| 21. |
- Lindhe Söderlund, Lena, 1954-, et al.
(författare)
-
Applying motivational interviewing (MI) in counselling obese and overweight children and parents in Swedish child health care
- 2010
-
Ingår i: Health Education Journal. - London, UK : Sage Publications. - 0017-8969 .- 1748-8176. ; 69:4, s. 390-400
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate how a motivational interviewing (MI) training course for child healthcare nurses in Sweden affected their work with children’s weight issues and their attitudes to MI.Design: Cross-sectional survey, descriptive design.Setting: Nurses were recruited from 33 different child healthcare centres in Östergötland, Sweden.Method: Seventy-six nurses who had participated in an MI training course (held in 2008) were approached one year later to answer a questionnaire by telephone. Most questions concerned the respondents’ routine use of MI in clinical practice and their attitudes towards MI as a method.Results: The response rate was 82 per cent. Nearly half of the nurses had changed the content and structure of their discussions regarding weight issues. Three-quarters of the nurses stated that they had sufficient time to use MI and that they had support from leadership and colleagues to use MI in their routine practice. The nurses’ attitudes to MI were positive, especially their perception that MI was consistent with their values and was better than traditional advice-giving approaches. Most MI techniques were found to be simple to use: 78 per cent found it very or quite simple to listen actively, 63 per cent believed it was very or quite simple to summarize parents’ opinions, 63 per cent found it very or quite simple to pay attention to parents’ change talk, and 60 per cent said that it was very or quite simple to ask permission before providing information.Conclusion: MI training can have a substantial effect on child healthcare nurses’ clinical work on paediatric weight issues.
|
|
| 22. |
- Lindhe Söderlund, Lena, 1954-
(författare)
-
Motivational Interviewing in Theory and Practice
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- An estimated 50% of mortality from the 10 leading causes of death is due to behaviour. Individuals can make important contributions to their own health by adopting health-related behaviours and avoiding others. Motivational interviewing (MI) has emerged as a counselling approach for behavioural change that builds on a patient empowerment perspective by supporting autonomy and self-efficacy.The overall aim of this thesis is to contribute to improved understanding of the different factors that impact on general health care professionals’ learning and practice of MI. Specific aims are; study I was to identify barriers, facilitators and modifiers to use MI with pharmacy clients in community pharmacies; study II was to identify barriers and facilitators to use MI with overweight and obese children in child welfare and school health services; study III was to evaluate the attitudes towards MI and clinical use of MI with children´s weight issues one year after child health care nurses’ participation in MI training; study IV was to systematically review studies that have evaluated the contents and outcomes of MI training for general health care professionals.Participants in study I were 15 community pharmacy pharmacists in Östergötland, Sweden. Participants in study II were five child welfare centre nurses from the county council and six municipally-employed school health service nurses, all from Östergötland, Sweden. Data for both studies were obtained through focus group interviews. Study III, participants were 76 nurses from child health care centres in Östergötland, Sweden. 1-year after MI training they answered a survey. Study IV, the material was 10 empirical studies that have evaluated different aspects of MI training.MI training for general health care providers is generally of short duration and tends to focus on specific topics such as diabetes, smoking, and alcohol. The training seems to contain more training on phase I elements, such as clients’ inner motivation, than on phase II, which involves strengthening clients’ commitment to change. MI is seen as practical and useful in work with lifestyle and health promotion issues, especially with issues that may be perceived as sensitive, such as alcohol and obesity. General health care providers have positive attitudes to MI and view MI as being compatible with their values and norms about how they want to work. Clients’ resistance reactions are difficult to handle in the first stages of learning MI, and may lead to frustration. Strategies to avoid resistance are including in the final stages of learning MI. Learning and clinical use of MI for general health care providers is influenced by interactions with their environment (colleagues, staff and organization). Unlearning of old knowledge can be a problem for general health care providers in the learning and clinical use of MI.
|
|
| 23. |
|
|
| 24. |
- McCambridge, Jim, et al.
(författare)
-
The Use of Deception in Public Health Behavioral Intervention Trials: A Case Study of Three Online Alcohol Trials
- 2013
-
Ingår i: American Journal of Bioethics. - : ROUTLEDGE JOURNALS, TAYLOR and FRANCIS LTD, 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND. - 1526-5161 .- 1536-0075. ; 13:11, s. 39-47
-
Tidskriftsartikel (refereegranskat)abstract
- Some public health behavioral intervention research studies involve deception. A methodological imperative to minimize bias can be in conflict with the ethical principle of informed consent. As a case study, we examine the specific forms of deception used in three online randomized controlled trials evaluating brief alcohol interventions. We elaborate our own decision making about the use of deception in these trials, and present our ongoing findings and uncertainties. We discuss the value of the approach of pragmatism for examining these kinds of ethical issues that can arise in research on public health interventions.
|
|
| 25. |
- Nilsen, Per, et al.
(författare)
-
Brief interventions in routine health care : a population-based study of conversations about alcohol in Sweden.
- 2011
-
Ingår i: Addiction. - : Blackwell-Wiley. - 0965-2140 .- 1360-0443. ; 106:10, s. 1748-1756
-
Tidskriftsartikel (refereegranskat)abstract
- Aims To investigate how brief alcohol interventions are delivered in routine practice in the Swedish health-care system. Design, setting and participants A cross-sectional sample of 6000 individuals representative of the adult population aged 18-64 years registered in the Swedish total population register was drawn randomly. Data were collected in 2010 by means of a mail questionnaire. The response rate was 54%. Measurements The questionnaire consisted of 27 questions, of which 15 variables were extracted for use in this study. Whether alcohol had been discussed and the duration, contents, experiences and effects of any conversations about alcohol, as reported by patients themselves, were assessed. Findings Sixty-six per cent of the respondents had visited health-care services in the past 12 months and 20% of these had had one or more conversations about alcohol during these visits (13% of the population aged 18-64 years). The duration of the conversations was generally brief, with 94% taking less than 5 minutes, and were not experienced as problematic. The duration, contents, experiences and effects of these conversations generally varied between abstainers, moderate, hazardous and excessive drinkers. Twelve per cent of those having a conversation about alcohol reported that it led to reduced alcohol consumption. Reduced alcohol consumption was more likely when conversations lasted for 1-10 minutes rather than less than 1 minute and included advice on how to reduce consumption. Conclusions Population survey data in Sweden suggest that when health-care professionals give brief advice to reduce alcohol consumption, greater effects are observed when the advice is longer and includes advice on how to achieve it.
|
|
| 26. |
- Nilsen, Per, et al.
(författare)
-
Is Questionnaire-Based Alcohol Counseling More Effective for Pregnant Women Than Standard Maternity Care?
- 2010
-
Ingår i: JOURNAL OF WOMENS HEALTH. - : Mary Ann Liebert Inc. - 1540-9996 .- 1931-843X. ; 19:1, s. 161-167
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare current standard maternity care in Sweden concerning provision of alcohol advice with a more comprehensive questionnaire-based counseling model. Methods: The study population included pregnant women in Linkoping who were registered at a maternity care center during a 2-year period and whose pregnancies resulted in liveborn infants without birth defects, representing 93% of all pregnant women. Anonymous questionnaires were mailed to the women. The first cohort (registered April 2005 1, to March 31, 2006) received standard care according to a procedure that is common practice in Sweden. The second cohort (April 1, 2006 to March 31, 2007) received alcohol advice based on a comprehensive counseling model, incorporating the use of the three-item Alcohol Use Disorders Identification Test (AUDIT-C) questionnaire and tailored counseling based on the AUDIT-C score. Results: The response rate was 61% in the first cohort (standard care) and 70% in the second cohort (questionnaire-based counseling). The cohorts were similar in sociodemographic variables and prepregnancy drinking characteristics. The proportion of women who continued drinking alcohol during the pregnancy was 6.0% in cohort 1 and 5.8% in cohort 2. Women in cohort 2 were more favorable to the advice and, to a larger extent, perceived the main message to be abstinence from drinking during pregnancy. Conclusions: The questionnaire-based counseling model was more favorably perceived than the standard care model, but the new model was not more effective in terms of its impact on the proportion of women who abstained from drinking during pregnancy.
|
|
| 27. |
- Nilsen, Per, et al.
(författare)
-
When is it appropriate to address patients alcohol consumption in health care-national survey of views of the general population in Sweden
- 2012
-
Ingår i: Addictive Behaviours. - Oxford, United Kingdom : Elsevier. - 0306-4603 .- 1873-6327. ; 37:11, s. 1211-1216
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the Swedish populations beliefs and attitudes on when it is appropriate to address patients alcohol in health care services and to identify the characteristics of those who are most supportive of this alcohol-preventive work. A cross-sectional study of 5981 nationally representative individuals (18-64 years) was done using confidential mail questionnaires. Alcohol consumption was assessed with AUDIT-C and respondents were classified into four levels of drinking status. Sociodemographic data were also collected. Thirty-four percent completely agreed that health care providers should routinely ask patients about their alcohol habits and 33% completely agreed that providers should ask but only if patients have consulted them with alcohol-related symptoms. There was limited support for a statement that alcohol conversations should be premised on the patient bringing up the issue and even less support for the notion that alcohol habits are peoples own business and not something that health care providers should address. Thirty-four percent believed that people did not answer honestly when asked about their alcohol habits in health care. There appears to be considerable support in the general population for alcohol prevention in Swedish health care services that involves questions being asked routinely about alcohol. This should be helpful in ongoing efforts to improve the implementation of alcohol screening and brief interventions in Sweden. Further studies on the views of hazardous and excessive drinkers appear particularly important.
|
|
| 28. |
|
|
| 29. |
- Reinholdz, Hanna K, et al.
(författare)
-
Different Methods of Early Identification of Risky Drinking: A Review of Clinical Signs
- 2011
-
Ingår i: ALCOHOL AND ALCOHOLISM. - : Oxford University Press. - 0735-0414 .- 1464-3502. ; 46:3, s. 283-291
-
Forskningsöversikt (refereegranskat)abstract
- Aims: To review the literature on detection of risky drinking to compare early identification based on everyday clinical encounters with systematic screening. We also reviewed specific clinical signs that have been suggested to be used as indicators of risky drinking. Methods: A literature review was performed in PubMed and CINAHL of articles up to November 2010. Results: Systematic screening and semi-systematic methods in various forms detected more risky drinkers than non-systematic identification during clinical encounter, but there was a lack of studies comparing the various means of identifying risky drinking. It may be too early to completely rule out the possibility of using non-systematic methods as an effective strategy to identify risky drinking. The earliest signs of risky drinking suggested in the literature are psychological distress and social problems. Conclusion: From a public health perspective, there is a lack of evidence that non-systematic or semi-systematic methods can substitute systematic screening in terms of numbers of risky drinkers detected. If early signs are going to be used to identify risky drinkers, or those to be screened for risky drinking, more focus should be on psychological and social signs because they appear earlier than somatic signs.
|
|
| 30. |
|
|
