institutions.
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| 4. |
- Kettis, Åsa, et al.
(författare)
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Patients'and doctors' views of using the schedule for individual quality of life in clinical practice.
- 2007
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Ingår i: JOURNAL OF SUPPORTIVE ONCOLOGY. - 1544-6794. ; 5:6, s. 281-287
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Tidskriftsartikel (refereegranskat)abstract
- This study explored patients’ and oncologists’ perceptions ofusing a computer-administered, individualized quality-of-life (QOL) in-strument to support an oncologic consultation. Twenty patients with gas-trointestinal cancer (50% female; mean age 60 years) at two hospitals inSweden completed the Schedule for the Evaluation of Individual Quality ofLife-Direct Weight (SEIQoL–DW) and the Disease-Related (DR) SEIQoL-DWand brought the results to the consultation. Afterwards, interviews wereconducted with all patients and six of eight doctors. All interviews wereaudiotaped, transcribed, and analyzed using an interpretivist approach.Most patients and doctors believed that the instrument would facilitatedetection of patients’ areas of concern and would support monitoringof patients’ QOL. This tool may empower the patient, give the doctor abroader picture of the patient, and influence clinical decision-making. TheSEIQoL-DW may be a systematic method of stimulating patient-centeredcare. It apparently encourages patients to reflect upon their own situationand allows them to be seen as whole persons. However, further quantita-tive evaluation of the intervention’s outcomes is required.
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| 5. |
- Kettis, Åsa, et al.
(författare)
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Perceptions of potential donors in the Swedish public towards information and consent procedures in relation to use of human tissue samples in biobanks : a population-based study
- 2007
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:2, s. 148-156
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess the Swedish public's preferences for information and consent procedures when being asked for permission to use previously collected tissue samples for new research studies. Methods: Cross-sectional study employing postal questionnaires to a random sample of the Swedish general public (n = 6,000) in October 2002-February 2003. The response rate was 49% (n = 2,928). This paper includes only respondents who reportedly would approve of samples being taken and stored (n = 2,122). Results: When potential tissue sample donors in the general public have to strike a balance between the values at stake, i.e. the autonomy of the donor versus the research value, most (72%) prefer general consent, i.e. where consent is asked for at the outset only. They want the research ethics committee (REC) alone to decide on the use of stored samples, and they would allow storage as long as the sample is useful for research. The minority of respondents who were in favour of specific consent were more likely to be young, well educated, have negative experiences of healthcare and low trust in healthcare authorities. Conclusions: The majority of the Swedish general public prefer general consent, and are thus willing to delegate some decisions to the RECs. However, preferences for information and consent procedures depend on the context, e.g. the risks for the donor and the purpose of the research. If feasible, procedures should be differentiated according to the preferences of individual donors, thus protecting the interests of both the minority and the majority.
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| 6. |
- Kettis, Åsa, et al.
(författare)
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The role of dermatologists, nurses and pharmacists in chronic dermatological treatment: patient and provider views and experiences.
- 2006
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 86:3, s. 202-8
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Tidskriftsartikel (refereegranskat)abstract
- Effectively co-ordinated treatment support from healthcare providers (doctors, nurses and pharmacists) may improve patients' adherence to treatment. The objective of this study was to identify patients' and providers' perceptions of the roles of different healthcare providers in dermatological treatment. Focus groups were used in two types of fora: patients with chronic dermatological diseases (n =2x6) and healthcare providers (n =2x6), including doctors, nurses and pharmacists working in dermatological care. Data were analysed according to the Consensual Qualitative Research approach. The respondents viewed the roles of the providers as complementary, but poorly co-ordinated. Treatment support is provided mainly by the nurse. During the doctor's appointment, diagnosis and treatment decisions are often prioritized, leaving limited time for treatment support. The pharmacist's provision of support is constrained by the lack of privacy and clinical history of individual patients. The most apparent "gap" in the chain of treatment support was between the pharmacist and the other providers. There was a wish for improved interprofessional collaboration to avoid giving conflicting advice. There is a need to improve interprofessional collaboration in dermatology, in order to optimize treatment support in clinical practice.
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| 7. |
- Krigsman, Kristin, et al.
(författare)
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Adherence to multiple drug therapies : Refill adherence to concomitant use of diabetes and asthma/COPD medication
- 2007
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 16:10, s. 1120-1128
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo investigate whether patients with drugs for two chronic diseases, type 2 diabetes and asthma/chronic obstructive pulmonary diseases (COPD), showed the same refill adherence pattern in relation to their drug treatments during a 3-year period.MethodsPatients 50 years and older who had been dispensed diabetes and asthma/COPD drugs in the county of Jämtland during 2001-2003 were included. The refill adherence was calculated based either on prescribed dosage or defined daily dose (DDD). A patient profile graph for each patient was constructed including the date of each dispensation and the time period covered by the dispensed drugs. For each patient, the dispensation pattern and the treatment persistency over time were determined.ResultsIn total, 56 patients were included in the study. Satisfactory refill adherence was found for 68% of the repeat prescriptions for diabetes drugs and for 42% of the repeat prescriptions for asthma/COPD drugs. About half (52%; 29/56) of the patients showed the same dispensation patterns for both diabetes and asthma/COPD drugs, and 86% (25/29) of these patients had a satisfactory refill adherence. However, there was no correlation or agreement regarding the dispensation patterns for diabetes and asthma/COPD drugs.ConclusionsPatients showed higher refill adherence for their diabetes drugs than their asthma/COPD drugs. Our hypothesis that patients with satisfactory refill adherence to antihyperglycaemic drugs would also have satisfactory refill adherence to asthma/COPD drugs, was not supported.
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| 8. |
- Krigsman, Kristin, et al.
(författare)
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Refill adherence by the elderly for asthma/chronic obstructive pulmonary disease drugs dispensed over a 10-year period
- 2007
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Ingår i: Journal of Clinical Pharmacy and Therapeutics. - : Hindawi Limited. - 0269-4727 .- 1365-2710. ; 32:6, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective was to survey prescription refill adherence for preventive asthma/chronic obstructive pulmonary disease (COPD) medication dispensed to patients 60 years and older over a 10-year period. Methods: A retrospective analysis was conducted based on a Swedish pharmacy record database in the county of Jämtland for the years 1994-2003. Satisfactory refill adherence was set as dispensed refills covering 80-120% of the prescribed treatment time for inhaled corticosteroids, combination products of adrenergics and steroids and anticholinergics. Results and discussion: Only 28% (n=160) of the repeat prescriptions for inhaled corticosteroids had been dispensed with a satisfactory refill adherence, 59% showed an undersupply and 12% showed an oversupply. There was no difference in refill adherence in relation to age and gender. However, during the 10-year study period repeat prescriptions being dispensed for 2-4 years showed higher satisfactory refill adherence than those being dispensed for <2 years. Conclusions: Our study shows that over half of the repeat prescriptions for inhaled corticosteroids dispensed to patients over 60 years showed an undersupply. Therefore, it is likely that elderly patients on long-term therapy have a non-optimal drug use of their preventive asthma/COPD medication
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| 9. |
- Krigsman, Kristin, et al.
(författare)
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Refill adherence for patients with asthma and COPD: comparison of a pharmacy record database with manually collected repeat prescriptions
- 2007
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 16:4, s. 441-448
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo compare refill adherence data based on two different methods of data capturing, that is, manually collected repeat prescriptions and a pharmacy record database.MethodsThe study comprised a comparison of adherence data from manually collected repeat prescriptions of asthma and chronic obstructive pulmonary disease (COPD) drugs with fixed dosages dispensed in 2002 and the corresponding data from a pharmacy record database. Data were collected in the county of Jämtland in Sweden. Refill adherence was calculated for the different collection methods.ResultsData from 285 manually collected repeat prescriptions for asthma/COPD drugs for 2002 showed that 35% of the prescribings had been satisfactory refilled, while 42% showed an undersupply and 23% an oversupply. The pharmacy record database had 490 prescribings for asthma/COPD drugs registered in 2002, 28% of these had a satisfactory refill adherence, while 43% showed an undersupply, and 29% an oversupply. Based on the database it could be shown that 11% of the individuals had used more than one repeat prescription of the same medicine during 2002. Based on the pharmacy record database for 1999-2002, it was shown that 29% of the prescribings had been satisfactory refilled whereas undersupply increased (53%) and oversupply decreased (18%) as compared to the 1-year data.ConclusionsRefill adherence determined from manually collected repeat prescriptions and from a pharmacy record database did not differ for a 1-year period. Four-year data might give a better overview of patients' refill adherence than 1-year data.
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| 10. |
- Krigsman, Kristin, 1979-
(författare)
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Refill Adherence to Long-Term Drug Treatment with a Focus on Asthma/COPD Medication
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible. The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD. The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply. Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy.Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types. The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.
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| 11. |
- Moen, Janne, et al.
(författare)
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Factors associated with multiple medication use in different age groups
- 2009
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Ingår i: The Annals of Pharmacotherapy. - 1060-0280 .- 1542-6270. ; 43:12, s. 1978-1985
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Multiple medicine use among elderly persons is likely to be the result of treatment regimens developed over a long period of time. By learning more about how multiple medication use develops, the quality of prescribing may be improved across the adult lifespan. OBJECTIVE: To describe patterns of multiple medicine use in the general Swedish population and its association with sociodemographic, lifestyle, and health status factors. METHODS: Data from a cross-sectional population health survey collected during 2001-2005 from 2816 randomly selected Swedish residents (age 30-75 y; response rate 76%) were analyzed. Multiple medicine use was restricted to prescription drugs and defined as the 75th percentile; that is, the 25% of the study group using the highest number of drugs per individual. RESULTS: Seventy-one percent of the respondents used some kind of drug, 51.5% used one or more prescription drug, 38.4% used one or more over-the-counter (OTC) medication, and 8.3% used one or more herbal preparation. The cutoff amounts defining multiple medicine use were: 2 or more medications for 30- to 49-year-olds, 3 or more for 50- to 64-year-olds, and 5 or more for 65- to 75-year-olds. No association between use of multiple medicines and use of OTC drugs or herbal preparations was found. When drugs were classified into therapeutic subgroups, 76.3% of those aged 30-49 years, 97.9% of those aged 50-64 years, and 100% of those aged 65-75 years were taking a unique combination of drugs. Multivariate analyses showed that diabetes and poor self-rated health were associated with multiple medicine use in all age cohorts. Female sex and hypertension were associated with multiple medicine use among those aged 30-49 and 50-64 years, current smoking among those aged 50-64 years, and obesity among those aged 65-75 years. CONCLUSIONS: Multiple medicine use was associated with morbidity and poor self-rated health across all age groups. The vast majority of users of multiple drugs are taking a unique combination of medications.
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| 12. |
- Moen, Janne, 1980-, et al.
(författare)
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"I don't know how many of these [medicines] are necessary.." - a focus group study among elderly users of multiple medicines
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 74:2, s. 135-141
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The growing prevalence of multiple medicine use among elderly challenges health care. The aim was to conduct an exploratory study describing multiple medicine use from the elderly patient's perspective. METHODS: Twelve focus groups of 29 men and 30 women 65 years of age or older, using five or more medicines were analysed qualitatively. RESULTS: Initially the participants reported no problems with using multiple medicines; they felt fortunate that medicines existed and kept them alive. However, negative attitudes were also revealed, both similar to those presented in studies on lay experience of medicine-taking and some that appear more specific to users of multiple medicines. The foremost of these was that acceptance of medicines depends on not experiencing adverse effects and worrying whether multiple medicine use is 'good' for the body. Furthermore, participants' perception of their medicines depended on interaction with doctors, i.e. trusting 'good' doctors. CONCLUSION: The participants revealed co-existing accounts of both immediate gratitude and problems with using multiple medicines. Furthermore, the patient-doctor relationship coloured their attitudes towards their medicines. PRACTICE IMPLICATIONS: Importance of the patient-doctor relationship for treatment success is highlighted. Moreover, to be able to capture both accounts of the elderly in this study an appropriate consultation length is needed.
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| 13. |
- Moen, Janne, 1980-
(författare)
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Multiple Medicine Use : Patients’ and general practitioners’ perceptions and patterns of use in relation to age and other patient characteristics
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There are widespread concerns about the increasing use of multiple medicines. The aims of this thesis were to identify older patients' and general practitioners' (GPs) attitudes to and experiences of multiple medicine use, as well as to describe patterns of multiple medicine use in different age groups in association with patient-related factors. An additional aim was to contribute to scientific methodological development by providing an empirical example of the application of the Lehoux, Poland, & Daudelin template for the analysis of interaction in focus groups. Data were collected via qualitative focus group discussions and from a cross-sectional community-based population survey conducted during 2001-2005. The patients revealed co-existing accounts of both immediate gratitude that medicines exist and problems with using multiple medicines such as worrying whether multiple medicine use is 'good' for the body. The patient-doctor relationship coloured their attitudes towards their treatment and care. The GPs at times felt insecure, though surrounded by treatment guidelines. Lack of communication with hospital specialists was perceived to reduce treatment quality, while influence of patient pressure was thought to contribute to the development of multiple medicine use. An interaction analysis helped in appreciating and clarifying the contexts in which results from the content analysis were created. Further discussion is needed on how to best report these results. Different cut-offs are useful in defining multiple medicine use in different age groups. Vast majorities of users of multiple medicines were found to have unique medicine combinations. Multiple medicine use was found to be associated with morbidity and poor self-rated health across all age groups.
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| 14. |
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| 15. |
- Ring, Lena, et al.
(författare)
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Feasibility and validity of a computer administered version of SEIQoL-DW
- 2006
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 15:7, s. 1173-1177
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Tidskriftsartikel (refereegranskat)abstract
- Computer administrered QoL instruments are increasingly used to assess outcomes. Our aim was to assess the feasibility and validity of an electronic version of the SEIQoL-DW. Pharmacy students (n = 40; mean age 25; 92% women) were administrated both the touch screen and the paper-and-pen versions in a cross-over study. The majority of the students (65 %) preferred the computer version, while almost a third (27%) preferred the paper and pen version. There was no overall order effect and the SEOQoL-DW index mean scores differed with 1.2 between the two versions. Those respondents completing the computer version first had higher scores than those completing the computer version second. The ICC comparing the formats was 0.77 (CI: 0.57-0.88) and the limits of agreement method showed that 85% of the observations were within +/- 1-10 units. Most students (82%) judged their QoL as being equivalent to their SEIQoL-DW score. The computer version of the SEIQoL-DW seems to be feasible and acceptable and seems to be valid alternative to the paper and pen version. However, further validation studies in larger patient populations are needed.
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| 16. |
- Ring, Lena, et al.
(författare)
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Individual quality of life : can it be accounted for by psychological or subjective well-being?
- 2007
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Ingår i: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 82:3, s. 443-461
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Tidskriftsartikel (refereegranskat)abstract
- There is ongoing discussion in the scientific literature about the need for a more theoretical foundation to underpin quality of life (QoL) measurement. This paper applied Keyes et al.'s [J. Pers. Soc. Psychol. 82 (2002) 1007] model of well-being as a framework to assess whether respondents (n = 136 students) focus on elements of subjective well-being (SWB), such as satisfaction and happiness, or on elements of psychological well-being (PWB), such as meaning and personal growth, when making individual QoL (IQoL) judgments using the Schedue of the Evaluation of Individual Quality of Life (SEIQoL). The Keyes et al.'s model was confirmed and explained 41% of the variance in SEIQoL scores. Both SWB and PWB were correlated with the SEIQoL Index Score and SWB was found to be an important mediating variable in the relationship between PWB and SEIQoL. When analyzing different well-being combinations, respondents with high SWB/high PWB had significantly higher SEIQoL scores than did those with low SWB/low PWB. Respondents with high PWB/high SWB had higher SEIQoL scores than did those with high PWB/low SWB. Longitudinal studies in different patient groups are needed to explore the dynamic relationship between IQoL and well-being. Further investigation of the relationship between PWB and SWB with other instruments purporting to measure QoL would contribute to an enhanced understanding of the underlying nature of QoL.
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| 17. |
- Ring, Lena, et al.
(författare)
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Living with skin diseases and topical treatment: patients' and providers' perspectives and priorities.
- 2007
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Ingår i: The Journal of dermatological treatment. - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 18:4, s. 209-18
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Relationship-centred care stresses the importance of taking both patients' and health-care providers' values, expectations and preferences into account to improve health outcomes. The aim of this qualitative study was to identify patients' and providers' views and experiences of skin disease and topical treatment. METHODS: Two types of focus group were used: (i) patients with chronic dermatological diseases and (ii) doctors, nurses and pharmacists working in dermatological care. RESULTS: Three major categories emerged: (i) problems related to the disease, (ii) problems related to the treatment and (iii) strategies for improving everyday life for patients. CONCLUSION: Patients and providers made several suggestions for improving everyday life. Future research needs to focus on how to achieve preference-matched shared decision-making, or concordance, between patients and health-care providers, taking different perspectives into account and how to evaluate the effect of the final, clinical, economical and humanistic outcomes of care and treatment. More seamless care and an increasingly shared understanding between patients and providers of their values, expectations and preferences for care and treatment may contribute to better health and better daily lives for patients.
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| 18. |
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| 19. |
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| 20. |
- Serup, Jørgen, et al.
(författare)
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Manage your skin problems for the dermatology patient
- 2006
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Ingår i: The European Academy of Dermatology and Venereology. The Continuing Medical Education Committee. EADV Master Class in Dermatology Series, F1. 2006. DVD-film.
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 21. |
- Serup, Jörgen, 1946-, et al.
(författare)
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To follow or not to follow dermatological treatment : A review of the literature
- 2006
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Ingår i: Acta Dermato-Venereologica. - : Taylor & Francis. - 0001-5555 .- 1651-2057. ; 86:3, s. 193-197
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Forskningsöversikt (refereegranskat)abstract
- Creams, ointments and solutions applied to the skin surface by patients as part of a daily routine might be expected to provide a more variable dosage than do standard tablets. However, adherence to treatment in dermatology has been little studied. This article reviews recent publications in the field. These are dominated by questionnaire-based studies, which tend to over-estimate adherence. Reduced adherence to dermatological treatment is noted in 34-45% of patients. It is likely that the percentage of patients who practice truly optimal treatment in their daily life is even lower considering the variable practice of self-treatment. Self-reported psychiatric morbidity contributes to poor adherence to dermatological treatment, while a well-functioning doctor-patient interaction is a major determinant of good adherence, as is patient satisfaction. In conclusion, adherence to dermatological treatment is unsatisfactory and there is a need for intervention and change in clinical routines. The therapeutic and economic benefits may be considerable. The immediate challenge is to stimulate a change in patient behaviour and improve self-treatment at home. © 2006 Acta Dermato-Venereologica.
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| 22. |
- Ulff, E, et al.
(författare)
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Single application of a fluorescent test cream by healthy volunteers: assessment of treated and neglected body sites.
- 2007
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Ingår i: The British journal of dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 156:5, s. 974-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Management of dermatological self-treatment is demanding. Imperfect application of creams and ointments and poor adherence to topical treatment are common, resulting in unsatisfactory treatment outcome. OBJECTIVES: To assess the technique and precision of test subjects' self-application of a test cream. Treated and neglected skin sites were measured after intended widespread single application of a fluorescent test cream. METHODS: Twenty healthy volunteers (10 women, 10 men) were included. They were asked to treat their whole skin surface with the fluorescent test cream, except the head and neck and skin covered by underwear. Treated and untreated sites were subsequently measured under Wood's ultraviolet radiation. RESULTS: Thirty-one per cent of the skin surface that was a target for application did not show any fluorescence and thus was assumed to have been untreated. Typical neglected sites included the central back, the upper breast, the axilla with surrounding skin, the legs and the feet, particularly the sole. The posterior aspect of both trunk and extremities, not easily inspected, was more often neglected. In the treated sites the fluorescence was typically uneven. CONCLUSIONS: Qualified and motivated persons with no obvious physical limitations practised imperfect self-application of a test cream mimicking a therapeutic cream product. As much as 31% of the skin surface was neglected. Sites especially prone to nonapplication were identified. This might imply that dermatological patients on long-term self-treatment may practise local application very poorly, a problem of major therapeutic and economic importance. A fluorescent test cream can be used for research, and as an educational tool in the training of dermatological patients on how to apply local treatment.
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| 23. |
- Wallman, Andy, et al.
(författare)
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A categorization scheme for assessing pharmacy students' levels of reflection during internships
- 2008
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Ingår i: American Journal of Pharmaceutical Education. - 0002-9459 .- 1553-6467. ; 72:1, s. 05-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To test the reliability, feasibility, and responsiveness of a categorization scheme for assessing pharmacy students' levels of reflection during internships. METHODS: Pharmacy interns at Uppsala University were asked to write a reflective essay about patient counseling at the start and end of their internships. A modified version of Kember's categorization scheme for assessing the level of reflection was used to evaluate these essays. RESULTS: Based on their essay scores, the students' levels of reflection increased during the internship course (p < 0.001) The mean time for categorization was 3 minutes per essay. The interrater reliability of the 182 essays was kappa = 0.63. CONCLUSIONS: The evaluation of the categorization scheme showed that it has good interrater reliability, feasibility, and responsiveness. This scheme might be useful in pharmacy practice educational settings, but needs further validation.
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| 24. |
- Wallman, Andy, 1975-, et al.
(författare)
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Factors associated with reflection among students after an advanced pharmacy practice experience (APPE) in Sweden
- 2009
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Ingår i: American Journal of Pharmaceutical Education. - 0002-9459 .- 1553-6467. ; 73:6, s. 107-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify individual and social factors associated with pharmacy students' level of reflection in an advanced pharmacy practice experience (APPE). METHODS: A postal questionnaire, including a reflective assignment, was sent to all pharmacy interns (n=262) at Uppsala University, Sweden, for 4 semesters in 2005-2007. RESULTS: In a univariate analysis, 7 factors were found to be associated with students' level of reflection. After controlling for covariates, 3 social factors were found to be independently associated with reflection: having a formal preceptor (OR=5.3), being at a small pharmacy (OR=19.8), and students' perception of the importance of discussing critical thinking with the preceptor (OR=1.2). No correlation could be observed between level of reflection and critical thinking, nor learning style. CONCLUSION: Social components seem to be of higher importance than individual components in students' reflective levels after pharmacy internship experience. Trained preceptors are important to foster reflection skills.
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| 25. |
- Wettergren, L, et al.
(författare)
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The use, feasibility and psychometric properties of an individualised quality-of-life instrument : a systematic review of the SEIQoL-DW
- 2009
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 18:6, s. 737-746
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE: To review published studies regarding the use, feasibility and psychometric performance of the schedule for the evaluation of individual quality of life-direct weighting (SEIQoL-DW) in clinical research. METHODS: Systematic literature review. Studies using the SEIQoL-DW were included if they were published in English and employed a quantitative design. A pre-defined checklist was used to analyse the reported results. RESULTS: Thirty-nine relevant articles were identified. The SEIQoL-DW has been included in studies relating to a variety of populations, including those who are severely ill. The results of convergent and discriminant validity support our hypotheses in which SEIQoL-DW was expected to correlate moderately to high with measures of global QoL, life satisfaction and mental health and weakly with measures of functional status and health. CONCLUSION: The SEIQoL-DW appears to be a feasible and valid instrument. The lack of association between the Index score and health, functional status, demographic and clinical parameters may be explained by the instrument's focus on global QoL and by that of the idiographic measurement approach reflecting the capacity of a patient to value domains other than health in life, despite having health problems. Nevertheless, continued psychometric evaluation in large populations with a longitudinal design is recommended.
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