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- Glock, Hanna, et al.
(author)
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Attitudes, Barriers, and Concerns Regarding Telemedicine Among Swedish Primary Care Physicians : A Qualitative Study
- 2021
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In: International Journal of General Medicine. - 1178-7074. ; 14, s. 9237-9246
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Journal article (peer-reviewed)abstract
- PURPOSE: The primary care physician's traditional patient contacts are challenged by the rapidly accelerating digital transformation. In a quantitative survey analysis based on the theory of planned behavior, we found high behavioral intention to use telemedicine among Swedish primary care physicians, but low reported use. The aim of this study was to further examine the physicians' experiences regarding telemedicine, with a focus on possible explanations for the gap between intention and use, through analysis of the free-text comments supplied in the survey.MATERIAL AND METHODS: The material was collected through a web-based survey which was sent out to physicians at 160 primary health care centers in southern Sweden from May to August 2019. The survey covered four areas: general experiences of telemedicine, digital contacts, chronic disease monitoring with digital tools, and artificial intelligence. A total of 100 physicians submitted one or more free-text comments. These were analyzed using qualitative content analysis with an inductive approach.RESULTS: The primary care physicians expressed attitudes towards telemedicine that focused on clinical usefulness. Barriers to use were the loss of personal contact with patients and a deficient technological infrastructure. The major concerns were that these factors would result in patient harm and an increased workload. The connection between intention and use postulated by the theory of planned behavior was not applicable in this context, as external factors in the form of availability and clinical usefulness of the specific technology were major impediments to use despite a generally positive attitude.CONCLUSION: All telemedicine tools must be evaluated regarding clinical usefulness, patient safety, and effects on staff workload, and end users should be included in this process. Utmost consideration is needed regarding how to retain the benefits of personal contact between patient and provider when digital solutions are introduced.
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- Hange, Dominique, 1963, et al.
(author)
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Experiences of staff members participating in primary care research activities: a qualitative study
- 2015
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In: International Journal of General Medicine. - 1178-7074. ; 8, s. 143-8
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Journal article (peer-reviewed)abstract
- BACKGROUND: The aim of this paper was to study primary care staff members' experiences and perceptions of participating in a randomized controlled trial concerning Internet therapy. METHODS: Data were collected via five focus groups, each containing four to eight nurses or general practitioners. The systematic text condensation method described by Malterud was used for thematic analysis of meaning and content of data across cases. RESULTS: The informants believed it was important to conduct research within the primary care setting, but it was difficult to combine clinical work and research. They stressed also that there was a need for continuous information and communication between primary care centers and researchers as well as internally at each primary care center. CONCLUSION: Staff members' experiences of participating in a research study were positive, although associated with various difficulties. It is important to include staff members when designing clinical studies; information should be given continuously during the study and communication facilitated between different occupational groups working at the primary care center.
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- Hange, Dominique, 1963, et al.
(author)
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Main causes of death among Swedish women born 1914 and 1918: 32-year follow-up of the Population Study of Women in Gothenburg : Vanligaste dödsorsakerna hos kvinnor i Sverige födda 1914 och 1918: 32 års uppföljning av Kvinnostudien i Göteborg
- 2012
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In: International Journal of General Medicine, Dovepress. - 1178-7074. ; 2012:5:5, s. 597-601
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Journal article (peer-reviewed)abstract
- Background: Coronary heart disease has been reported to be the major cause of death of postmenopausal women in industrialized countries. The risk for women of dying from myocardial infarction is significantly greater than the risk of dying from cancer. The aim of this study was to compare previous observations regarding causes of death with the results from the Population Study of Women in Gothenburg. We also examined how causes of deaths vary among different age cohorts. Methods: This follow-up report based on the prospective observational Population Study of Women in Gothenburg, Sweden was confined to mortality in two age cohorts: 180 women born in 1914 and 398 women born in 1918. These women were representative of the female population in Gothenburg in these age groups. Women were followed for 32 years, from 1968–1969 to 2000–2001. During the follow-up period, data on mortality were obtained from the population registry and the Cause of Death Register. Women’s death certificates were also examined. Results: In women aged between 60 and 80 years, cancer accounted for 30% of deaths, myocardial infarction for 19%, and stroke for 14%. In women who died after the age of 80 years, myocardial infarction was a more common cause of death than cancer. Conclusions: Cancer accounts for most years lost from a woman’s normal life span. Myocardial infarction was a more common cause of death than cancer only in women above the age of 80 years. Although myocardial infarction is a common cause of death among women, cancer is a more common cause of death at younger ages. This should be emphasized when planning care, prevention, and research involving women’s health. Keywords: causes of death, mortality, population study, women
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- Hange, Dominique, 1963, et al.
(author)
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Perceived nervousness and moodiness associated with increased CVD but not cancer morbidity in pre- and postmenopausal women. Observations from the Population Study of Women in Gothenburg, Sweden
- 2009
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In: International Journal of General Medicine. - 1178-7074. ; 2, s. 39-45
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Journal article (peer-reviewed)abstract
- Abstract: A 32-year prospective observational study was initiated in 1968, including 1462 women aged 60, 54, 50, 46, and 38, representative of the female population in these age groups. Measures included self-reported nervous symptoms and moodiness at baseline, menopausal status, risk factors as smoking, s-cholesterol, s-triglycerides, body mass index (BMI), waist–hip ratio (WHR), blood pressure, and socioeconomic status (SES). The prevalence of nervousness and moodiness was investigated as well as if these reported symptoms could predict mortality and morbidity within 32 years in pre-and postmenopausal women. Women who reported at least two of the symptoms suffered from an increased risk of 32-year mortality, independent of all background variables described above (hazard ratio [HR] = 1.28, confidence interval [CI] 1.03–1.58). Women with only one of the nervous symptoms already had an increased risk of suffering from cardiovascular disease (CVD) also after multivariable adjustment (HR = 1.29, CI 1.09–1.52) a risk that also remained significant when analyzing CVD risk in the group of premenopausal women (HR = 1.28, CI 1.02–1.62). There was no significantly increased risk among pre-or postmenopausal women with perceived nervousness/moodiness of developing cancer during the 32-year follow-up. There seems to be an association between nervousness/moodiness and premature mortality and morbidity in CVD, especially when present already in the premenopausal state in women.
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- Hange, Dominique, 1963, et al.
(author)
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The impact of internet-based cognitive behavior therapy on work ability in patients with depression - a randomized controlled study.
- 2017
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In: International Journal of General Medicine. - 1178-7074. ; 10, s. 151-159
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Journal article (peer-reviewed)abstract
- The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU.This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013.Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million.A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women.Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale - self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days.Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days.Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression.
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- Håkonsen, Helle, 1980, et al.
(author)
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Intra-individual variability in self-reported use of non-steroidal anti-inflammatory and analgesic medicines depending on mode of data collection - observations from the Population Study of Women in Gothenburg, Sweden
- 2021
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In: International Journal of General Medicine. - 1178-7074. ; 14, s. 3243-3250
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Journal article (peer-reviewed)abstract
- Background: Self-report by questionnaire is one of the main methods to collect data on drug utilization. There are several modes of data collection by questionnaire, differing in the way of delivering the questionnaire to respondents and in the administration of the questions, both influencing the recall and participation rates. The aim of this study was to compare different modes of data collection for self-reported use of non-steroidal anti-inflammatory (NSAIDs) and analgesic medicines. Methods: Data on 573 women (38 or 50 years) were retrieved from the Population Study of Women in Gothenburg. Data on medicine use were collected using two different modes: (1) a self-administered questionnaire with closed-ended medicine-specific questions; and (2) an interviewer-administered questionnaire with open-ended questions. Cohen’s kappa statistics were applied to assess the agreement of the two modes. Results: The proportion of participants that reported use of NSAIDs and analgesics was higher with the self-administered questionnaire compared with the interviewer-administered questionnaire (69.3% vs 58.5%, p < 0.001). The overall agreement between the two modes of data collection was fair (Ⱪ=0.27), ranging from none for antimigraine preparations to fair (Ⱪ=0.36) for NSAIDs. A higher proportion of the participants aged 38 years reported use of NSAIDs and analgesics compared with the 50-year olds. In the regression model using data from the self-administered questionnaire, all four categories of bodily pain were significant predictors for use of NSAIDs and analgesics. The most severe reported bodily pain was the only significant predictor in the model using data from the interviewer-administered questionnaire. Conclusion: This study showed that use of a self-administered questionnaire with closed-ended medicine-specific questions identified more users of NSAIDs and analgesic medicines compared with an interviewer-administered questionnaire with open-ended questions. Reported use according to the self-administered questionnaire was also more strongly associated with experienced pain.
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