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Sökning: AMNE:(MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi) > Högskolan i Gävle

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1.
  • Beernaert, Kim, et al. (författare)
  • Distrust in the End-of-Life Care Provided to a Parent and Long-Term Negative Outcomes Among Bereaved Adolescents : A Population-Based Survey Study
  • 2017
  • Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 35:27, s. 3136-3142
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Previous research shows that the death of a parent places children at risk for a number of negative outcomes. The role of trust in health care at the end of life has been acknowledged as crucial for patients and adult family members. However, the consequences of children's distrust in the care provided to their parents remain unknown. Therefore, we investigated the negative long-term outcomes of cancer-bereaved sons' and daughters' distrust in the care that was provided to a dying parent. Methods We used a population-based nationwide survey to investigate self-reported distrust in the care provided and possible negative outcomes in 622 (73%) participants who had lost a parent as a result of cancer 6 to 9 years earlier, at ages 13 to 16 years. All participants were 18 years or older at the time of the survey. Results In those who reported no or little trust (ie, distrust) in the health care provided to their dying parents, we found statistically significantly higher risks of various negative outcomes at the time of survey: bitterness toward health care professionals for not having done everything that was possible (crude risk ratio [RR], 3.5; 95% CI, 2.3 to 5.1) and for having stopped treatment (RR, 3.4; 95% CI, 2.1 to 6.0), self-destructiveness (eg, self-injury [RR, 1.7; 95% CI, 1.2 to 2.4]), and psychological problems (eg, moderate to severe depression according to the Patient Health Questionnaire-9 [RR, 2.3; 95% CI, 1.5 to 3.5]). Conclusion In cancer-bereaved former adolescents, distrust in the health care provided to the dying parent is associated with a higher risk of negative long-term outcomes. The health care professionals involved in this care might play an important role in safeguarding the trust of adolescents.
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2.
  • Kaminsky, Elenor, et al. (författare)
  • Telephone Nursing in Sweden : a narrative literature review
  • 2017
  • Ingår i: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 19:3, s. 278-286
  • Forskningsöversikt (refereegranskat)abstract
    • elephone nursing services are expanding globally. Swedish Healthcare Direct is the largest healthcare provider in Sweden. This paper provides a comprehensive understanding of telephone nursing, as reflected by research on Swedish national telephone nursing, and discusses the findings in relation to international literature. A descriptive, mixed-studies literature review was conducted. Twenty-four articles from January 2003 to April 2015 were identified from PubMed, Scopus, and CINAHL, and included. The issues explored in this study are how telephone nursing is perceived by callers, telephone nurses, and managers, and what characterizes such calls. Callers value reassurance, support, respect and satisfaction and involvement in decisions can increase their adherence. The telephone nurses' perspective focused on problems and ethical dilemmas, communication, the decision support tool, and working tasks. The managers' perspective focused on nursing work goals and malpractice claims. Concerning call characteristics, authentic calls, incident reports, and threats to patient safety were considered. Telephone nursing seems safe, but gender can play a role in calls. Future research on caller access, equity, and efficiency, healthcare cost-effectiveness, distribution, and patient safety is needed.
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4.
  • Diarbakerli, E., et al. (författare)
  • Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010-2020
  • 2022
  • Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden. Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors. Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively). Conclusions: Swedish-affiliated MSK disorder research 2010-2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.
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5.
  • Diarbakerli, Elias, et al. (författare)
  • Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare
  • 2024
  • Ingår i: Musculoskeletal Care. - : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management.Objective: To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research.Methods: A web-based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research.Results: The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network.Conclusion: The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden.
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6.
  • Mentsen Ness, Tove, et al. (författare)
  • ‘Struggling for independence’; the meanings of being an oldest old man in rural areas. Interpretation of oldest old men’s narrations
  • 2014
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa Healthcare. - 1748-2623 .- 1748-2631. ; 9:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The amount of older people receiving home nursing care is increasing; in rural areas, they are at additional risk because of the distance between people and health care facilities. No specific studies have been found about oldest old men living alone and receiving home nursing care and the meaning of living alone in one's own home. The aim of this study was therefore to illuminate the meaning of being an oldest old man living alone in a rural area and receiving home nursing care. A sample of 12 oldest old men living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and data were analyzed using the phenomenological hermeneutical method. After a naïve reading and a structural analysis of the text, we identified three themes: feelings of insufficiency in everyday life, finding hope in life, and feeling reconciliation with life. The comprehensive understanding suggested that being an oldest old man living alone in a rural area means a struggle between a dependent existence and a desire to be independent. Living in the tension between independence and dependency is a complex emotional situation where one is trying to accept the consequences of life and loss—reconciling the wish to live with the fact that life will come to an end.
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7.
  • Olsson, Ulf (författare)
  • OM FRISKVÅRDSPEDAGOGIK I ARBETSLIVET. : EN O/RÄTTVIS BETRAKTELSE.
  • 1993
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • I fokus för detta arbete står friskvård inom arbetslivet som pedagogisk praktik med hälsoprofilsbedömning, en metod för undersökning och påverkan av människors hälsostatus och hälsovanor, som konkret exempel. En bakgrund till detta är framväxten av insatser för folkhälsa och den ökade betoning av friskvård inom arbetslivet som skett inom såväl privat som offentlig sektor. Friskvård handlar om människors levnadsvanor när det gäller kost, motion, stress, alkohol, tobak m.m.Hälsoprofilsbedömning och friskvårdspedagogik inom arbetslivet ses här ur två olika perspektiv. Ur det ena perspektivet behandlas verksamheten på dess egna villkor - som en metod att inom ramen för arbetslivet få till stånd ner hälsosamma livsstilar genom kontrakt mellan självständiga parter. Det andra perspektivet kan ses som kritiskt granskande. Här ifrågasätts premissema för hälsoprofilsbedömningen utifrån begrepp som makt och disciplinering. En inspirationskälla har därvid bland annat Michel Foucaults arbeten varit. Som empiriskt material för analysen används två avhandlingar som presenterar hälsoprofilbedömningen som metod.Ur dessa båda perspektiv erhålles två olika betraktelser om hälsoprofilsbedömning och friskvårdspedagogik inom arbetslivet - en rättvis och en orättvis. På basis av en kritisk pragmatisk ansats diskuteras möjligheten till ett samtal baserad på relationen mellan de båda betrakelserna.
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8.
  • Sjölander, Per, et al. (författare)
  • Stroke and acute myocardial infarction in the Swedish Sami population : incidence and mortality in relation to income and level of education
  • 2008
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE. - 1403-4948 .- 1651-1905. ; 36:1, s. 84-91
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Gender differences in cardiovascular diseases (CVD) among the Sami have been reported previously. The aim of the present study was to investigate the incidence of and mortality from stroke, subarachnoid haemorrhage (SAH), and acute myocardial infarction (AMI) in the Swedish Sami population between 1985 and 2002, and to analyse the potential impact of income and level of education on cardiovascular morbidity and mortality. Methods: A Sami cohort of 15,914 persons (4,465 reindeer herding and 11,449 non-herding Sami) were followed up from 1985 to 2002 with regard to incidence and mortality rates of AMI, stroke, and SAH. Incidence and mortality ratios were calculated using a demographically matched non-Sami control population (DMC) as the standard (71,550 persons). Results: There was no elevated risk of developing AMI among the Sami compared with the DMC. However, the mortality ratio of AMI was significantly higher for Sami women. Higher incidence rates of stroke and SAH for both Sami men and women was observed, but no differences in mortality rates. Apart from the reindeer-herding men who demonstrated lower levels of income and education, the income and education levels among Sami were similar to the DMC. Conclusions: High mortality rates from AMI rather than stroke explain the excess mortality for CVD previously shown among Sami women. The results suggest that the differences in incidence of stroke between herding and non-herding Sami men, and between Sami women and non-Sami women, are caused by behavioural and psychosocial risk factors rather than by traditional socioeconomic ones.
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9.
  • Göras, Camilla, 1969-, et al. (författare)
  • Tasks, multitasking and interruptions among the surgical team in an operating room : a prospective observational study
  • 2019
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:5, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR.DESIGN: Prospective observational study using the Work Observation Method By Activity Timing tool.SETTING: An OR department at a county hospital in Sweden.PARTICIPANTS: OR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9).RESULTS: The type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons' and ORNs' intraoperative time, while in RNAs' work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs' and surgeons' work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication.CONCLUSIONS: The surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system.TRIAL REGISTRATION NUMBER: 2016/264.
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10.
  • Samuelsson, Åsa, et al. (författare)
  • Psychosocial working conditions, occupational groups, and risk of disability pension due to mental diagnoses: a cohort study of 43 000 Swedish twins
  • 2012
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : NOROSH. - 0355-3140 .- 1795-990X. ; 39:4, s. 351-360
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesThe aim of this study was to investigate associations between psychosocial working conditions, occupational groups defined by sector, and disability pension (DP) with mental diagnoses while accounting for familial confounding.MethodsA prospective population-based cohort study was conducted, including all Swedish twins who, in January 1993, were living and working in Sweden and not on old-age pension or DP (N=42 715). The twins were followed from 1993–2008 regarding DP. Data on DP, exposures, and covariates were obtained from national registries. Cox proportional hazards regression models with hazard ratios (HR) and 95% confidence intervals (95% CI) were constructed for the whole cohort, and for discordant twin pairs.ResultsThe associations for the whole cohort between DP with mental diagnoses and (i) job demands (HR 1.23, 95% CI 1.06–1.43), (ii) job control (HR 0.91, 95% CI 0.83–0.99), (iii) healthcare and social work (HR 1.41, 95% CI 1.04–1.92), and (iv) service and military work (HR 2.07, 95% CI 1.37–3.14) remained after accounting for possible confounders, including familial factors, while the associations between DP and (i) social support, (ii) type of jobs, and (iii) some of the occupational groups were attenuated, becoming non-significant. In the discordant twin pair analyses, commercial work was significantly associated with lower risk of DP (HR 0.55, 95% CI 0.32–0.95).ConclusionsOne unit increase in job demands and working in the occupational groups healthcare and social work or service and military work seem to be risk factors of DP with mental diagnoses, independent from various background factors including familial ones. However, one unit increase in job control or working in commercial work seem to be protective factors of such DP, accounting for confounding factors of this study.
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