| 1. |
- Jerdén, Lars, et al.
(author)
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Gender Differences and Predictors of Self-Rated Health Development Among Swedish Adolescents
- 2011
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In: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 48:2, s. 143-150
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of the study was to evaluate the development of self-rated health among boys and girls during adolescence. Methods: Longitudinal cohort study, involving 1,046 Swedish adolescents from the seventh (12-13 years old) to the ninth grade. Self-rated health (well-being) and health-related empowerment were measured using a questionnaire. Results: In the seventh as well as in the ninth grade, the proportion of adolescents reporting a good health was lower in girls than in boys. In general, girls showed lower health-related empowerment as compared with boys and this difference remained between both the grades. In boys and girls belonging to both grades, a high empowerment score was related to a high self-rated health. For both boys and girls, self-rated health declined between the seventh and ninth grade. In girls, the proportion rating their health as "very good" declined from 47 % to 30%, and in boys the same proportion declined from 56% to 46%, indicating an increasing gender difference. Only a minor proportion of adolescents (16% of the boys and 13% of the girls) reported an improvement. A high self-rated health in grade nine was, in girls, predicted by positive school experiences in seventh grade and, in boys, by a good mood in the family. Conclusion: During adolescence, girls reported lower self-rated health than boys and this gender difference increased over the years. High empowerment is related to high self-rated health, and positive school experiences and a good mood in the family seem to be important predictors of a positive development of self-rated health.
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| 2. |
- Kardakis, Therese, et al.
(author)
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Lifestyle interventions in primary health care : professional and organizational challenges
- 2014
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 24:1, s. 79-84
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Journal article (peer-reviewed)abstract
- BACKGROUND: Interventions that support patient efforts at lifestyle changes that reduce tobacco use, hazardous use of alcohol, unhealthy eating habits and insufficient physical activity represent important areas of development for health care. Current research shows that it is challenging to reorient health care toward health promotion. The aim of this study was to explore the extent of health care professional work with lifestyle interventions in Swedish primary health care, and to describe professional knowledge, attitudes and perceived organizational support for lifestyle interventions.METHODS: The study is based on a cross-sectional Web-based survey directed at general practitioners, other physicians, residents, public health nurses and registered nurses (n = 315) in primary health care.RESULTS: Fifty-nine percent of the participants indicated that lifestyle interventions were a substantial part of their duties. A majority (77%) would like to work more with patient lifestyles. Health professionals generally reported a thorough knowledge of lifestyle intervention methods for disease prevention. Significant differences between professional groups were found with regard to specific knowledge and extent of work with lifestyle interventions. Alcohol was the least addressed lifestyle habit. Management was supportive, but structures to sustain work with lifestyle interventions were scarce, and a need for national guidelines was identified.CONCLUSIONS: Health professionals reported thorough knowledge and positive attitudes toward lifestyle interventions. When planning for further implementation of lifestyle interventions in primary health care, differences between professional groups in knowledge, extent of work with promotion of healthy lifestyles and lifestyle issues and provision of organizational support such as national guidelines should be considered.
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| 3. |
- Weinehall, Lars, et al.
(author)
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Counseling on lifestyle habits in the United States and Sweden : a report comparing primary care health professionals' perspectives on lifestyle counseling in terms of scope, importance and competence
- 2014
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In: BMC Family Practice. - : BioMed Central. - 1471-2296. ; 15:1, s. 83-
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Journal article (peer-reviewed)abstract
- BACKGROUND: The role of primary care professionals in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing international research collaboration provides a unique opportunity to study this issue.METHODS: Data from a national survey in Sweden and a study in rural Upstate New York were compared to contrast the perspectives, attitudes, and practice of primary care professionals in the two countries. Answers to four key questions on counseling for tobacco use, alcohol consumption, physical activity, and eating habits were compared.RESULTS: The response rates were 71% (n = 180) and 89% (n = 86) in the Sweden and the U.S. respectively. U.S. professionals rated counseling "very important" significantly more frequently than Swedish professionals for tobacco (99% versus 92%, p < .0001), physical activity (90% versus 79%, p = .04), and eating habits (86% versus 69%, p = .003). U.S. professionals also reported giving "very much" counseling more frequently for these same three endpoints than did the Swedish professionals (tobacco 81% versus 38%, p < .0001, physical activity 64% versus 31%, p < .0001, eating 59% versus 34%, p = .0001). Swedish professionals also rated their level of expertise in providing counseling significantly lower than did their U.S. counterparts for all four endpoints. A higher percentage of U.S. professionals expressed a desire to increase levels of counseling "very much", but only significantly so for eating habits (42% versus 28%, p = .037).CONCLUSIONS: The study demonstrates large differences between the extent that Swedish and American primary care professionals report being engaged in counseling on lifestyle issues, how important they perceive counseling to be, and what expertise they possess in this regard. Explanations might be found in inter-professional attitudes, the organization of healthcare, including the method of reimbursement, traditions of preventive healthcare, and cultural differences between the two countries. Further studies are needed to explore these questions, with the aim of facilitating improved lifestyle counseling in primary care.
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| 4. |
- Flacking, Renée, 1964-, et al.
(author)
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'In or Out'-On the Dynamic between Acceptance and Rejection and its Influence on Health in Adolescent Girls
- 2014
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In: Young - Nordic Journal of Youth Research. - : SAGE Publications India. - 1103-3088 .- 1741-3222. ; 22:3, s. 291-303
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Journal article (peer-reviewed)abstract
- Adolescent girls' subjective health, or well-being, is of international concern as the frequency of psychological and psychosomatic complaints is continuously increasing in several countries world-wide. The causes of this development are still obscure. The aim of this study was to explore well-being and strategies for increased well-being among adolescent girls. Grounded Theory method was used, in which in-depth interviews were held with 18 adolescent girls, 17-18 years of age. Results showed that striving for acceptance and avoiding rejection were central for their well-being. When rejection was experienced, emotions of stress-shame were recognized, a phenomena we call the stress-shame cycle. In the struggle to prevent rejection and to become accepted, the girls strived to boost their social attractiveness by impression management.
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| 5. |
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| 6. |
- Joffer, Junia, et al.
(author)
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Predictors of smoking among Swedish adolescents
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 1296-
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Journal article (peer-reviewed)abstract
- Background: Smoking most often starts in adolescence, implying that understanding of predicting factors for smoking initiation during this time period is essential for successful smoking prevention. The aim of this study was to examine predicting factors in early adolescence for smoking in late adolescence. Methods: Longitudinal cohort study, involving 649 Swedish adolescents from lower secondary school (12-13 years old) to upper secondary school (17-18 years old). Tobacco habits, behavioural, intra-and interpersonal factors and socio-demographic variables were assessed through questionnaires. Descriptive statistics, univariable and multivariable logistic regression were used to identify predicting factors. Results: Smoking prevalence increased from 3.3% among 12-13 year olds to 25.1% among 17-18 year olds. Possible predictors of smoking were: female sex, lower parental education, poorer family mood, poorer self-rated health, poorer self-esteem, less negative attitude towards smoking, binge drinking, snus use and smoking. In a multivariable logistic regression analysis, female sex (OR 1.64, CI 1.08-2.49), medium and low self-esteem (medium: OR 1.57, CI 1.03-2.38, low: 2.79, CI 1.46-5.33), less negative attitude towards smoking (OR 2.81, CI 1.70-4.66) and ever using snus (OR 3.43, CI 1.78-6.62) remained significant independent predicting factors. Conclusions: The study stresses the importance of strengthening adolescents' self-esteem, promoting anti-smoking attitudes in early adolescence, as well as avoidance of early initiation of snus. Such measures should be joint efforts involving parents, schools, youth associations, and legislating authorities.
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| 7. |
- Wennberg, Patrik, et al.
(author)
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Self-rated health and mortality in individuals with diabetes mellitus : prospective cohort study
- 2012
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In: BMJ Open. - : BMJ. - 2044-6055. ; 2:1, s. e000760-
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Journal article (peer-reviewed)abstract
- Objectives: To investigate whether low self-rated health (SRH) is associated with increased mortality in individuals with diabetes.Design: Population-based prospective cohort study. Setting: Enrolment took place between 1992 and 2000 in four centres (Bilthoven, Heidelberg, Potsdam, Umea) in a subcohort nested in the European Prospective Investigation into Cancer and Nutrition.Participants: 3257 individuals (mean +/- SD age was 55.8 +/- 7.6 years and 42% women) with confirmed diagnosis of diabetes mellitus.Primary outcome measure: The authors used Cox proportional hazards modelling to estimate HRs for total mortality controlling for age, centre, sex, educational level, body mass index, physical inactivity, smoking, insulin treatment, hypertension, hyperlipidaemia and history of myocardial infarction, stroke or cancer.Results: During follow-up (mean follow-up +/- SD was 8.6 +/- 2.3 years), 344 deaths (241 men/103 women) occurred. In a multivariate model, individuals with low SRH were at higher risk of mortality (HR 1.38, 95% CI 1.10 to 1.73) than those with high SRH. The association was mainly driven by increased 5-year mortality and was stronger among individuals with body mass index of <25 kg/m(2) than among obese individuals. In sex-specific analyses, the association was statistically significant in men only. There was no indication of heterogeneity across centres.Conclusions: Low SRH was associated with increased mortality in individuals with diabetes after controlling for established risk factors. In patients with diabetes with low SRH, the physician should consider a more detailed consultation and intensified support.
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