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| 2. |
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| 3. |
- Abrahamsson, Kajsa, et al.
(författare)
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Dental beliefs : factor structure of the revised dental beliefs survey in a group of regular dental patients
- 2009
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 117:6, s. 720-727
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.
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| 4. |
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| 5. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Dental beliefs: evaluation of the Swedish version of the revised Dental Beliefs Survey in different patient groups and in a non-clinical student sample.
- 2006
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 114:3, s. 209-15
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate and to test the psychometric properties of a Swedish version of the revised Dental Beliefs Survey (DBS-R) in different patient groups and in a non-clinical sample of students. It was hypothesized that negative dental beliefs, assessed using the DBS-R, would discriminate between fearful and non-fearful study groups. The questionnaire was distributed together with the Dental Anxiety Scale (DAS). The sample included 550 adults who responded to the questionnaires (206 students, 177 general dental patients, 105 periodontal patients and 62 patients at a waiting list for dental-fear treatment). The internal drop-out rate was low. The results confirmed that the DBS-R discriminates well between fearful patients and the other study groups. The DBS-R had a high internal consistency in all the study groups. Furthermore, the DBS-R correlated significantly with age (higher values in younger age groups) and the DAS. Regression analyses showed that the DBS-R subdimensions of 'communication' and 'control'/or 'trust', respectively, were significant predictors for dental fear. The results suggest that the DBS-R is a reliable and valid instrument for use in different Swedish patient- and non-clinical population groups in order to assess attitudes to dentists. However, the underlying factor structure of the DBS-R needs to be further explored and established.
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| 6. |
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| 7. |
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| 8. |
- Andersson, Pia
(författare)
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Munhälsa och ätandet
- 2006
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Ingår i: Munvård inom vård och omsorg. - Lund : Studentlitteratur. ; , s. 53-66
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
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| 10. |
- Dahl, KE, et al.
(författare)
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Does oral health matter in people’s daily life? : Oral health-related quality of life in adults 35–47 years of age in Norway
- 2012
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Ingår i: International Journal of Dental Hygiene. - Oxford : Blackwell. - 1601-5029 .- 1601-5037. ; 10:1, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health.Material and methods: A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used.Results: Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P = 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales.Conclusions: This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life.
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| 11. |
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| 12. |
- Dahl, Kari Elisabeth, et al.
(författare)
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Oral health-related quality of life and associated factors in Norwegian adults
- 2011
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 69:4, s. 208-214
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians.Material and methods. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed.Results. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [ odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses.Conclusion. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.
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| 13. |
- Dahl, KE, et al.
(författare)
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Oral health-related quality of life among adults 68-77 years old in Nord-Tröndelag, Norway
- 2011
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Ingår i: International Journal of Dental Hygiene. - : Wiley-Blackwell. - 1601-5029 .- 1601-5037. ; 9:1, s. 87-92
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Tidskriftsartikel (refereegranskat)abstract
- Dental health has mostly been measured by dental staff disregarding patient’s experiences. However, clinical conditions alone do not fully indicate how people feel affected by their oral status. The aim of this study was to investigate how clinical recorded dental health, self-rated dental health, satisfaction with dental health were related to oral health-related quality of life (OHRQoL) assessed by Oral Health Impact Profile (OHIP-14) in 68–77 years old. A total of 151 individuals completed a questionnaire on self-rated dental health, satisfaction with dental health and the short form of OHIP-14. Clinical examination was performed registering number of teeth and dental caries. In total 63% of the individuals rated their dental health as good, and 59% were satisfied with their dental health. Using the OHIP-14 42% reported no problems or oral discomfort at all. The proportion of individuals reporting problems or discomfort varied between 13% and 43% according to the dimensions of OHIP-14. The most frequently reported problems were physical pain (43%), psychological discomfort (28%) and psychological disability (28%). Individuals who rated their dental health as poor and those who were dissatisfied with their dental health had significantly lower OHRQoL than other individuals. The study showed relationship between self-evaluations of dental health and OHRQoL in 68–77 years old. Individuals with few teeth reported lower OHRQoL than others, but no association between clinical caries status and OHRQoL could be found.
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| 14. |
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| 15. |
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| 16. |
- Edman, Kristina, 1958-, et al.
(författare)
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Attitudes and demands of dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objective. The aim of the present study was to investigate attitudes to, and demands of dental care, and to assess possible associations with socioeconomic and clinical variables over a period of ten years. A further aim was to investigate the association between OHRQoL assessed by OIDP, and socioeconomic, dental care habits, smoking and oral status. Materials and methods. Three cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1542–2244 individuals, aged 30-85 years, who answered a questionnaire about socio-economic, socio-behavioral factors, oral health-related quality of life were radiographically and clinically examined. Results. The importance of preventive treatment, regular recalls, meeting the same caregiver as on previous visits, and information on treatment cost have become less important. Difficulty in booking treatment time was reported by 17% in 2013, compared with 11% in 2003 and 12% in 2008 (p<0.05). In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (p<0.05). In individuals with temporomandibular disorder (TMD) and manifest caries, information on treatment cost was important, while prevention became less important (p<0.05). Oral impact on daily performance (OIDP) was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and TMD reported OIDP to a significantly higher degree, compared to orally healthy individuals. Conclusion. Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years, and difficulty in booking treatment time was reported more frequently in 2013. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, less than 20 remaining teeth, TMD and manifest caries.
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| 17. |
- Edman, Kristina, 1958-, et al.
(författare)
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Attitudes to dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013
- 2018
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Ingår i: International Journal of Dental Hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 16:2, s. 257-266
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate attitudes to dental care, and to assess possible associations with socio‐economic and clinical variables over a period of ten years, and to investigate the association between OHRQoL assessed by oral impact on daily performance (OIDP), and socio‐economic, dental care habits, smoking and oral status.Materials and methods: Cross‐sectional studies performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1,107‐1,115 dentate individuals, aged 30‐85 years, who answered a questionnaire and who were radiographically and clinically examined were included.Results: The importance of preventive treatment, regular recalls and meeting the same caregiver as on previous visits became less important. In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (P<.05). In individuals with manifest caries, information on treatment cost was important, while prevention became less important (P<.05). OIDP was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and temporomandibular disorders (TMD) reported OIDP to a significantly higher degree, compared to orally healthy individuals.Conclusion: Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, individuals with less than 20 remaining teeth, TMD and manifest caries.
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| 18. |
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| 19. |
- Edman, Kristina, et al.
(författare)
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Comparison of oral status in an adult population 35-75 year of age in the county of Dalarna, Sweden in 1983 and 2008
- 2012
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Ingår i: Swedish Dental Journal. - Jönköping : Swedish Dental Association. - 0347-9994. ; 36:2, s. 61-70
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50,65 and 75 answered a questionnaire and were also clinically and radiographically examined. The number of edentulous individuals decreased from 15% in 1983 to 3 % in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15 % in 1983 to 2 % in 2008. Individuals with moderate periodontitis decreased from 45 % in 1983 to 16 % in 2008. Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated. This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.
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| 20. |
- Edman, Kristina, 1958-
(författare)
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Epidemiological studies of Oral Health, development and influencing factors in the county of Dalarna, Sweden 1983–2013
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to describe the development of oral health and possible associations with socioeconomic and socio-behavioural factors, in an adult population over a period of 30 years. A further aim is to describe attitudes to, and demands of dental care, and the impact of oral conditions on quality of life.The study sample consisted of 787-1158 individuals, aged between 35-85 years, randomly selected from Dalarna’s population register in 1982, 2002, 2007 and 2012. The studies were carried out in 1983, 2003, 2008 and 2013, and the participants responded to a questionnaire and a clinical examination of oral status.There has been a substantial improvement in oral status in regard to the mean number of teeth, intact teeth, and less removable dentures over this period of 30 years. The proportion of individuals with alveolar bone loss decreased significantly between 1983 and 2008, but increased significantly between 2008 and 2013. Smoking was the overall strongest factor associated with alveolar bone loss, after adjustment for socioeconomic and socio-behaviour factors, age and number of teeth. Calculus, visible on radiographs, increased significantly between 2003 and 2013. The proportion of individuals with manifest caries declined significantly between 1983 and 2008, but seems to level out between 2008 and 2013. Socioeconomic and socio-behaviour factors were significantly associated with manifest caries. Preventive treatment, meeting the same caregiver as on previous visits, and information about treatment cost was reported to a significantly lower degree as important in 2013, compared with 2003 and 2008, and booking time for treatment was reported as more difficult in 2013, compared with earlier years. Regular recalls was reported as less important in 2013, compared with 2008. A third of the respondents reported oral impact on daily performance and irregular dental visits, limited economy for dental care, less than 20 remaining teeth, manifest caries and temporomandibular disorder were significantly associated with oral impact on daily performance.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Edman, Kristina, 1958-, et al.
(författare)
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Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population : Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden
- 2016
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:5, s. 385-392
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this study was to investigate the prevalence of dental caries in an adult population using four different cross-sectional studies over a 30-year period and to assess its possible associations with socio-economic and socio-behavioral factors. Materials and methods. Four cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008, and 2013. Random samples of 1012–2243 individuals, aged 20–85 years, who answered a questionnaire about socio-economic and socio-behavioral factors, were radiographically and clinically examined. Results. The proportion of individuals with at least one decayed surface (DS) was 58% in 1983 and significantly lower, 34% in 2008 (p<0.05) and 33% in 2013; the mean number of DS was 2.0 in 1983 and 1.1 in 2013 in the age group 35 to 75 (p < 0.05). In the age group 85, the mean number of DS was 1.2 in 2008 and 2.4 in 2013. Adjusted for age and number of teeth, irregular dental visits, limited financial resources for dental care, smoking, education below university, male gender, daily medication, and single living were positively and statistically associated with manifest caries. Conclusion. The declining trend in the prevalence of manifest caries seems to be broken. In the oldest age group mean number of DS was higher in 2013 compared with 2008, indicating a possible beginning of an increase. This needs special attention as this group increases in the population, retaining natural teeth high up in age. Manifest caries was found to be associated with socio-economic and socio-behavioral factors.
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| 25. |
- Edman, Kristina, et al.
(författare)
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Trends over 30 years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors : based on epidemiological surveys in Sweden 1983-2013
- 2015
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Ingår i: International Journal of Dental Hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 13:4, s. 283-291
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Epidemiological studies of the prevalence of periodontitis over an extended time using the same methodology to investigate and classify periodontitis are sparse in the literature. Smoking and socio-economic factors have been proven to increase the risk for periodontal disease. The objective of this study was to investigate 30-year time trends, using the same methodology to classify the prevalence and severity in alveolar bone loss (ABL) and to investigate the influence of tobacco and socio-economic factors.METHODS: Four cross-sectional epidemiological studies in an adult population were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008 and 2013. Random samples of 787-1133 individuals aged 35-85 who answered a questionnaire about tobacco use and socio-economic factors were radiographically and clinically examined. A number of teeth, ABL and calculus visible on radiographs were registered. The severity of ABL as detected on radiographs was classified into no bone loss, moderate or severe.RESULTS: The prevalence of moderate ABL decreased from 45% in 1983 to 16% in 2008, but increased to 33% in 2013 (P < 0.05). The prevalence of severe ABL remained the same from 1983 (7%) to 2013 (6%). Calculus visible on radiographs increased from 22% in 2008 to 32% in 2013 (P < 0.05). Socio-economic factors had limited impact on the severity of ABL.CONCLUSION: Moderate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.
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| 26. |
- Einarson, Susanne, 1958-
(författare)
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Oral health-related quality ofl ife in an adult population
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim: The overall aim of this licentiate thesis was to describe and analyze oral health-related quality of life measured with OHIP-14. The thesis comprises two studies, each with a specific aim. Study I: To describe oral health-related quality of life measured with OHIP-14 in an Swedish adult population Study II: To study the relationship between oral health-related quality of life, measured with OHIP-14, and subjective as well as objective dry mouth conditions in fragile old people. Furthermore, the aim was to study the reliability and validity of a new instrument (VAS) to measure dry mouth Material and methods: Study I comprised a stratified random sample of 519 individuals 20-80 years of age. In Study II, 41 randomly selected fragile old people, residents at three different community care centers, participated. In both studies, the questionnaire OHIP-14 was used for measurement of oral health-related quality of life. The participants in Study II answered a questionnaire for subjectively experienced dry mouth (VAS). For objective dry mouth measurements, saliva was absorbed into a preweighted cotton roll. Results: In Study I, 21% of the respondents stated that they had no oral problems that had a negative impact on their well-being. In Study II, the corresponding figure was 71%. In study I the mean value for OHIP-14 was 6.4 (SD=7.1) for the entire population; 5.9 (SD=7.1) for men and 6.8 (SD=7.2) for women in. Subjects, who frequently experienced problems related to oral health, with scores ranging from 16 to 41 points, accounted for 10% of the study group. In Study II, significant associations were identified between both objectively measured respective subjectively experienced dry mouth and oral health-related quality of life. The validity of the VAS instrument was good for subjective mouth dryness, but poor for objectively measured dry mouth in fragile old people. Conclusion: From Study I it can be concluded that, in this Swedish population, a number of individuals, both young and old, experience oral problems that have a negative impact on their well-being. From Study II, the conclusion is that dry mouth (both objective and subjective) is significantly associated with poorer oral health-related quality of life, underlining the value of monitoring dry mouth conditions in the care of fraigile old people.
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| 27. |
- Elf, Lena Marie, 1962, et al.
(författare)
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A dynamic conceptual model of care planning
- 2007
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Ingår i: SCANDINAVIAN JOURNAL OF CARING SCIENCES. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:4, s. 530-538
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Tidskriftsartikel (refereegranskat)abstract
- This article presents a conceptual model of the care planning process developed to identify the hypothetical links between structural, process and outcome factors important to the quality of the process. Based on existing literature, it was hypothesized that a thorough assessment of patients' health needs is an important prerequisite when making a rigorous diagnosis and preparing plans for various care interventions. Other important variables that are assumed to influence the quality of the process are the care culture and professional knowledge. The conceptual model was developed as a system dynamics causal loop diagram as a first essential step towards a computed model. System dynamics offers the potential to describe processes in a nonlinear, dynamic way and is suitable for exploring, comprehending, learning and communicating complex ideas about care processes.
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| 28. |
- Elf, Lena Marie, 1962, et al.
(författare)
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Developing a model of a Stroke Care Process
- 2009
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Ingår i: Online Journal of Nursing Informatics. - 1089-9758. ; 13:3, s. 1-34
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The paper presents the development and structure of a generic stroke care simulation model, used in designing of a stroke unit in Sweden. Background and rationale. Designing new health care spaces is a multifaceted process; requiring multi-professional (nurses, other healthcare professionals, building planners and architects) involvement. To secure that the patients’ interest are in focus the different stakeholders need to analyze and develop a common understanding of the care processes that are to take place in the new space. Modeling and simulation is one significant method, making it possible to depict the dynamic structure of the system and experiment with the model, asking “what – ifs” questions. Methods. System dynamics, a modeling method was used to develop the model. The iterative and group-modeling process included development of a quantified model (with a multi-professional design team, based on evidence from the literature, and a survey from stroke care experts), and validation of the model. Results. The dynamic care model developed included variables that are essential in modern care, such as patient-participation, care-planning, and teamwork. Conclusion. The presented generic model provides a framework for exploring, comprehending, and communicating complex ideas about stroke care.
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| 29. |
- Elf, Marie, et al.
(författare)
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Designing patient-centered healthcare spaces
- 2013
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Konferensbidrag (refereegranskat)abstract
- The architecture can promote patients health. Accessibility, safety and care quality can be built into the design of healthcare environments. The current planning process has been criticized to be guided by technical solutions rather than the users’ needs and a lack of correspondence between the goal of the organization and the planning process. We used the system dynamics (SD) modeling method to facilitate the pre-planning process (before architectural design details are presented) of new healthcare environments. SD is an interactive computer-based method that is suitable for use with a group-modeling approach with a focus on learning, which is facilitated through the construction of simple models of the system that help the user to experiment with and study the behavior of these models. The aim of using SD was to strengthen the understanding of the healthcare organization and its care processes, enhance the integration of scientific knowledge related to care processes and architecture. A case study design was used in five different healthcare settings. The participants built the model in collaboration through a reflective and iterative process of learning about their organization/system to contribute to the planning process. The preliminary results show that we succeeded in turning the discussions toward the work and related care processes as a basis for further planning of the building.
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| 30. |
- Elf, Marie, 1962, et al.
(författare)
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Designing Sustainable Health Care Spaces
- 2008
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Ingår i: The Natural Step´s Sustainability Leadership Challenge - conference in Stockholm. - Stockholm.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 31. |
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| 32. |
- Elf, Marie, 1962, et al.
(författare)
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Designing sustainable healthcare environments.
- 2012
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Ingår i: 19th International Conference on Health Promoting Hospitals and Health Services. June 1-3, 2011 Turku, Finland.
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Konferensbidrag (refereegranskat)
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Elf, Marie, 1962, et al.
(författare)
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upporting pre-planning design phases of new dementia care environments through group-modeling
- 2012
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Ingår i: Operations Research Society, OR54.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Problem and rationale The pre-design phase, before architectural design details are presented is important for the success of the entire construction process. In this phase, it is important to identify the needs of the users and the organization. The present project describes a group-modeling project with system dynamics (SD) in the pre-design phase of a new dementia care environment. The aim was to support a dynamic design process that was oriented towards the users needs. SD uses models to create scenarios and experiment with different solutions to understand complex problems. The method is interactive and suited for group- modeling. The tools used are a construction of a diagram depicting the system and a mathematical model for scenario experiments. Methods and procedureThe group- modeling was performed during five workshops with stakeholders from the organization. The data for the model was collected through discussions with the modeling group, a questionnaire, literature reviews and documents. The process was documented by video-recording and field notes. The participants were interviewed at the end of the project. The data was analyzed by content analysis. ResultsResult show that the modeling process supported the group to explicitly express their goal regarding care. The modeling process moved the group discussions from space solutions and square meters to the goals of the care process. The model developed illustrates a modern perspective of dementia care. Conclusions Group-modeling using SD is interesting for the pre-design process. It can be feasible for linking strategic planning of the organization with the plan over the new healthcare environment since it moves the participants in the pre-design phase to focus on important issues about the care and away from a wish list of various needed spaces, commonly achieved in traditional planning processes.
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| 37. |
- Elf, Marie, et al.
(författare)
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Using modeling as a co-design approach in the planning process of new care environments
- 2016
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Ingår i: Nordic Conference in Nursing Research 2016.
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Konferensbidrag (refereegranskat)abstract
- Current research shows a relationship between healthcare architecture and patient-related Outcomes. The planning and designing of new healthcare environments is a complex process; the needs of the various end-users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modelling utilizing system dynamics in the pre-design phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction, and then interviewed them about their experience. An explorative and qualitative design was used to describe participants’ experiences of participating in the group modelling projects. Participants (n=20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analysed by qualitative content analysis. Two themes were formed, representing the experiences in the group modeling process: ‘Partaking in the G-M created knowledge and empowerment’and ‘Partaking in the G-M was different from what was expected and required time and skills’. The method can support participants in design teams to focus more on their healthcare organization, their care activities and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.
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| 38. |
- Elf, Marie, et al.
(författare)
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Using of Group-Modeling in Predesign Phase of New Healthcare Environments: Stakeholders Experiences
- 2016
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Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 9:2, s. 69-81
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Tidskriftsartikel (refereegranskat)abstract
- Background: Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process. The needs of the various end users of the environment must be considered, including the patients, the patients' significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modeling utilizing system dynamics in the predesign phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction and then interviewed them about their experience. Methods: An explorative and qualitative design was used to describe participants' experiences of participating in the group-modeling projects. Participants (N = 20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analyzed by qualitative content analysis. Results: Two themes were formed, representing the experiences in the group-modeling process: Participation in the group modeling generated knowledge and was empowering and Participation in the group modeling differed from what was expected and required the dedication of time and skills. Conclusions: The method can support participants in design teams to focus more on their healthcare organization, their care activities, and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.
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| 39. |
- Elf, Marie, et al.
(författare)
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Using system dynamics for collaborative design : a case study
- 2007
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 7:123
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Tidskriftsartikel (refereegranskat)abstract
- Background In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group.AimTo explore to which extent and how the use of system dynamics contributed to the collaborative design process.MethodA case study was conducted using several data sources.ResultsSD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care.ConclusionSD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.
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| 40. |
- Fundak, A, et al.
(författare)
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Dental Hygiene Debate
- 2006
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Ingår i: Europerio 5. - Madrid.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 41. |
- Hovan, AJ, et al.
(författare)
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A systematic review of dysgeusia induced by cancer therapies
- 2010
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 18:8, s. 1081-1087
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The purpose was to review relevant scientific papers written since 1989 which focused on the prevalence and management of dysgeusia as an oral side effect of cancer treatment.Methods. Our literature search was limited to English language papers published between 1990 and 2008. A total of 30 papers were reviewed; the results of 26 of these papers were included in the present systematic review. A structured assessment form was used by two reviewers for each paper. Studies were weighted as to the quality of the study design, and treatment recommendations were based on the relative strength of each paper.Results. A wide range in reported prevalence of dysgeusia was identified with the weighted prevalence from 56–76%, depending on the type of cancer treatment. Attempts to prevent dysgeusia through the prophylactic use of zinc sulfate or amifostine have been of limited benefit. Nutritional counseling may be helpful to some patients in minimizing the symptoms of dysgeusia.
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| 42. |
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| 43. |
- Jönsson, Birgitta, et al.
(författare)
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An individually tailored treatment programme for improved oral hygiene : introduction of a new course of action in health education for patients with periodontitis
- 2009
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Ingår i: International Journal of Dental Hygiene. - Oxford : Wiley. - 1601-5029 .- 1601-5037. ; 7:3, s. 166-175
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis.Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse.Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period.Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.
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| 44. |
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| 45. |
- Jönsson, Birgitta, 1962-
(författare)
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Behavioural Medicine Perspectives for Change and Prediction of Oral Hygiene Behaviour : Development and Evaluation of an Individually Tailored Oral Health Educational Program
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour. Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status. Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour. These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment.
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| 46. |
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| 47. |
- Jönsson, Birgitta, et al.
(författare)
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Cost-effectiveness of an individually tailored oral health educational programme based on cognitive behavioural strategies in non-surgical periodontal treatment
- 2012
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 39:7, s. 659-665
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this cost-effectiveness analysis (CEA), performed from a societal perspective, was to compare costs and consequences of an individually tailored oral health educational programme (ITOHEP) based on cognitive behavioural strategies integrated in non-surgical periodontal treatment compared with a standard treatment programme (ST).Material and Methods: A randomized (n = 113), evaluator-blinded, controlled trial, with two different active treatments, was analysed with respect to their costs and consequences 12 months after non-surgical treatment. Costs referred to both treatment costs and costs contributed by the patient. Consequences (outcome) were expressed as the proportion of individuals classified as having reached the pre-set criteria for treatment success after non-surgical treatment (successful-NSPT).Results: More individuals in the ITOHEP group reached the pre-set criteria for treatment success than individuals in the ST group did. The CEA revealed an incremental cost-effectiveness of SEK1724 [191.09; pound SEK9.02 = 1 pound (January 2007)] per successful-NSPT case, of which treatment costs represented SEK1189 (131.82) pound, using the unit cost for a dental hygienist.Conclusion: The incremental costs per successful-NSPT case can be considered as low and strengthens the suggestion that an ITOHEP integrated into non-surgical periodontal treatment is preferable to a standardized education programme.
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| 48. |
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| 49. |
- Jönsson, Birgitta, et al.
(författare)
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Evaluation of an individually tailored oral health educational programme on periodontal health
- 2010
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Ingår i: Journal of Clinical Periodontology. - : Blackwell. - 0303-6979 .- 1600-051X. ; 37:10, s. 912-919
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate an individually tailored oral health educational programme (ITOHEP) on periodontal health compared with a standard oral health educational programme. A further aim was to evaluate whether both interventions had a clinically significant effect on non-surgical periodontal treatment at 12-month follow-up. Material and Method: A randomized, evaluator-blinded, controlled trial with 113 subjects (60 females and 53 males) randomly allocated into two different active treatments was used. ITOHEP was based on cognitive behavioural principles and motivational interviewing. The control condition was standard oral hygiene education (ST). The effect on bleeding on probing (BoP), periodontal pocket depth, "pocket closure" i.e. percentage of periodontal pocket >4 mm before treatment that were <5 mm after treatment, oral hygiene [plaque indices (PlI)], and participants' global rating of oral health was evaluated. Preset criteria for PlI, BoP, and "pocket closure" were used to describe clinically significant non-surgical periodontal treatment success. Results: The ITOHEP group had lower BoP scores 12-month post-treatment (95% confidence interval: 5-15, p<0.001) than the ST group. No difference between the two groups was observed for "pocket closure" and reduction of periodontal pocket depth. More individuals in the ITOHEP group reached a level of treatment success. Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success. Conclusions: ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment.
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| 50. |
- Jönsson, Birgitta, et al.
(författare)
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Evaluation of the effect of nonsurgical periodontal treatment on oral health-related quality of life : estimation of minimal important differences 1 year after treatment
- 2014
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 41:3, s. 275-282
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate an individually tailored oral health educational programme on patient-reported outcome compared with a standard oral health educational programme, assess change over time and determine minimal important differences (MID) in change scores for two different oral health related quality of life (OHRQoL) instrument after non-surgical periodontal treatment (NSPT).Materials and Methods: In a randomized controlled trial evaluating two educational programmes, patients (n=87) with chronic periodontitis completed a questionnaire at baseline and after 12months. OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI) and the UK oral health-related quality-of-life measure (OHQoL-UK). In addition, patients' global rating of oral health and socio-demographic variables were recorded. The MID was estimated with anchor-based and distributions-based methods.Results: There were no differences between the two educational groups. The OHRQoL was significantly improved after treatment. The MID was approximately five for OHQoL-UK with a moderate ES, and three for GOHAI with a Small ES, and 46-50% of the patients showed improvements beyond the MID.Conclusion: Both oral health educational groups reported higher scores in OHRQoL after NSPT resulting in more positive well-being (OHQoL-UK) and less frequent oral problems (GOHAI). OHQoL-UK gave a greater effect size and mean change scores but both instruments were associated with the participants' self-rated change in oral health. The changes were meaningful for the patients supported by the estimated MID.
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