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Johansson, Gunvi
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Johansson, G. (2015). On Oral Health-Related Quality of Life in Swedish Young Adults. (Doctoral dissertation). Göteborg: Förlag Göteborgs Universitet
Open this publication in new window or tab >>On Oral Health-Related Quality of Life in Swedish Young Adults
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Munhälsorelaterad livskvalitet hos unga vuxna
Abstract [en]

Young adults in Sweden have grown up with dental care free of charge until the age of twenty. Their self-perceived oral health has been reported as being good, but rapid changes in society have led to a weaker economic situation for many young adults, which may influence their dental attendance and priorities concerning oral health and oral health care. The overall aim of this thesis was to explore the views of young adults on dental care, oral health and Oral Health-Related Quality of Life (OHRQoL).

The thesis is based on four scientific papers which all apply a qualitative approach. In Paper I, the views of young adults on dental care were explored. Paper II investigated the views of young adults on their oral health and OHRQoL. In Paper III, measures of OHRQoL were described and analysed from a public health perspective, and in Paper IV, the views of young adults on the relevance of three measures of OHRQoL were explored. In Paper I, II, and IV, data collection was performed through qualitative interviews. The selection of informants was strategic with reference to age (21-29 years), sex and education. For Paper III, a literature search for OHRQoL measures was made in the PubMed database. The data in Paper I was analysed in accordance with the constant comparative method (inspired by Grounded Theory), and in Papers II, III and IV, qualitative content analysis was used.

The results showed that young adults were satisfied with the dental care that they had received but reported specific views and demands on dental care (Paper I). They perceived their oral health as good, but an array of oral health problems was described (Paper II). The young adults’ perceived control of their OHRQoL depended on their future prospects of oral health, in relation to their perceptions of their past and present oral health. In Paper III, the search for measures of OHRQoL in the PubMed database generated 22 measures. The measures were analysed with regard to their theoretical framework and in relation to four principles of health promotion. Some elements of public health principles were found in all the measures, but most of them originated in disease-oriented theories. The occurrence of oral problems was reflected in young adults’ views on the measures of OHRQoL (Paper IV). The analysed measures were deemed to have both advantages and disadvantages but to be fairly equal.

The conclusions are that young adults’ OHRQoL was dependent on their earlier experiences of dental care and their former and present oral health, as well as their future prospects regarding oral health. Elements of public health principles were present to a varying degree in all the measures of OHRQoL. Young adults regarded the frequently used measures of OHRQoL as being equal. The measures were mainly disease-oriented and no specific measures had been developed for young adults.

Abstract [sv]

Unga vuxna i Sverige har vuxit upp med fri tandvård till och med det år de fyller 19 år och de upplever ofta en god munhälsa. Snabba samhällsförändringar har bl a medfört sämre ekonomi för många unga och detta kan ha påverkat deras tandvårdsbesök och deras prioriteringar vad gäller tandvård. Det övergripande syftet med avhandlingen var att utforska unga vuxnas syn på tandvården, deras munhälsa och munhälsorelaterade livskvalitet (OHRQoL).

Avhandlingen baseras på fyra studier. I Studie I undersöktes unga vuxnas syn på tandvården. Studie II undersökte och beskrev unga vuxnas syn på sin munhälsa och OHRQoL. I Studie III beskrevs och analyserades mätinstrument för OHRQoL ur ett folkhälsoperspektiv och i Studie IV beskrevs hur unga vuxna ser på tre mätinstrument för OHRQoL. I Studie I, Studie II och Studie IV samlades data in genom kvalitativa intervjuer. Urvalet var strategiskt i förhållande till ålder (21-29 år), kön (hälften kvinnor) och utbildning (gymnasienivå/mer). De flesta deltagarna i studierna besökte tandvården regelbundet. I Studie III gjordes sökningar i databasen PubMed för att finna mätinstrument för OHRQoL. 

Data i Studie I analyserades genom komparativ metod som är inspirerad av ”Grounded Theory”. I Studie II, Studie III och Studie IV genomfördes dataanalysen med kvalitativ innehållsanalys.

Resultaten visade att unga vuxna var nöjda med den tandvård de erhållit men att de hade speciella önskemål och krav på denna (Studie I). Unga vuxna beskrev sin munhälsa som god men angav trots det en mängd olika munhälsoproblem. Deras upplevda kontroll över sin OHRQoL var relaterad till deras syn på sin framtida munhälsa i relation till tidigare erfarenheter av tandvården och synen på sin egen munhälsa (Studie II).

I Studie III genererade datasökningen 22 mätinstrument för OHRQoL. Mätinstrumenten analyserades utifrån deras teoretiska utgångspunkter och i relation till fyra principer för folkhälsoarbete (empowerment, medinflytande, holism, rättvisa). Aspekter av de fyra principerna återfanns i varierande grad hos alla mätinstrumenten varav de flesta hade sin utgångspunkt i sjukdomsinriktade teorier. I Studie IV framkom att de unga vuxnas upplevelse av sin egen munhälsa hade betydelse för deras syn på de tre undersökta mätinstrumenten för OHRQoL. Alla mätinstrumenten ansågs ha för- och nackdelar men bedömdes som ungefär likvärdiga.

Konklusionen är att unga vuxnas OHRQoL är beroende av deras tidigare erfarenheter från tandvården och deras tidigare och nuvarande munhälsa samt i deras syn på sin framtida munhälsa. Principer för folkhälsoarbete uppfylldes i varierande grad i analyserade mätinstrument för OHRQoL och unga vuxna ansåg att mätinstrumenten var ungefär likvärdiga. Mätinstrumenten var i huvudsak sjukdomsinriktade. Det saknas ett speciellt instrument för att mäta unga vuxnas munhälsorelaterade livskvalitet.

Place, publisher, year, edition, pages
Göteborg: Förlag Göteborgs Universitet, 2015. p. 44
Keywords
measures, oral health, quality of life, young adults
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hh:diva-28363 (URN)978-916289315-6 (ISBN)
Public defence
2015-03-27, Hörsal Arvid Carlsson, Sahlgrenska Akademin, Medicinargatan 3, Göteborg, 13:00 (Swedish)
Opponent
Supervisors
Note

Odontologie doktorsexamen i ämnet odontologisk vetenskap

Available from: 2015-06-08 Created: 2015-06-01 Last updated: 2018-03-22Bibliographically approved
Johansson, G. & Östberg, A.-L. (2015). Oral health-related quality of life in Swedish young adults. International Journal of Qualitative Studies on Health and Well-being, 10, Article ID 27125.
Open this publication in new window or tab >>Oral health-related quality of life in Swedish young adults
2015 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 27125Article in journal (Refereed) Published
Abstract [en]

The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21-29 years, were interviewed. The findings from the interviews were summarized under the theme "Young adults reflected on their OHRQoL in a time perspective" consisting of three categories: "Past experiences, Present situation, and Future prospects." The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up. © 2015 G. Johansson & A.-L. Östberg.

Place, publisher, year, edition, pages
Järfälla: Co-Action Publishing, 2015
Keywords
oral health, quality of life, young adults
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hh:diva-28796 (URN)10.3402/qhw.v10.27125 (DOI)000356439100001 ()26066517 (PubMedID)2-s2.0-84935009449 (Scopus ID)
Available from: 2015-06-24 Created: 2015-06-24 Last updated: 2018-03-22Bibliographically approved
Johansson, G., Söderfeldt, B. & Östberg, A.-L. (2015). Young adults' views on the relevance of three measures for oral health-related quality of life. International Journal of Dental Hygiene, 13(3), 184-191
Open this publication in new window or tab >>Young adults' views on the relevance of three measures for oral health-related quality of life
2015 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 3, p. 184-191Article in journal (Refereed) Published
Abstract [en]

Objective

The aim of this study was to explore the views of young adults on the relevance of three measures of oral health-related quality of life (OHRQoL).

Methods

Sixteen young adults aged 21–29 years were interviewed. The selection was strategic with reference to age (21–25 years.; 26–30 years), sex and education (university degree; upper secondary school). The interview guide covered areas on the content and construction of the measures: The Oral Health Impact Profile (OHIP), the Oral Impacts on Daily Performances (OIDP) and the Oral Health-Related Quality of Life UK (OHRQoL-UK). The data were analysed using qualitative content analysis.

Results

A theme expressing the latent content was formulated during the data analysis: ‘young adults' own experiences were reflected in their views on the OHRQoL measures’; that is, the experiences of young adults of own oral problems and aspects that were found to be especially important for their age group influenced their view on the measures. The self-reported ability to understand and answer the questions varied and the perceived advantages and disadvantages were almost equally distributed among the three measures.

Conclusions

The OHIP, OIDP and OHRQoL-UK were evaluated as being equal by the young adults in this study, with regard both to their pros and cons. The clarity of the measures was regarded as the most important factor, while the length and assessment period were less significant.

© 2014 John Wiley & Sons A/S.

Place, publisher, year, edition, pages
Malden, MA: Wiley-Blackwell, 2015
Keywords
oral health, quality of life, questionnaires, young adult
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hh:diva-27213 (URN)10.1111/idh.12107 (DOI)000357889300006 ()25399740 (PubMedID)2-s2.0-84937024382 (Scopus ID)
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2018-03-22Bibliographically approved
Johansson, G., Söderfeldt, B. & Östberg, A.-L. (2011). Young Swedish adults' views on measures of oral health related quality of life. In: Andrea Salvati (Ed.), Abstract book: European Association of Dental Public Health, 16th annual meeting, Rome, 22-24 September 2011. Paper presented at European Association of Dental Public Health, 16th annual meeting, Rome 22-24 September 2011 (pp. 33). Roma: CIC Edizioni internazionali, 2
Open this publication in new window or tab >>Young Swedish adults' views on measures of oral health related quality of life
2011 (English)In: Abstract book: European Association of Dental Public Health, 16th annual meeting, Rome, 22-24 September 2011 / [ed] Andrea Salvati, Roma: CIC Edizioni internazionali , 2011, Vol. 2, p. 33-Conference paper, Published paper (Refereed)
Abstract [en]

The aim of the study was to describe Swedish young adults’ views on three measures of OHRQOL.

Background: Many measures have been developed to estimate the impact of oral health on quality of life (OHRQOL). However no measure has been especially developed för young adults. This study describes how young adults consider the appropriateness of three available validated and translated measures of OHRQOL.

Methods: The study had a qualitative approach. Sixteen informants (eight woman and eight men) aged 21-29 years were interviewed during 2010-2011 about their views on the Oral Health Impact Profile (OHIP), the Oral Health-Related Quality of Life-UK (OHRQoL-UK) and the Oral Impacts on Daily Performances (OIDP). The sampling of informants was strategic with reference to age (21-25 yrs, 26-29 yrs), education (compulsory school vs more). Two of the measures were sent to the informants two weeks before the day for the interview, and they were asked to fill in and bring them to the interview. The third measure (OIDP) was presented and the informants answered it orally in connection with the interview. Data was collected by thematic, open-ended interviews. The data analysis was performed by manifest and latent content analysis. The study was approved by the Ethics Committee of Lund University, Lund, Sweden (Dnr 209/124).

Results: The informants considered the measures to contain relevant and important aspects concerning the oral health related quality of life in young adults. The questionnaires were not to time-consuming to fill in. Furthermore, the young adults were most concerned about their oral health and especially the aesthetics.

Conclusions: The content in the analysed measures was deemed relevant to the informants but highlighting aspects important to the agegroup would be useful for research and in clinical praxis.

Acknowledgements: The study was supported by Malmö University, Malmö and Halmstad University, Halmstad, Sweden.

Place, publisher, year, edition, pages
Roma: CIC Edizioni internazionali, 2011
Series
Supplement to Annali di Stomatologia, ISSN 0003-4681 ; Suppl. No. 1/2, January-June 2011
National Category
Dentistry
Identifiers
urn:nbn:se:hh:diva-16544 (URN)
Conference
European Association of Dental Public Health, 16th annual meeting, Rome 22-24 September 2011
Available from: 2011-11-08 Created: 2011-11-08 Last updated: 2018-03-22Bibliographically approved
Johansson, G. (2009). Oral health-related quality of life and young adults. (Licentiate dissertation). Malmö: Faculty of Odontology, Malmö University
Open this publication in new window or tab >>Oral health-related quality of life and young adults
2009 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The aims were to describe and analyse measures for oral health-related quality of life (OHRQOL) from a Public Health perspective and to determine young adults' views on dental care. The methods used included one literature review (Paper I) and one empirical study with qualitative design (Paper II). In Paper I, twenty-two measures for oral healthrelated quality of life (OHRQOL) were analysed from a public health perspective as to the mirroring of the health promotion principles empowerment, participation, holism and equity. In Paper II, regular dental attenders in Sweden aged 21-30 were interviewed about their views on dental care. Data from eleven interviews were analysed in accordance with the constant comparative method. The results in Paper I showed, that elements of the public health principles were found in the OHRQOL measures. There were measures developed for different ages but no measures were specifically adapted to young adults. In Paper II, two principal views in young adults’ views on dental care were discerned: patients’ attitudes to dental care costs and attitudes to given functions within dental care. Dental care costs, as well as the patients’ views on the treatment, however not expressed to the dental staff, were deemed important. Young adults were found to have specific views and demands on received dental care that was not mirrored in the instruments. An urgent task would therefore be to explore young adults’needs and expectations regarding their OHRQOL and dental care.

Abstract [sv]

Syftet var att ur ett folkhälsoperspektiv beskriva och analysera olika instrument för att mäta livskvalitet som är relaterad till oral hälsa (OHRQOL) och att undersöka unga vuxnas syn på tandvården. Metoderna som användes var en litteraturstudie (Arbete I) och en empirisk studie med kvalitativ design (Arbete II). Tjugotvå mätinstrument för oral hälsorelaterad livskvalitet (OHRQOL) analyserades ur ett folkhälsoperspektiv för att bedöma huruvida fyra principer förknippade med folkhälsoarbete återfanns i instrumenten. De fyra principerna var empowerment, deltagande, holism och jämlikhet. I Arbete II intervjuades unga vuxna i åldern 21- 30 år, som gjorde regelbundna tandvårdsbesök, om sin syn på tandvården. Data från 11 intervjuer analyserades i enlighet med komparativ metod. Resultatet i Arbete I visade att det fanns inslag av de fyra principerna för folkhälsoarbete i mätinstrumenten för OHRQOL. Det fanns mätinstrument för olika åldrar men inga mätinstrument var specifikt anpassade till unga vuxna. I Arbete II framkom två olika principiella synsätt i de unga vuxnas syn på tandvården: patientens syn på tandvårdskostnader och patientens förhållningssätt till beskrivna funktioner inom tandvården. Tandvårdskostnaderna såväl som synpunkter på behandlingen, som de dock inte framförde till tandvårdspersonalen, bedömdes vara viktiga. Unga vuxna tycks ha specifika synpunkter och krav på tandvården som inte speglas i de analyserade mätinstrumenten för OHRQOL. En angelägen uppgift skulle därför vara att undersöka unga vuxnas behov och förväntningar vad gäller oral hälsorelaterad livskvalitet och tandvård.

Place, publisher, year, edition, pages
Malmö: Faculty of Odontology, Malmö University, 2009. p. 68
Series
Malmö University odontological dissertations, ISSN 1650-6065
National Category
Dentistry
Identifiers
urn:nbn:se:hh:diva-3202 (URN)91-7104-307-1 (ISBN)
Presentation
Odontologiska Fakulteten, Malmö Högskola, Carl Gustafs väg 36, Malmö (Swedish)
Opponent
Supervisors
Available from: 2009-11-04 Created: 2009-11-02 Last updated: 2018-03-23Bibliographically approved
Johansson, G., Söderfeldt, B., Wärnberg Gerdin, E., Halling, A., Axtelius, B. & Ostberg, A.-L. (2008). Measuring oral health from a public health perspective. Swedish Dental Journal, 32(3), 125-137
Open this publication in new window or tab >>Measuring oral health from a public health perspective
Show others...
2008 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 3, p. 125-137Article in journal (Refereed) Published
Abstract [en]

The paper aims to analyse measures of oral health-related quality of life (OHQOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health.

Place, publisher, year, edition, pages
Stockholm: Swedish Dental Journal, 2008
Keywords
oral health-related quality of life, OHQOL
National Category
Dentistry
Identifiers
urn:nbn:se:hh:diva-2921 (URN)000260200100003 ()18973083 (PubMedID)2-s2.0-53949107176 (Scopus ID)2082/3323 (Local ID)2082/3323 (Archive number)2082/3323 (OAI)
Available from: 2009-09-04 Created: 2009-09-04 Last updated: 2018-03-23Bibliographically approved
Johansson, G. & Fridlund, B. (1996). Young adults' views on dental care: a qualitative analysis. Scandinavian Journal of Caring Sciences, 10(4), 197-204
Open this publication in new window or tab >>Young adults' views on dental care: a qualitative analysis
1996 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 10, no 4, p. 197-204Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to determine young adults' views on dental care. The gathered data were gleaned from interviews and analysed in accordance with comparative method. It was possible to discern the views from two perspectives: the patients' opinions regarding costs in relation to given functions within dental care, and the attitudes to given functions in dental care per se. Costs for information and service were deemed questionable, whereas the costs for examination and treatment were accepted. The patients' stance was active with respect to information and treatment, whereas a greater degree of passivity prevailed within the areas of examination and service. According to this report, maintaining cheap dental care rates was deemed important. The patients questioned having to pay for information perceived as irrelevant to dental care. They expressed a hidden wish to assume an active role while being given more information, and to exercise greater influence with reference to own dental care, but were not in the habit of stating their views to dental staff. Thus, continuous patient satisfaction studies are vital in order to meet this group's needs. One suggestion for further research is to study how young adults regard dental care based on the theory presented.

Place, publisher, year, edition, pages
Blackwell Publishing, 1996
Keywords
adults, comparative, method, dental care, patient satisfaction, quality of care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-2922 (URN)A1996WE98200002 ()9060773 (PubMedID)2-s2.0-0030450176 (Scopus ID)2082/3324 (Local ID)2082/3324 (Archive number)2082/3324 (OAI)
Available from: 2009-09-04 Created: 2009-09-04 Last updated: 2018-03-23Bibliographically approved
Johansson, G. & Östberg, A.-L.Oral health-related quality of life in Swedish young adults.
Open this publication in new window or tab >>Oral health-related quality of life in Swedish young adults
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The living conditions of young adults in Sweden have changed during the last decades, due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe and explore the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21 to 29 years, were interviewed. The findings from the interviews were summarized under the theme “The perceived control of OHRQOL of young adults is dependent on their future prospects of oral health, in relation to their perceptions of past and present own oral health,” consisting of three categories: Past experience, Present situation and Future prospects. The OHRQoL of young adults is dependent on their experiences of own oral health during childhood and their received dental care, but also on their present self-perceived oral health, oral health habits and social life together with their expectations of future oral health. The findings in the study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up.

National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hh:diva-28362 (URN)
Available from: 2015-06-01 Created: 2015-06-01 Last updated: 2018-03-22Bibliographically approved
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