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  • 1.
    Andersson, Elisabet
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jönsson, Helena
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskans förmåga att uppmärksamma och åtgärda malnutrition hos äldre2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    It is the nurse’s responsibility to observe, prevent and treat malnutrition. The reform of geriatric care, where the responsibility for the elderly residents has been moved from county council into municipality, has implied that access to nurses in Home Care Service is deficient in proportion to the amount of residents. This matter together with poor knowledge in nutrition among the nursing care staff, accompanied by high burden of care, have led to deficiencies in nutritional care, which can remain for a long time before revealed. The aim of the literature study was to examine the nurse’s ability to discover and treat malnutrition in elderly Home Care residents. A literature study based on 20 scientific articles was made. The nutritional knowledge among nurses and members of nursing care staff is generally low, only a small amount of the nursing care staff had knowledge in nutritional screening methods and even fewer used screening methods in practice. The individual requirement of energy for the elderly in the studies was in most of the cases not met, but increased energy intake through energy enriched food or supplement drinks, had a positive effect to counteract malnutrition. Further research in Swedish conditions, where the knowledge among the nursing care staff ought to be inventoried, is highly relevant for further development of the Home Care Services.

  • 2.
    Ashfaq, Awais
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Predicting clinical outcomes via machine learning on electronic health records2019Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The rising complexity in healthcare, exacerbated by an ageing population, results in ineffective decision-making leading to detrimental effects on care quality and escalates care costs. Consequently, there is a need for smart decision support systems that can empower clinician's to make better informed care decisions. Decisions, which are not only based on general clinical knowledge and personal experience, but also rest on personalised and precise insights about future patient outcomes. A promising approach is to leverage the ongoing digitization of healthcare that generates unprecedented amounts of clinical data stored in Electronic Health Records (EHRs) and couple it with modern Machine Learning (ML) toolset for clinical decision support, and simultaneously, expand the evidence base of medicine. As promising as it sounds, assimilating complete clinical data that provides a rich perspective of the patient's health state comes with a multitude of data-science challenges that impede efficient learning of ML models. This thesis primarily focuses on learning comprehensive patient representations from EHRs. The key challenges of heterogeneity and temporality in EHR data are addressed using human-derived features appended to contextual embeddings of clinical concepts and Long-Short-Term-Memory networks, respectively. The developed models are empirically evaluated in the context of predicting adverse clinical outcomes such as mortality or hospital readmissions. We also present evidence that, surprisingly, different ML models primarily designed for non-EHR analysis (like language processing and time-series prediction) can be combined and adapted into a single framework to efficiently represent EHR data and predict patient outcomes.

  • 3.
    Ashfaq, Awais
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Lönn, Stefan
    Research and Development, Region Halland, Sweden.
    Nilsson, Håkan
    Economic Department, Region Halland, Sweden.
    Eriksson, Jonny
    Halland Hospital, Region Halland, Sweden.
    Kwatra, Japneet
    Brigham and Women’s Hospital, US.
    Yasin, Zayed
    Brigham and Women’s Hospital, US.
    Slutzman, Jonathan
    Massachusetts General Hospital, US.
    Wallenfeldt, Thomas
    CGI Group Inc. Consultants to Government and Industries, Sweden.
    Obermeyer, Ziad
    School of Public Health, University of California at Berkeley, US.
    Anderson, Philip
    Department of Emergency Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, US..
    Lingman, Markus
    Halland Hospital, Region Halland, Sweden.
    Data Profile: Regional Healthcare Information Platform in Halland, Sweden2019In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685Article in journal (Refereed)
    Abstract [en]

    Accurate and comprehensive healthcare data coupled with modern analytical tools can play a vital role in enabling care providers to make better-informed decisions, leading to effective and cost-efficient care delivery. This paper describes a novel strategic healthcare analysis and research platform that encapsulates 360-degree pseudo-anonymized data covering clinical, operational capacity and financial data on over 500,000 patients treated since 2009 across all care delivery units in the county of Halland, Sweden. The over-arching goal is to develop a comprehensive healthcare data infrastructure that captures complete care processes at individual, organizational and population levels. These longitudinal linked healthcare data are a valuable tool for research in a broad range of areas including health economy and process development using real world evidence.

    Key messages

    Structured and standardized variables have been linked from different regional healthcare sources into a research information platform including all healthcare visits in the county of Halland in Sweden, from 2009 to date.

    Since 2015, the regional information platform integrates a cost component to each healthcare visit: thus being able to quantify patient level value, safety and cost efficiency across the continuum of care.

  • 4.
    Ashfaq, Awais
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research. Halland Hospital, Region Halland, Sweden.
    Pinheiro Sant'Anna, Anita
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Lingman, Markus
    Halland Hospital, Region Halland, Sweden & Institute of Medicine, Dept. of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nowaczyk, Sławomir
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Readmission prediction using deep learning on electronic health records2019In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 97, article id 103256Article in journal (Refereed)
    Abstract [en]

    Unscheduled 30-day readmissions are a hallmark of Congestive Heart Failure (CHF) patients that pose significant health risks and escalate care cost. In order to reduce readmissions and curb the cost of care, it is important to initiate targeted intervention programs for patients at risk of readmission. This requires identifying high-risk patients at the time of discharge from hospital. Here, using real data from over 7,500 CHF patients hospitalized between 2012 and 2016 in Sweden, we built and tested a deep learning framework to predict 30-day unscheduled readmission. We present a cost-sensitive formulation of Long Short-Term Memory (LSTM) neural network using expert features and contextual embedding of clinical concepts. This study targets key elements of an Electronic Health Record (EHR) driven prediction model in a single framework: using both expert and machine derived features, incorporating sequential patterns and addressing the class imbalance problem. We show that the model with all key elements achieves a higher discrimination ability (AUC 0.77) compared to the rest. Additionally, we present a simple financial analysis to estimate annual savings if targeted interventions are offered to high risk patients. © 2019 The Authors

  • 5.
    Backman, Linn
    et al.
    Halmstad University, School of Health and Welfare.
    Kleveland, Therese
    Halmstad University, School of Health and Welfare.
    Wetterlöv, Malin
    Halmstad University, School of Health and Welfare.
    Jag älskar mitt jobb men...: Aspekter i sjuksköterskors arbetsmiljö som påverkar omvårdnadskvalitén2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    By findingoutwhich aspectsofnurseworkenvironmentthatmayaffect the qualityofcarenursescanhavegreateropportunity to design their ideal work situation and ultimatelyprovide the best possiblecare. The aimofthisstudywas to investigateaspectsofnurses' workenvironmentthataffectcarequality. The result is based on 20 scientificarticles: bothqualitative and quantitative design. The results show thatifnursesexperience a goodworkingenvironmentthisimprovesnurses' and patients' assessmentofcarequality. Workload has a criticalimpact on the qualityofcare. Nursesareforced to set prioritiesdue to timeconstraints and a heavyworkload, thisnegativelyaffects patients and results in increasedcosts ofcare. Being part of a well-functioning team withgoodcommunicationimprovesnurses' jobsatisfaction. A leadershouldtakenurses' opinions seriously and ensureenoughqualifiedstaff. Salary, careeropportunities, skillsdevelopment, and nurse representation at decision-makinglevelsareseen as importantaspects to raise the profession's status and jobsatisfaction. Implication for further research on the subjectcould be interventional studies thatattempt to improve the revealedaspectsof the workenvironment. Decision-makers, patients and their relatives understandingof the qualityofcarerelated to nurses' workenvironmentare alsoneeded to clearlydescribe the subject.

  • 6.
    Billsten, Johan
    et al.
    Department of Psychology, Linnaeus University, Sweden.
    Fridell, Mats
    Department of Psychology, Lund University, Sweden.
    Holmberg, Robert
    Department of Psychology, Lund University, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study2018In: Journal of Substance Abuse Treatment, ISSN 0740-5472, E-ISSN 1873-6483, Vol. 84, p. 9-16Article in journal (Refereed)
    Abstract [en]

    Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. Aim The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. Design and recruitment The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Statistics Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. Results A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α = 0.67 to α = 0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α = 0.64), institutional resources (α = 0.52), staff attributes (α = 0.76), and organizational climate (α = 0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n = 614), Profile 2 (n = 934), and Profile 1 (n = 246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile. Conclusion In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users. © 2017

  • 7.
    Bjurling-Sjöberg, Petronella
    et al.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Sect Caring Sci, Uppsala, Sweden.;Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden..
    Jansson, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wadensten, Barbro
    Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Engström, Gabriella
    Florida Atlantic Univ, Christine E Lynn Coll Nursing, Boca Raton, FL 33431 USA..
    Pöder, Ulrika
    Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey2014In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 20, no 1, p. 48-57Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectivesTo identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. MethodsA descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. ResultsCPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. ConclusionsProgress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed.

  • 8.
    Brantmark, Anna
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Karlsson, Rebecca
    Halmstad University, School of Social and Health Sciences (HOS).
    Föräldrars påverkan i utvecklingen av övervikt och fetma hos barn2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Overweight and obesity in children are serious conditions, with many negative consequences to the health of individuals and the health care system as a whole. The prevalence is particularly great in certain groups of people and the frequency of these conditions is increasing at an alarming rate. Parents, as the primary caregivers, play a vital role in determining whether or not their children lead a healthy lifestyle. The aim of this literature review was to establish the influence that parents have on the development of overweight and obesity in their children. 19 articles were systematically reviewed and the results showed three main areas of influence; socio-economic factors, factors within the family and the role of the parent. In each of these areas, risk factors of developing overweight and obesity in children were identified. In general, parents lack information about these conditions and are in need of support from nurses and other health care professionals, who in turn carry the responsibility to support the parents, promote good health and prevent disease.

  • 9.
    Chrisén, Mia
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Holm, Sofia
    Halmstad University, School of Social and Health Sciences (HOS).
    Faktorer som har betydelse för telefonsjuksköterskans triage och rådgivning2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sjukvårdsrådgivningen via telefon är väl förankrat hos Sveriges befolkning då det varje år rings många samtal dit. Avsaknaden av visuell kontakt och den begränsade tillgången till problemet gör att triage och rådgivning försvåras. Telefonsjuksköterskan kan inte ta del av den icke verbala kommunikationen såsom exempelvis ansiktsuttryck, kroppshållning eller sjukdomstecken på kroppen. Syftet med denna litteraturstudie var att belysa faktorer som har betydelse för telefonsjuksköterskans triage och rådgivning i kontakt med den vårdsökande. I litteraturstudien som grund för resultatet har metoden varit att granska fjorton artiklar med kvalitativ ansats ur ett sjuksköterskeperspektiv. Resultatet visar att telefonsjuksköterskans triage och rådgivning påverkas av olika faktorer som är relaterade till den vårdsökande, telefonsjuksköterskans egna färdigheter och erfarenheter samt faktorer relaterade till organisation. Samtalen som telefonsjuksköterskorna tar emot är varierande till innehåll. Detta ställer krav på telefonsjuksköterskans professionella kompetens. Tidigare klinisk erfarenhet, bred kunskap och en god kommunikativ förmåga är viktiga egenskaper för telefonsjuksköterskan. Omvårdnadssituationen är komplex och för att kompensera för detta använder hon sig av olika strategier. Organisatoriska faktorer som påverkar triage och rådgivning via telefon är tillgången till beslutsstöd och tillgängligheten i vården. Framtida forskning som belyser hur telefonsjuksköterskan kan hantera stress och konfliktsituationer kan underlätta för telefonsjuksköterskan i hennes utsatta arbetssituation. Specialistutbildning till telefonsjuksköterska skulle göra vården säkrare för uppringaren men även förbereda telefonsjuksköterskan inför hennes yrkesroll.

  • 10.
    Claesson, Hanna
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Sidorson, Maria
    Halmstad University, School of Social and Health Sciences (HOS).
    Äldres syn på förutsättningar för att bibehålla välbefinnandet efter pensioneringen: En kvalitativ studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The health of the elderly has improved during the last years, and they have at the same time become more physical active. The aim of the study was to describe the seniors’ views on prerequisites in order to maintain their well-being after retirement. The study was carried out using a qualitive method through semistructured interviews of informants in the age range of 63-84 years. The interviews showed the importance of at least one close friend in order to promote well-being. Interaction between friends and family was another important aspect. Also, maintaining the physical ability counted as important as walking in the nature was a significant aspect of well-being. It also appeared to be of great importance to continue having an active life after reirement. Several of the informants were engaged at no profit to create added value. Avaliability was of a major importance in making the choice of activity, but the informants were to a great deal satisfied by the supply. The study can be used as a foundation for further research in the area of activities, communities and active life among elderly. An important aspect would be to illuminate how people who does not engage in organisationed activities view their well-being and the reason to why they do not participate

     

  • 11.
    Cregård, Anna
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Inter-occupational cooperation and boundary work in the hospital setting2018In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 32, no 5, p. 658-673Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to add a little piece to the research on boundary work and inter-occupational cooperation by addressing two questions: how do actors perform boundary work in an inter-occupational cooperation project that seeks to improve the personnel health work in a hospital setting? What impact does the boundary work have on such cooperation in the personnel health project?

    Design/methodology/approach: The study is based on individual, in-depth interviews and participative observations of focus group discussions conducted at a regional municipal organization in Sweden. Respondents are hospital line managers, experts and strategists in the HR departments, and experts from the internal occupational health service.

    Findings: The concepts on boundary work, which include closing/opening boundary strategies, provide the framework for the empirical illustrations. The cooperation runs smoothly in the rehabilitation work because of an agreed upon process in which the professionals’ jurisdictions are preserved through closing strategies. Illness prevention and health promotion are not areas of inter-occupational cooperation because the stronger actors use closing strategies. While the weaker actors, who try to cooperate, use opening boundary strategies in these areas, they are excluded or marginalized.

    Research limitations/implications: The empirical investigation concerns one cooperation project and was completed at one data collection point.

    Originality/value: No similar study of boundary work and inter-occupational cooperation in a hospital setting is available despite the frequency of this professional group configuration in practice. A more inclusive concept of professionalism may facilitate the study of boundary work and inter-occupational cooperation among actors with different professional authority. © Emerald Publishing Limited 2018

  • 12.
    Eliasson, Sofia
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Larsson, Emelie
    Halmstad University, School of Social and Health Sciences (HOS).
    Olne, Karin
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskans möte med etiska situationer och problem2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In everyday health care the nurse is constantly confronted with situations presenting ethical issues. A developed personal ethical ability and a good knowledge of one´s own and others´ values is an important part in dealing with such situations. To be able to meet ethical issues the vulnerability of one´s own and of the patients´ must also be noticed and reflected upon. The vulnerability can be seen as an asset, but can also be experienced as a strain which leads to emotional stress. Because of this strain it is important to identify the situations that nurses experience as ethical complicated along with describing the experience of these situations. The aim of this study was to describe the nurse´s experience of ethical situations and issues in nursing practice. The study was conducted as a literature review where 18 research articles were processed and analyzed. The results showed that the nurse is compelled by a desire to do what is best for the patient. When this desire cannot be followed, ethical situations and issues arise. Nurses experienced understaffing, lack of competence and unethical behavior among colleagues as factors leading to ethical situations and issues. Despite a consciousness of what is right and wrong in certain situations, the nurse was limited by different factors in providing quality care with the patient in focus. Reflection of ethical issues and further research on how the nurse uses and applies ethical theories, principles and guidelines in the daily nursing practice, are all needed, in increasing ethical awareness. Awareness, in turn, leads to a “platform of courage” in confronting ethical issues.

  • 13.
    Emilson, C.
    et al.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Åsenlöf, Pernilla
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Pettersson, Susanne
    Division of Physiotherapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden & Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult, Oskarström, Sweden & Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sandborgh, Maria
    School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Martin, Cathrin
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Demmelmaier, Ingrid
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Physical therapists’ assessments, analyses and use of behavior change techniques in initial consultations on musculoskeletal pain: direct observations in primary health care2016In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, article id 316Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Behavioral medicine (BM) treatment is recommended to be implemented for pain management in physical therapy. Its implementation requires physical therapists (PTs), who are skilled at performing functional behavioral analyses based on physical, psychological and behavioral assessments. The purpose of the current study was to explore and describe PTs' assessments, analyses and their use of behavioral change techniques (BCTs) in initial consultations with patients who seek primary health care due to musculoskeletal pain.

    METHODS: A descriptive and explorative research design was applied, using data from video recordings of 12 primary health care PTs. A deductive analysis was performed, based on a specific protocol with definitions of PTs' assessment of physical and psychological prognostic factors (red and yellow flags, respectively), analysis of the clinical problem, and use of BCTs. An additional inductive analysis was performed to identify and describe the variation in the PTs' clinical practice.

    RESULTS: Red and yellow flags were assessed in a majority of the cases. Analyses were mainly based on biomedical assessments and none of the PTs performed functional behavioral analyses. All of the PTs used BCTs, mainly instruction and information, to facilitate physical activity and improved posture. The four most clinically relevant cases were selected to illustrate the variation in the PTs' clinical practice. The results are based on 12 experienced primary health care PTs in Sweden, limiting the generalizability to similar populations and settings.

    CONCLUSION: Red and yellow flags were assessed by PTs in the current study, but their interpretation and integration of the findings in analyses and treatment were incomplete, indicating a need of further strategies to implement behavioral medicine in Swedish primary health care physical therapy. © 2016 The Author(s).

  • 14.
    Engdahl, Birgitta
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Laidler Roslund, Birgitta
    Halmstad University, School of Social and Health Sciences (HOS).
    Höftskydd som prevention2014Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Falls is a major patient safety and socio- economic concern. In Sweden approximately 18 000 persons every year suffer a hip fracture which causes the person major suffering and cost forthe society. The aim of this literature study was to describe the outcome of using hipprotectors as prevention. A literature overview was carried out were twelve scientific articleswere the basis of the result. The result is presented in three categories: effect of hip protectors, compliance to the use of hip protectors and the experiences of hip protectors. The risk of contacting a hip fracture is reducing if the fall occurs when using hip protectors. Compliance to the use of hip protector decreases over time. The result showed that patient and staff both agreed that a large reason for not using hip protectors is that they are uncomfortable. Through education nurses need to increase their awareness about the effect of hip protectors and thereby decrease the amount of hip fractures. Further research to increase compliance and to make the hip protector more comfortable would be desirable to reduce the amount of hip fractures. This will not only reduce suffering for those who contract a hip fracture but also reduce society´s major cost for the care and rehabilitation of a hip fracture.

  • 15.
    Folkhammar Andersson, Siv
    et al.
    Kalmar County Council, Oskarshamn, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Welin Henriksson, Elisabet
    Karolinska Institutet, Huddinge, Sweden & Linköping University, Linköping, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Lund University, Lund, Sweden.
    Arthritis management in primary care – a study of physiotherapists’ current practice, educational needs, and adherence to national guidelines2017In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 15, no 3, p. 333-340Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: With an increasing number of patients with osteoarthritis (OA) and rheumatoid arthritis (RA) in primary care, our aim was to investigate arthritis-related practice in physiotherapy and to study adherence to evidence-based care.

    METHODS: Seventy physiotherapists (PTs) working in primary care were emailed a questionnaire to investigate current practice and the number of roles assumed by PTs, the degree of confidence, educational needs and adherence to national guidelines in managing patients with OA or RA. Interventions supported by national guidelines were compared with reports of treatment modalities in the questionnaire.

    RESULTS: Sixty-four (91%) PTs responded, and they reported a higher degree of confidence in assessment, treatment and education of patients with OA than for those with RA (p < 0.001). The total number of roles assumed by the PTs was higher in the management of OA than for RA (p < 0.001). PTs who assumed a greater number of roles also reported a stronger degree of confidence in assessing OA (p = 0.036). Those who assumed fewer roles also reported less confidence in RA treatment (p = 0.045). Recommendations in the guidelines were followed by the majority of PTs for eight of 11 treatment modalities in OA and for six of six in RA.

    CONCLUSIONS: PTs reported a lower degree of confidence and the assumption of fewer roles in managing patients with RA compared with OA. There was good adherence to the national guidelines for almost all the treatment modalities listed. Even so, the results indicate a need for education, especially in chronic inflammatory arthritis care.

    Copyright © 2016 John Wiley & Sons, Ltd.

  • 16.
    Grönevall, Richard
    et al.
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Danilovic, Mike
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL). Shanghai Dianji University, Shanghai, China.
    Designing an integrated project, program and portfolio system: A case study of healthcare2014In: Risk and change management in complex systems: Proceedings of the 16th International DSM Conference, Paris, France, 2-4 July 2014 / [ed] Marija Jankovic, Maik Mauer, Frank Marle, Danilo Marcello Schmidt, Udo Lindemann, München: Carl Hanser Verlag GmbH, 2014, p. 309-318Conference paper (Refereed)
    Abstract [en]

    Healthcare organizations are subject to an increasing complexity in the management of patient information. The modern healthcare system is developed through projects in large scale. The complexity is rapidly increasing and lack of coordination between projects is crucial in relation to performance. The contemporary approach following the traditional project related approach is insufficient and obsolete and the underlying interconnectivity between elements in a multi-project environment can be used to explore new compositions of projects, programs and portfolios. By a systematic approach in managing interdependencies based on exploring the flow of information between projects on three different levels two major outcomes can be concluded. In our systematic DSM/DMM approach we explore how projects can be organized in programs and in portfolios.

  • 17.
    Grönevall, Richard
    et al.
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Danilovic, Mike
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL). Shanghai Dianji University, Shanghai, China.
    Designing an Integrated Project, Program and Portfolio System: A Case Study of Healthcare2014In: Journal of Modern Project Management, ISSN 2317-3963, E-ISSN 1747-0862, Vol. 2, no 2, p. 78-85Article in journal (Refereed)
    Abstract [en]

    Healthcare organizations are subject to an increasing complexity in the management of patient information. The modern healthcare system is developed through large-scale projects. The complexity is rapidly increasing but the lack of coordination between projects in relation to performance is critical. The contemporary approach following the traditional project related approach is insuffi cient and obsolete and the underlying interconnectivity between elements in a multi-project environment can be used to explore new compositions of projects, programs and portfolios. By a systematic approach in managing interdependencies based on exploring the fl ow of information between projects at three different levels and two major outcomes can be concluded. In our systematic DSM/DMM approach we explore how projects can be organized in programs and in portfolios.

  • 18.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Eriksson, I.
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wengström, Y.
    Cancer Theme, Karolinska University Hospital, Stockholm, Sweden.
    Langius-Eklöf, Ann
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Brovall, M.
    School of Health and Education, University of Skövde, Skövde, Sweden.
    Kihlgren, A.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Blomberg, K.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Testing an app for reporting health concerns-Experiences from older people and home care nurses2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12181Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore the experiences of using an app among older people with home-based health care and their nurses. Background: Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Design: Explorative qualitative design. Methods: For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. Results: The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. Conclusions: The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. Implications for practice: The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd

  • 19.
    Göransson, Patrik
    et al.
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL). Hallands Hospital, Halmstad, Sweden.
    Börjesson, Elinore
    Hallands Hospital, Halmstad, Sweden.
    Wahlgren, Birgitta
    Hallands Hospital, Halmstad, Sweden.
    From Vision to Action - Innovation and Implementation of an Integrated Cancer Rehabilitation Within Clinical Practice2013In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, no Suppl. s3, p. 79-79, article id X-5Article in journal (Other academic)
  • 20.
    Hagel, Sofia
    et al.
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Sweden & Skåne University Hospital, Lund, Sweden.
    Petersson, Ingemar F.
    Department of Orthopedics, Lund University, Lund, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Lindqvist, Elisabet
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Sweden and Skåne University Hospital, Lund, Sweden.
    Bergknut, Charlotte
    Department of Orthopedics, Lund University, Lund, Sweden.
    Englund, Martin
    Department of Orthopedics, Lund University, Lund, Sweden.
    Trends in 21st century Health Care Utilization in a Rheumatoid Arthritis Cohort Compared to the General Population2012In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, no S10, p. S31-S32, article id 73Article in journal (Refereed)
    Abstract [en]

    Statement of purpose: To study twenty-first century trends in health care utilization by rheumatoid arthritis (RA) patients compared to the general population. Methods: Observational cohort study; using Swedish health care register data, we identified 3977 Region Skåne residents (mean age year 2001, 62.7 years and 73% women) consulting for RA (ICD-10 codes M05 or M06) in 1998-2001. We randomly sampled two referents from the general population per RA patient matched for age, sex, and area of residence. We calculated the year 2001-2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalizations and outpatient clinic visits. Results: By the end of the 10-year period 62% of RA patients and 74% of referents were still alive and resident in the region. From 2001 to 2010 the ratio (RA cohort/referents) of the mean number of hospitalizations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005), and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy (Figure 1 and 2). Figure 1.Health care utilization during the first decade of the twenty-first century by patients in a closed rheumatoid arthritis cohort and their matched referents from the general population. The y-axes show the mean number of visits per subject per calendar year. Figure 2.Health care utilization during the first decade of the twenty-first century by patients in a closed rheumatoid arthritis cohort and their matched referents from the general population. The y-axes show the mean number of visits per subject per calendar year. Conclusions: During the twenty-first century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, the overall inpatient and outpatient health care utilization by a cohort of RA patients decreased relative to the general population.

  • 21.
    Holmqvist, Gärd
    et al.
    Skaraborg Hospital, Skövde, Sweden & Skaraborg Institute for Research and Development, Skövde, Sweden.
    Lundqvist-Persson, Cristina
    Skaraborg Institute for Research and Development, Skövde, Sweden & Lund University, Lund, Sweden.
    Is there evidence for the use of art therapy in treatment of psychosomatic disorders, eating disorders and crisis?: A comparative study of two different systems for evaluation2012In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 53, no 1, p. 47-53Article in journal (Refereed)
    Abstract [en]

    As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  • 22.
    Hägerholt, Natalie
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Pedersén, Caroline
    Halmstad University, School of Social and Health Sciences (HOS).
    Som att andas genom ett sugrör: Patientens upplevelse av att leva med kroniskt obstruktiv lungsjukdom med fokus på ångestsymtom2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Chronic Obstructive Pulmonary disease is an underdiagnosed disease that today affects more and more individuals. The disease appears mainly with smokers but non-smokers can be affected too. The most occurring symptoms at chronic obstructive pulmonary disease are breathlessness and shortness of breath. The symptoms affect one another and can create a feeling of anxiety. The aim of the study was to illuminate the experience of living with chronic obstructive pulmonary disease with focus on the symptom anxiety. The study was conducted as a literature review containing 13 qualitative and quantitative articles. Difficulties to breathe were described as one of the biggest reasons behind anxiety which affected both the physical and psychological well-being of the patients. The limited airflow and symptoms of anxiety involved a feeling of one being suffocated. The breathing was described as a dreadful situation and the patients compared the condition to breathing through a straw. Many of the patients chose to postpone the contact with medical care thinking that the symptoms would moderate. When the symptoms accelerated medical care yet seemed important for the patients. The study can contribute with meaningful information to the care of patients with chronic obstructive pulmonary disease. The study can also give valuable input to further research studies, especially on patients’ view on health related quality of life related to the symptoms of the disease.

  • 23.
    Johnsson, Elin
    Halmstad University, School of Social and Health Sciences (HOS).
    Motionärers frivilliga och spontana visualiseringsupplevelser2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Exercise is important for our health, but many who start exercise drop out in the near future (Fallon, Hausenblas, & Nigg, 2005). It is therefore important to develop strategies that motivate people to exercise. Imagery has been shown to have a motivating effect on exercisers. Kim and Giacobbi (2009) argue that there is a need to distinguish between content, functions and effects in exercise imagery and that a new instrument therefore is needed. The objectives of this study were therefore to: (1) develop and test the instrument Individual Profile of Imagery Experiences in Exercise (IPIEE; Weibull & Johnsson 2010) and (2) study exercisers’ voluntary and spontaneous imagery experiences. The theoretical frameworks that were used were the Analytic Framework of Imagery Experiences (Weibull, 2009) and An Applied Model of Imagery Use in Exercise (Munroe-Chandler & Gammage, 2005). The result shows that IPIEE worked well, that voluntary imagery was mostly used to increase motivation and the most spontaneous imagery patterns had an effect on motivation. The most common contents were Exercise situations followed by Non-exercise related events/situations. The results are discussed in relation to theoretical frameworks and previous research.

  • 24.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Supporting positive dimensions of health, challenges in mental health care2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 2, p. 7126-Article in journal (Refereed)
    Abstract [en]

    This paper will explore two contrasting paradigms in mental health care and their relationship to evidence-based practice. The biomedical perspective of pathogenesis and the health perspective of salotogenesis are two major diverse views in mental health care. Positive dimensions of health are traditionally viewed as software not suitable for statistical analysis, while absence of symptoms of disease are regarded as measurable and suitable for statistical analysis and appropriate as a foundation of evidence-based practice. If the main goal of mental health care is to enhance subjectively experienced health among patients, it will not be sufficient to evaluate absence of symptoms of disease as a measure of quality of care. The discussion focuses on the paradox of evidence-based absence of illness and disease versus subjectively experienced health and well-being as criterions of quality of care in mental health care.

  • 25.
    Järpe, Eric
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Visit to care center Angeles Cobo Lopez, Alcaudete, Andalucia, Spain: A secondment within the REMIND project2019Report (Other (popular science, discussion, etc.))
  • 26.
    Karlsson, Ann-Kristin
    et al.
    Hosp Varberg, Dept Internal Med, Varberg, Sweden..
    Lidell, Evy
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Johansson, Mats
    Vastra Vall, Dept Gen Med, Varberg, Sweden..
    Health-care professionals' documentation of wellbeing in patients following open heart surgery: a content analysis of medical records2013In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 1, p. 112-120Article in journal (Refereed)
    Abstract [en]

    Aim To explore health-care professionals' documentation of patient wellbeing in the first five months after open heart surgery. Background Open heart surgery (coronary artery bypass grafting or heart valve replacement) is an intervention aimed at relief of symptoms and increased wellbeing. It is a complex procedure with deep experiences encompassing physiological, psychological and social aspects. Health-care professionals' documentation of expressions of decreased wellbeing related to open heart surgery is an important basis for decisions and for the understanding of patients' overall health situation. Method Eighty medical records were examined by means of qualitative and quantitative methods in order to explore documentation of patient wellbeing at four points in time. The analysis was performed by content analysis and descriptive statistics. Results Documentation of physical wellbeing was dominant on all occasions, while psychological wellbeing was moderately well documented and social aspects of wellbeing were rarely documented. Conclusion The medical records did not adequately reflect the complexity of undergoing open heart surgery. Hence the holistic approach was not confirmed in health-care professionals' documentation. Implications for nursing management Managers need to support and work for a patient-centred approach in cardiac care, resulting in patient documentation that reflects patient wellbeing as a whole.

  • 27.
    Kristén, Lars
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Luleå University of Technology, Luleå, Sweden.
    Patriksson, Göran
    Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities2003In: European Physical Education Review, ISSN 1356-336X, E-ISSN 1741-2749, Vol. 9, no 1, p. 23-41Article in journal (Refereed)
    Abstract [en]

    Parents of children and adolescents with physical disabilities have an important role in strengthening and supporting their children in everyday life. Children and adolescents with physical disabilities do not ordinarily have natural access to club activities, nor do they receive the same support for physical activities as their peers without disabilities. The aim of this Swedish study was to describe parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities. The data were collected from 20 parents of children and adolescents with disabilities in the 9-15 year age group through interviews based on a holistic view. The method of analysis used was inspired by phenomenography. Three descriptive categories emerged: achieving good health, being part of a social group and learning a sporting activity. The findings show that the parents regarded sport as a form of health education and as a means for their children to achieve increased participation in society. The findings also show that the learning process was important for empowering the children to influence their life situation.

  • 28.
    Larsson, Anne-Lie
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Brandt, Maria
    Halmstad University, School of Social and Health Sciences (HOS).
    Samverkan mellan sjuksköterskor och läkare i hälso- och sjukvård2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Nursing profession is the oldest traditional female occupation in medical care. The nurse can contribute to a good collaboration by her nursing knowledge and professional competence. The aim of this study was to illuminate factors of meaning between nurse and physician that has impact on collaboration between those professions. The method was a literature study where research was compiled within the topical area and conducted by systematical searches in different databases. The result shows different categories that appeared to be important factors for collaboration between nurses and physicians. Categories shown were traditional hierarchical structures, respect and equality, knowledge, communication and different strategies for improved collaboration. Several nurses experienced that subordination of nurses depended on inequalities that comes from lack of respect and bad knowledge about each others professional occupations. Communication was pointed out as a conclusive factor that contributed to a positive collaboration between the nurse and the physician. Nurses knowledge about informing, planning, organizing, and communicating both in oral and in writing was of importance for developing collaboration between different professions. The foundation for a good relationship between nurse and physician is to be able to communicate and to use different strategies in order to promote collaboration in a positive manner. Nurses have the ability to improve different factors of collaboration between the professions.

  • 29.
    Larsson, Glenn
    et al.
    Department of Ambulance and Prehospital Care, Region Halland, Halmstad, Sweden & Department of Orthopaedics, Lund University, Lund, Sweden.
    Holmén, Anders
    Department of R&D, Region Halland, Halmstad, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Early prehospital assessment of non-urgent patients and outcomes at the appropriate level of care: A prospective exploratory study2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, p. 45-49Article in journal (Refereed)
    Abstract [en]

    Introduction: The Ambulance Organization of Sweden provides qualified medical assessment and treatment by ambulance nurses based on patient needs regarding appropriate levels of care. A new model for patients with non-urgent medical conditions has been introduced. The main objective of this study was to examine early prehospital assessment of non-urgent patients, and its impact on the choice of the appropriate level of care.

    Methods: The study design was a 1-year, prospective study, involving an ambulance district in southwestern Sweden with a population of 78,000. Eligible patients were from18 years of age, assessed as priority GREEN by Rapid Emergency Triage and Treatment System (RETTS). Ambulance nurses contacted primary care physicians on decisions on whether a patient should be transported to a primary healthcare unit or an A&E. Data was collected from electronic health records from April 2014 to July 2015. A comparison was made with a retrospective control group without consulting a physician concerning the appropriate level of care.

    Results: 394 patients were included, 184 in the intervention group, and 210 in the control group. There were statistically significant differences in favor of the study group (p < 0.001) regarding no transport, or transport and admission to an A&E. The groups did not differ significantly regarding transport to a primary care unit.

    Conclusion: This prehospital assessment model indicates a decrease in ambulance transports to an A&E and admissions to a hospital ward. Collaboration between ambulance nurses and primary physicians affects the decision for the appropriate level of care for patients with a non-urgent condition. © 2017 Elsevier Ltd

  • 30.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nurse-led Care and Patients as Partners Are Essential Aspects of the Future of Rheumatology Care2017In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 44, no 6, p. 720-722Article in journal (Refereed)
  • 31.
    Larsson, Ingrid
    et al.
    School of Health Sciences, Jönköping University.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy: a phenomenographic study2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 2, p. 5146-1-5146-10Article in journal (Refereed)
    Abstract [en]

    Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseases experience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Four ways of understanding the patients' experience of their subcutaneous anti-TNF therapy and independence of a nurse emerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achieving independence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In their strive for independence, patients progress by learning about and participating in drug treatment, after which they experience that the injections make them independent.

  • 32.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Perspectives on power relations in human health and well-being2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no Suppl. 2, article id 1358581Article in journal (Refereed)
  • 33.
    Lindström, Ulf
    et al.
    Rheumatology and Inflammation Research, Sahlgrenska Academy, Gothenburg, Sweden.
    Bremander, Ann
    Lund University, Lund, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden.
    Haglund, Emma
    Lund University, Lund, Sweden.
    Petersson, Ingemar F.
    Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Jacobsson, Lennart
    Rheumatology and Inflammation Research, Sahlgrenska Academy, Gothenburg, Sweden.
    Patients with Non-AS Axial SpA Have Similar Prevalence Compared to AS, but Worse Perceived Health. Results from a Population Based Study2013In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, no Suppl. 3, p. A667-A668Article in journal (Refereed)
    Abstract [en]

    Background: Non-radiographic axial spondyloarthritis (SpA) is emerging as a treatable disease comparable to ankylosing spondylitis (AS), but less well studied. Previous studies have described a reversed gender distribution, with AS being more prevalent in the male population and non-radiographic axial SpA more prevalent in the female population. Recent studies have also indicated a similar benefit from treatment with TNF-inhibitors.

    Objectives: The aim of this study was to estimate the prevalence of non-radiographic axial SpA and compare the patient reported outcome measures (PROMS) to that of AS, in Southern Sweden.

    Methods: All health care seeking individuals, ≥18 years, given a SpA-diagnosis, according to the ICD-10 (M45.9, M072, M460, M461, M468, M469, M074, M705 and L405 or M071 or M073), either in primary or specialized care, (N = 5771), during 2003 - 2007, were identified through the regional health care register in Skåne, a county in Southern Sweden with 1.2 million inhabitants (SpAScania cohort). In 2009 they were all sent a questionnaire (response rate; 48%), including questions concerning inflammatory back pain (IBP), the SpA-associated comorbidities constituting the ASAS-criteria (IBD, Ps, Uveitis/tendinitis, heredity), PROMS (BAS-indices, VAS-pain/fatigue/global, EQ5D) and previous/current medication.Non-AS axial SpA was defined as having an ICD10 code supporting a diagnosis of SpA without having one of AS (M45.9), in combination with > 3 months of back pain the last year and the presence of ≥2 of the SpA associated comorbidities. Record review support the notion of using AS as a substitute for radiographic changes. For the “non imaging arm” of the ASAS criteria for axial disease, we used the ICD10 codes above as a substitute for HLA-B27 status. Assuming similar answers from the questionnaire non-responders, prevalence rates were estimated for non-AS axial SpA and AS.

    Results: Among responders 742 had an AS-diagnosis and 640 fulfilled the study criteria for non-AS axial SpA. The frequency of men was 60.5% in the AS group and 29.5% in the non-AS axial SpA group. The prevalence of AS was 0.13% (95% CI; 0.115-0.148) and for non-AS axial SpA 0.11 % (95% CI; 0.096-0.130), with a reverse gender distribution. The means of the PROMs and frequency of comorbidities were higher in the non-AS axial SpA vs both the AS, and the subgroup of AS individuals reporting back pain (BP) > 3months during the last year. Self-reported present use of TNF-inhibitors were similar between the groups (Image 1).

    Conclusions: Prevalence rates for AS and non-AS axial SpA were similar, with a reverse gender distribution. The results suggest that at a population level the proportion with non-AS axial SpA is at least as large as that of AS and report lower levels of perceived health status and similar frequencies of SpA-related comorbidities (except psoriasis) and treatment with TNF-inhibitors, supporting the validity for the used definition in future research.

    Disclosure of Interest: None Declared

  • 34.
    Linge, Lotta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Joy without demands: Hospital clowns in the world of ailing children2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 1Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to achieve, using an affect theory approach (Tomkins, 1962; 1963; 1991), a deeper theoretical understanding of the psychological significance of hospital clowns´work in caring for ailing children viewed from a care-giver perspective. The methodological approach was qualitative and based on 20 interviews with healthcare staff: 3 men and 17 women. The result showed how the staff emphasized a psychological quality of care alongside the physical quality of care. The hospital clowns´"unexpected possibility" provided a safe area for recovery, for both the childrren and the staff. The theoretical interpretation showed the presence of the affects surprise/startle, interest/excitement, and enjoyment/joy, as well as specifically how "joy without demands" often had a lingering effects in the form of vitality. Joy without demands is discussed in relation to psychological theory with emphasis on: a confirmation of the body´s possibilities, a magical attachment, a chance to transcend boundaries, and a non-demanding situation.

  • 35.
    Linge, Lotta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Joyful and serious intentions in the work of hospital clowns: A meta-analysis based on a 7-year research project conducted in three parts2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, article id 18907Article in journal (Refereed)
    Abstract [en]

    The present meta-analysis focuses on a 7-year research project entitled "Hospital clowns-in encounters with ailing children" and funded by the Swedish Childhood Cancer Foundation. The aim of the meta-analysis, which is based on the project's three studies, was to attempt to achieve a deeper psychological and more nuanced understanding of the unique encounters taking place between the hospital clowns and ailing children in the study. The methodological procedures were qualitative and included 51 interviews with four informant groups: the clowns, staff, children, and their parents. The meta-analysis revealed the unique aspects of hospital clowns' work with respect to: a) a quality of care that transcends boundaries, that is, a magical safe area where demands and adjustment were temporarily set aside and where the lighter side of life took precedence; b) a non-demanding quality of care, where joy could be experienced without requiring something in return, where the child's terms mattered and where the child perspective was clearly in focus; and c) a defusing quality of care, which is expressed as a positive counterweight that was otherwise lacking in medical care, where the hospital clowns used different solutions that bypassed regular hospital routines by temporarily distracting and making things easier for the children, parents, and staff in various care situations. Finally, the aim of the theoretical framework, in its synthesizing form, was to promote further psychological understanding of the area of humor that exists between fantasy and reality-an intermediate or transitional area that the hospital clowns created together with the children. In this transitional area, the hospital clowns' unique contribution can be interpreted, in psychological terms, as being available as a vicarious therapeutic clown figure in a magical world that parallels reality.

  • 36.
    Lydell, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Söderbom, Arne
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project2017In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 10, p. 217-225Article in journal (Refereed)
    Abstract [en]

    Background: There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs.

    Objective: The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies.

    Methodology: An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken.

    Results: Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners.

    Conclusion: The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

     

  • 37.
    Malmberg, Claes
    et al.
    Halmstad University, School of Education, Humanities and Social Science, Centrum för lärande, kultur och samhälle (CLKS), Lärande, Profession och Samhällsutveckling.
    Urbas, Anders
    Halmstad University, School of Education, Humanities and Social Science, Centrum för lärande, kultur och samhälle (CLKS), Språk, kultur och samhälle.
    Health education and citizenship - from democratic politics to individual responsibility?2017Conference paper (Refereed)
    Abstract [en]

    According to previous research health is, in contemporary western societies, seen as an increasingly non-political issue. Rather than being at the centre of collective decision-making and democratic politics, health is more and more regarded as resting on individual responsibility. In our study we address the question of health education in schools as well as the question of citizenship. Our study consists of two parts. Firstly, we analyse whether health is portrayed as a political or non-political issue in teaching material, that is, whether health is regarded as a governmental or as an individual issue. Secondly, and informed by the results from our analyse, we dissect and problematize what kind of citizen (citizenship) that is constructed in teaching material. Our empirical data consists of Swedish textbooks for secondary and upper-secondary school in three school subjects’ biology, home economics and physical education and health. Our preliminary results are that the issue of health is quite strictly de-politicized and regarded as the responsibility of the individual, which not only corroborates previous research on health and citizenship. It also reinforces the currently predominant construction of the individual as detached from politics and democracy.

  • 38.
    Moesch, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kenttä, G.
    The Swedish School of Sport and Health Sciences, Box 5626, Stockholm, 11486, Sweden & School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, ON K1N 6N5, Canada.
    Kleinert, J.
    Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, Köln, 50933, Germany & German Research Centre of Elite Sport – Momentum, German Sport University Cologne, Am Sportpark Müngersdorf .
    Quignon-Fleuret, C.
    National Institute of Sport, Expertise and Performance (INSEP), 11 avenue du Tremblay, Paris, 75012, France.
    Cecil, S.
    English Institute of Sport, Ground Floor, 21 Bloomsbury Street, London, Great Britain WC1B 3HF, United Kingdom.
    Bertollo, M.
    FEPSAC Managing Council, Belgium & BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, “G. d'Annunzio” University of Chieti-Pescara, Via dei Vestini 31, Chieti, 66100, Italy & Department of Science and Technology, University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich, IP4 1QJ, United Kingdom.
    FEPSAC position statement: Mental health disorders in elite athletes and models of service provision2018In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 38, no September 2018, p. 61-71Article, review/survey (Refereed)
    Abstract [en]

    Mental health disorders (MHD) in elite athletes is a topic that has received increased attention in recent years. The overall aim of this position statement is to enhance awareness of this important topic and to critically discuss optimal service provision for athletes who suffer from MHD. In the first part of the paper a short overview of the research on MHD in elite athletes is provided. Elite athletes seem to have comparable prevalence rates for the most common MHD when compared to non-athletic peers, but there are still many disorders that have not been investigated in athletes. Sport specific situations such as injuries, periods of overtraining and career termination may put athletes at an increased risk of developing MHD. In the second part of the paper, models of service provision for elite athletes suffering from MHD from six European countries are presented, focusing on 1) professional service providers, 2) support systems, 3) diagnostic assessment, 4) clinical treatment, 5) performance during treatment, 6) screening, and 7) education systems. It emerges that competencies, certification issues, and professional boundaries of the involved service providers, as well as the structure of the National Health Care systems differ strongly across European countries, which makes defining a golden standard difficult. In the third part of this paper, the authors provide general recommendations for athletes and coaches, clubs, federations, organizations and scholars that hopefully will inspire stakeholders to optimize their support systems. © 2018

  • 39.
    Mortenius, Helena
    et al.
    Region Halland, Dept Res & Dev, Halmstad, Sweden. & Univ Gothenburg, Sahlgrenska Acad, Dept Primary Hlth Care, Gothenburg, Sweden..
    Baigi, Amir
    Region Halland, Dept Res & Dev, Halmstad, Sweden. & Univ Gothenburg, Sahlgrenska Acad, Dept Primary Hlth Care, Gothenburg, Sweden..
    Palm, Lars
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Univ Gothenburg, Sahlgrenska Acad, Dept Primary Hlth Care, Gothenburg, Sweden. & Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden..
    Björkelund, Cecilia
    Univ Gothenburg, Sahlgrenska Acad, Dept Primary Hlth Care, Gothenburg, Sweden..
    Hedberg, Berith
    Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden. & Ryhov Hosp, Jonkoping Cty Council, Jonkoping, Sweden..
    Impact of the organisational culture on primary care staff members' intention to engage in research and development2015In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 29, no 2, p. 234-251Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of this paper is to understand how organisational culture influences the intentions of primary care staff members (PCSM) to engage in research and development (R&D).

    Design/methodology/approach

    The participants (n = 30) were PCSM employed in a care centre in south-western Sweden. The study had an observational design with an ethnographic approach. The data were collected by means of observations, interviews and analysis of documents.

    Findings

    The results revealed the perceptions of PCSM in two domains, research and clinical practice, both of which existed at three different cultural levels: visible (structures and policy), semivisible (norms and values) and invisible (taken-for-granted attitudes).

    Research limitations/implications

    It is difficult to conduct a purely objective ethnographic study because the investigation is controlled by its context. However, it is necessary to highlight and discuss the invisible level to improve understanding of negative attitudes and preconceptions related to the implementation of R&D in the clinical setting. Practical implications - By highlighting the invisible level of culture, the management of an organisation has the opportunity to initiate discussion of issues related to concealed norms and values as well as attitudes towards new thinking and change in the primary health context.

    Originality/value

    This paper is one of the very few studies to investigate the influence of organisational culture on the intentions of PCSM to engage in R&D.

  • 40.
    Mortenius, Helena
    et al.
    Hosp Halland, Dept Res & Dev, Cty Council Halland, SE-30185 Halmstad, Sweden..
    Marklund, Bertil
    Hosp Halland, Dept Res & Dev, Cty Council Halland, SE-30185 Halmstad, Sweden..
    Palm, Lars
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Univ Gothenburg, Dept Primary Healthcare, Gothenburg, Sweden.;Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden..
    Baigi, Amir
    Univ Gothenburg, Dept Primary Healthcare, Gothenburg, Sweden..
    The utilization of knowledge of and interest in research and development among primary care staff by means of strategic communication - a staff cohort study2012In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 18, no 4, p. 768-775Article in journal (Refereed)
    Abstract [en]

    Objective

    The obvious gap between evidence and practice in health care is unfavourable for patient care and requires the promotion of a scientific attitude among health care professionals. The aim of the present study was to determine the utilization of knowledge of and interest in research and development among primary care staff by means of a strategic communication process.

    Method

    A cohort consisting of primary care staff (n = 1276) was designed and strategic communication was utilized as a platform over a 7-year period. Quantitative and qualitative methods were taken in account.

    Results

    We found that 97% of the staff had gained knowledge of research and development, 60% of whom remained interested in the subject. The oral communication channel was the most powerful for creating research interest. Organizational culture was a barrier to interest in science.

    Conclusion

    The study demonstrates a significant increase in knowledge and interest among primary care staff as a result of a strategic communication process. Practice implications Strategic communication should lead to a more evenly distributed research commitment among all health care professionals, thus facilitating communication between them and patients in order to clarify, for example, the causes of disease.

  • 41.
    Morténius, Helena
    et al.
    Department of Research and Development, Region Halland, Hospital of Halland, Halmstad, Sweden.
    Marklund, Bertil
    Department of Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Palm, Lars
    Halmstad University, School of Education, Humanities and Social Science, Center for Social Analysis (CESAM), Centre for Studies of Political Science, Communication and Media (CPKM).
    Björkelund, Cecilia
    Research Supervisor and Professor, Department of Primary Health Care, the Sahlgrenska Academy, University of Gothenburg.
    Baigi, Amir
    Department of Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Implementation of innovative attitudes and behaviour in primary health care by means of strategic communication: a 7-year follow-up2012In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 18, no 3, p. 659-665Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives: To bridge the gap between theory and practice, methods are needed that promote a positive attitude to change among health care professionals and facilitate the incorporation of new research findings. In this context, communication plays a significant role. The aim of this study was to analyse primary care staff members' readiness to adopt new ways of thinking and willingness to change their work practices by means of strategic communication.

    Method: An evaluative design was used to study a primary care staff cohort for 7 years. The study population comprised all primary care staff in a region of Sweden (n = 1206). The strategic communication encompassed managerial impact, planning and implementation of reflexive communication processes, in addition to activities in three established communication channels (oral, written and digital). A questionnaire was used, and bivariate and multivariate statistical analyses were performed.

    Results: A total of 846 individuals participated in the evaluation (70%). Strategic communication had a significant effect on staff members' new way of thinking (61%) and willingness to change daily work practices (33%). The communication channels had a significant synergy effect on the adoption of new ideas and willingness to change attitudes. Oral and digital communication had a significant impact on staff members' readiness to change.

    Conclusions: Strategic communication plays an important role in the process of creating innovative attitudes and behaviour among primary care professionals. The willingness to change attitudes enhances primary care staff's readiness to change everyday practices, thus facilitating the implementation of evidence-based care.

  • 42.
    Nielsen, Isabell
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Werner, Hanna
    Halmstad University, School of Social and Health Sciences (HOS).
    Patientens upplevelse av ett cancerbesked2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Every year, over 50 000 individuals in Sweden are diagnosed with cancer. The disclosure of the cancer diagnosis arouses emotions and is often associated with suffering and death. Receiving bad news may lead to changes in life and can also be seen as the beginning of a long and difficult journey. A scientific study based on 15 original articles was carried out with the purpose to identify the patient’s experience of receiving a cancer diagnosis and therefore increase the nurse’s understanding for the patient’s situation and deepen the knowledge of the subject. When examining the articles three themes were identified: information, emotional reactions and psychosocial support. The patient experience that it is important that the information is given in an open and honest manner. Patients also find it important that their emotional reaction is being observed as receiving the diagnosis. As the disclosure of the cancer diagnosis affects the patient’s further perception of the disease the nurse has an important role providing psychosocial support in various situations that may arise in connection with the disclosure. Continued research is needed to compare how guidelines for giving bad news to a patient correspond with the patient’s own experiences and preferences.

  • 43.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Brobeck, Elisabeth
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Couples in Need of Home Care Services: Experiences With Support From Care Professionals2018In: Home Health Care Management & Practice, ISSN 1084-8223, E-ISSN 1552-6739, Vol. 30, no 3, p. 116-121Article in journal (Refereed)
    Abstract [en]

    Many older people desire to remain in their homes and be cared for by a family member, but this arrangement requires support from care professionals. The aim was to describe how couples in need of home care services experienced the received support from care professionals. A qualitative design with content analysis was used. Data were collected through diaries and focus groups consisting of eight couples between 65 and 80 years, and two registered nurses. The main findings are described by the following categories: Organizational adaptedWithholdingBeing in a gap, resulting in the theme Lack of professional support. Couples experienced shortcomings that were related to the organization, the care professionals, and the couples themselves. The theme Lack of professional support requires more knowledge. © The Author(s) 2018

  • 44.
    Olsson, Anneli
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jonsson, Amelie
    Halmstad University, School of Social and Health Sciences (HOS).
    Början på något nytt: Betydelsefulla faktorer för livsstilsförändringar efter hjärtinfarkt2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The numbers of people in Sweden suffering from heart attacks have diminished, while the survival rate among those affected has increased. The reason why heart attacks reduced is partly because we live more healthily. Despite a healthier lifestyle, the major causes of heart attacks today are lifestyle factors that are changeable. During the course of the disease, the patient undergoes a crisis and the difficulty is to find the motivation for long-term lifestyle changes. The purpose of this study was to elucidate factors that may affect patient’s ability to make lifestyle changes after a myocardial infarction. For the study 15 scientific articles were selected. The result revealed four categories: social, physical, cognitive and emotional factors. Social support was showed to be important in connection with lifestyle changes but can also constrain. The other categories also contain factors that impede and facilitate lifestyle changes for the patient. One of the most important findings in the result proved to be the need for individually designed support for the patient. Knowledge of personal risk factors, participation and understanding of their responsibilities increased motivation. Future research on the topic lifestyle changes after myocardial infarction should include behavioral, cardiac rehabilitation, stress and women’s views on the need for lifestyle change.

  • 45.
    Pesämaa, Ossi
    et al.
    Luleå University of Technology, Luleå, Sweden.
    Johansson, Jeaneth
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Näsvall, Pia
    Region Norrbotten, Luleå, Sweden.
    Lack of patient interaction among Swedish medical doctors2018Conference paper (Refereed)
    Abstract [en]

    This paper is an exploratory paper that examines and suggests controls for patient flows in the Swedish medical system. A multi-study critical approach is used to first generate a better understanding of the relationship between the number of patients encountered by doctors and work related exhaustion. A number of theoretical concepts are developed from the interviews. Furthermore, as this area of research contains an abundance of flaws that have not truly been tested, we also tested such flaws by means of a small separate study (Study 2). This study focuses on if administration should absorb all the time of medical doctors. We expected a negative correlation, but found a positive one. Finally, we used constructs from Study 1 (i.e., interviews) to develop and test theoretical constructs. The proposed constructs reported a high validity. A final structural equation modeling approach confirmed that a greater work recognition is negatively correlated with patient performance, but that a high patient performance is also negatively associated with work-related exhaustion. Our results support a study found in another context suggesting that a lack of patient contact may create stress for both medical doctors and patients.

  • 46.
    Petersson, Lena
    et al.
    Lund University, Lund, Sweden.
    Erlingsdóttir, Gudbjörg
    Lund University, Lund, Sweden.
    Open Notes in Swedish Psychiatric Care (Part 1): Survey Among Psychiatric Care Professionals2018In: JMIR Mental Health, E-ISSN 2368-7959, Vol. 5, no 1, article id e11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015. This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice. This is the first of two papers about the implementation of Open Notes in adult psychiatric care in Region Skåne.

    OBJECTIVE: The objective of this study was to describe, compare, and discuss how different HCPs in adult psychiatric care in Region Skåne expect Open Notes to impact their patients and their own practice.

    METHODS: A full population Web-based questionnaire was distributed to psychiatric care professionals in Region Skåne in late 2015. The response rate was 28.86% (871/3017). Analyses show that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between different professionals and attitudes to the Open Notes service.

    RESULTS: The results show that the psychiatric HCPs are generally of the opinion that the service would affect their own practice and their patients negatively. The most striking result was that more than 60% of both doctors (80/132, 60.6%) and psychologists (55/90, 61%) were concerned that they would be less candid in their documentation in the future.

    CONCLUSIONS: Open Notes can increase the transparency between patients and psychiatric HCPs because patients are able to access their EHRs online without delay and thus, can read notes that have not yet been approved by the responsible HCP. This may be one explanation as to why HCPs are concerned that the service will affect both their own work and their patients. © Lena Petersson, Gudbjörg Erlingsdóttir.

  • 47.
    Skärsäter, Ingela
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Keogh, Brian
    School of Nursing and Midwifery, Trinity College, Dublin, Ireland.
    Doyle, Louise
    School of Nursing and Midwifery, Trinity College, Dublin, Ireland.
    Ellilä, Heikki
    University of Applied Science Turku, Turku, Finland.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Lahti, Mari
    School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Institute of Mental Health Building, Triumph Road, Innovation Park, United Kingdom.
    Higgins, Agnes
    Halmstad University, School of Health and Welfare.
    Meade, Oonagh
    School of Psychology, National University of Ireland, Galway, Ireland.
    Sitvast, Jan
    University of Applied Sciences HU, Utrecht, Netherlands.
    Stickley, Theodore
    School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Institute of Mental Health Building, Triumph Road, Innovation Park, United Kingdom.
    Kilkku, Nina
    Tampere University of Applied Sciences, Tampere, Finland.
    Advancing the knowledge, skills and attitudes of mental health nurses working with families and caregivers: A critical review of the literature2018In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 32, p. 138-146Article, review/survey (Refereed)
    Abstract [en]

    Involving and supporting the family members and caregivers of people with mental illness is essential to high-quality mental health services. However, literature suggests that there is a lack of engagement between family members and mental health nurses (MHNs). Lack of knowledge among MHNs is often cited as one of the main reasons for this lack of engagement. The aim of this review was to explore the knowledge, skills and attitudes that are required by MHNs to enable to them to work more effectively with families affected by mental illness. A literature based critical review was used to access and review 35 papers in order to extract concepts that could inform the design of eLearning materials to assist MHNs advance their knowledge in this area. Two overarching themes were identified; ‘Mental health problems and the family’ and ‘Working with the family’. From these themes, the knowledge, skills and attitudes required to work more effectively with families are described. The findings from this review provide a descriptive account of the knowledge skills and attitudes that are required for effective family work. In addition, the review provides an empirical foundation for education programmes in the area. © 2018 Elsevier Ltd

  • 48.
    Skärsäter, Ingela
    et al.
    Sahlgrenska akademin, Göteborg universitet, Göteborg, Sverige.
    Thernlund, Gunilla
    Barn- och ungdomspsykiatriska kliniken, Lund, Sverige.
    Wieselgren, Ing-Marie
    Sveriges Kommuner och Landsting (SKL), Stockholm, Sverige.
    Systematisk litteraturöversikt – Organisation inom psykiatrin med fokus på autismspektrumtillstånd2013In: Autismspektrumtillstånd: Diagnostik och insatser, vårdens organisation och patientens delaktighet – en systematisk litteraturöversikt, Stockholm: Statens Beredning för Medicinsk Utvärdering (SBU) , 2013, p. 281-294Chapter in book (Refereed)
  • 49.
    Staland Nyman, Carin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nilsén, Åke
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Perspectives on health and well-being in social sciences2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 31468Article in journal (Refereed)
  • 50.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    In what direction should we go to promote health in mental health care?2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 2, article id 7118Article in journal (Refereed)
    Abstract [en]

    There is a growing recognition of the need for health promotion interventions in all health care today. In spite of this, health promotion interventions among patients with mental illnesses have been scarce in research, practice, and policies. There is also an ambiguous interpretation of the definition of health promotion in the literature. The emphasis in this paper is thus to (1) discuss why we should pay attention to the interpretations of the concept of health promotion and (2) present a possible model for what nurses do when they intend to promote health in mental health care. This paper was presented at the Nordic Conference of Mental Health Nursing in Helsinki, Finland in 2010.

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