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- Abma, Tineke, et al.
(author)
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Social impact of participatory health research : collaborative none- linear processes of knowledge mobilization
- 2017
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In: Educational action research. - : Routledge. - 0965-0792 .- 1747-5074. ; 25:4, s. 489-505
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Journal article (peer-reviewed)abstract
- Social impact, defined as an effect on society, culture, quality of life, community services, or public policy beyond academia, is widely considered as a relevant requirement for scientific research, especially in the field of health care. Traditionally, in health research, the process of knowledge transfer is rather linear and one-sided and has not recognized and integrated the expertise of practitioners and those who use services. This can lead to discrimination or disqualification of knowledge and epistemic injustice. Epidemic injustice is a situation wherein certain kinds of knowers and knowledge are not taken seriously into account to define a situation. The purpose of our article is to explore how health researchers can achieve social impact for a wide audience, involving them in a non-linear process of joint learning on urgent problems recognized by the various stakeholders in public health. In participatory health research impact is not preordained by one group of stakeholders, but the result of a process of reflection and dialog with multiple stakeholders on what counts as valuable outcomes. This knowledge mobilization and winding pathway embarked upon during such research have the potential for impact along the way as opposed to the expectation that impact will occur merely at the end of a research project. We will discuss and illustrate the merits of taking a negotiated, discursive and flexible pathway in the area of community-based health promotion.
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- Al Musawi, Ahmed, et al.
(author)
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Intervention for a correct medication list and medication use in older adults : a non-randomised feasibility study among inpatients and residents during care transitions
- 2024
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In: International Journal of Clinical Pharmacy. - : Springer. - 2210-7703 .- 2210-7711. ; 46, s. 639-647
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Journal article (peer-reviewed)abstract
- BackgroundMedication discrepancies in care transitions and medication non-adherence are problematic. Few interventions consider the entire process, from the hospital to the patient's medication use at home.AimIn preparation for randomised controlled trials (RCTs), this study aimed (1) to investigate the feasibility of recruitment and retention of patients, and data collection to reduce medication discrepancies at discharge and improve medication adherence, and (2) to explore the outcomes of the interventions.MethodParticipants were recruited from a hospital and a residential area. Hospital patients participated in a pharmacist-led intervention to establish a correct medication list upon discharge and a follow-up interview two weeks post-discharge. All participants received a person-centred adherence intervention for three to six months. Discrepancies in the medication lists, the Beliefs about Medicines Questionnaire (BMQ-S), and the Medication Adherence Report Scale (MARS-5) were assessed.ResultsOf 87 asked to participate, 35 were included, and 12 completed the study. Identifying discrepancies, discussing discrepancies with physicians, and performing follow-up interviews were possible. Conducting the adherence intervention was also possible using individual health plans for medication use. Among the seven hospital patients, 24 discrepancies were found. Discharging physicians agreed that all discrepancies were errors, but only ten were corrected in the discharge information. Ten participants decreased their total BMQ-S concern scores, and seven increased their total MARS-5 scores.ConclusionBased on this study, conducting the two RCTs separately may increase the inclusion rate. Data collection was feasible. Both interventions were feasible in many aspects but need to be optimised in upcoming RCTs.
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- Annersten Gershater, Magdalena, et al.
(author)
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Diabetes type 2 prevalence is rising among young residents in Malmö, Sweden.
- 2024
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In: Primary Care Diabetes. - : Elsevier. - 1751-9918 .- 1878-0210. ; 18:4, s. 409-413
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Journal article (peer-reviewed)abstract
- Aim: Type 2 diabetes is becoming more prevalent in many parts of the world. Malmö's population has increased in recent years mainly because of migration from other parts of Sweden and the world in addition to increased birth rates. We aimed to explore diabetes prevalence in Malmö in 2011-2018 as well as the achieved treatment targets for selected diabetes-related outcomes.Method: The current study is a part of the Cities Changing Diabetes Malmö project. Prevalence data were retrieved from the region's primary care and hospital diagnosis register, and data on treatment targets were collected from the National Diabetes Register. The inclusion criteria were either being a resident of Malmö or using a primary healthcare centre located in Malmö.Results: The prevalence of type 2 diabetes in 2018 doubled from 2011 in the entire Malmö population. During the same period, the prevalence of type 1 diabetes remained stable at 0.49 %. In 2011, the type 2 diabetes prevalence was 2.46 % (2.76 % for males and 2.28 % for females), and in 2018, it was 4.26 % (4.84 % for males and 3.82 % for females). The increase was 139 % for residents aged 0-29 years, 119.6 % for residents aged 30-39 years, 96.2 % for residents aged 40-49 years, 102 % for residents aged 50-59 years, 98.2 % for residents aged 60-69 years, and 115.5 % for those aged 70-79 years. Finally, the increase was 60.9 % for those aged 80-84 years and 90.7 % for residents 90 years of age and older. The National Diabetes Register reported that during 2019, 58 % of all patients with diabetes using primary care in Malmö reached HbA1c <52 mmol/mol, 20 % had albuminuria, 36 % had retinopathy, and 21 % had not had their feet inspected by a healthcare professional during the last year. The median HbA1c was 52.6 mmol/mol, and 17 % were registered as active smokers.Conclusion: Diabetes prevalence in Malmö has increased markedly in recent years, exacerbated by a rise in type 2 diabetes mainly in the younger population. Targets regarding p-glucose lowering treatments were not met by 42 %. One patient out of three had microvascular complications in the eye, one out of five had impaired kidney function, one out of five had not had their feet inspected, and one out of five was an active smoker. Active diabetes treatments need to be improved to reduce the number of younger patients developing microvascular complications. Preventive activities need to target younger populations to counteract even more residents developing type 2 diabetes.
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- Avery, Helen, et al.
(author)
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Empowering communities with health promotion labs: result from a CBPR programme in Malmö, Sweden
- 2022
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In: Health Promotion International. - : Oxford University Press (OUP). - 1460-2245 .- 0957-4824. ; 37:1, s. 1-15
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Journal article (peer-reviewed)abstract
- The study describes findings from a community-based participatory and challenge-driven research programme, that aimed to improve health equity through a health promotion platform in an ethnically diverse low-income neighbourhood of Malmo, Sweden. Local residents, together with lay health promoters living in the area, were actively involved in the planning phase and decided on the structure and content of the programme. Academic, public sector and commercial actors were involved, as well as NGOs. In this study, empowerment was used as a lens to analyse focus group interviews with participants (n=322) in six co-creative health-promoting labs on three occasions in the period 2017-2019. The CBPR interview guide focused on the dimensions of participation, collaboration, and experience of the activities. The CBPR approach driven by community members contributed to empowerment processes within the health promotion labs. Findings indicate that health promotors were able to build trust in social places for integration; participants motivated each other by social support, and that the programme design enabled them to act for community health in a wider circle. To understand the processes of change and empowerment on the community level, the CBPR Health promotion programme should be followed up longitudinally with community participants.
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6. |
- Awad, Eman, et al.
(author)
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Developing and evaluating non-invasive healthcare technologies for a group of female participants from a socioeconomically disadvantaged area
- 2021
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In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 11:1
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Journal article (peer-reviewed)abstract
- When compared to the general population, socioeconomically disadvantaged communitiesfrequently experience compromised health. Monitoring the divide is challenging since standardizedbiomedical tests are linguistically and culturally inappropriate. The aim of this study was to developand test a unique mobile biomedical testbed based on non-invasive analysis, as well as to explorethe relationships between the objective health measures and subjective health outcomes, asevaluated with the World Health Organization Quality of Life survey. The testbed was evaluated in asocioeconomically disadvantaged neighborhood in Malmö, which has been listed as one of the twelvemost vulnerable districts in Sweden. The study revealed that compared to conventional protocolsthe less intrusive biomedical approach was highly appreciated by the participants. Surprisingly, thecollected biomedical data illustrated that the apparent health of the participants from the ethnicallydiverse low-income neighborhood was comparable to the general Swedish population. Statisticallysignificant correlations between perceived health and biomedical data were disclosed, even thoughthe dependences found were complex, and recognition of the manifest complexity needs to beincluded in further research. Our results validate the potential of non-invasive technologies incombination with advanced statistical analysis, especially when combined with linguistically andculturally appropriate healthcare methodologies, allowing participants to appreciate the significanceof the different parameters to evaluate and monitor aspects of health.
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- Bendtsen Kronkvist, Maria, et al.
(author)
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User participation in decision-making : a qualitative intervention study on mental health professionals’ experiences
- 2022
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In: Journal of Public Mental Health. - : Emerald Group Publishing Limited. - 1746-5729 .- 2042-8731. ; 21:3, s. 250-261
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to describe mental health professionals’ experiences of changes in attitudes towards, and knowledge about, users of mental health-care recovery and decisional participation in clinical practice after an educational intervention.Design/methodology/approach: Users of mental health care want to participate in decisions regarding their own mental health care. Shared decision-making as a method is coherent with recovery orientation in mental health services and results in better-informed patients and fewer conflicts regarding decisions. A qualitative intervention study was designed to evaluate changes in attitudes and knowledge about mental health recovery in Sweden. Nine participants were interviewed, and the data were analysed by content analysis.Findings: Three categories were generated from the analysis: Increased theoretical knowledge, changing attitudes about practical approaches and the significance of social factors in recovery.Originality/value: When shared decision-making is to be implemented in mental health, professionals need to gain knowledge about recovery and need to adopt changed roles as health professionals. Educational interventions therefore seem necessary if such changes are to happen.
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- Bolmsjö, Ingrid, et al.
(author)
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Existential loneliness : An attempt at an analysis of the concept and the phenomen
- 2019
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In: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 26:5, s. 1310-1325
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Journal article (peer-reviewed)abstract
- Abstract Background: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. Aim: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. Method: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. Results: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. Conclusion: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them.
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10. |
- Carlson, Elisabeth, et al.
(author)
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Registered nurses' perceptions of their professional work in nursing homes and home-based care : A focus group study
- 2014
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 51:5, s. 761-767
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Journal article (peer-reviewed)abstract
- Background: In Sweden, as well as in most industrialized countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialized in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. Objective: The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. Method: This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analyzed in line with the tradition of naturalistic inquiry. Results: Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing with the older person at its centre. Three categories emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. Conclusions: We suggest that nurse educators and nurse managers promote continuity and long term relationships with patients, as well as independence and the opportunity to provide holistic care as key aspects of elderly care. These key aspects can be used to attract and retain nurses to a much needed area as well as be used as positive examples that can influence values and attitudes towards a career in elderly care.
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