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  • 1.
    Ahonen, Hanna
    et al.
    Jönköping University.
    Broström, Anders
    Jönköping University; University Hospital Linköping.
    Fransson, Eleonor I.
    Jönköping University.
    Neher, Margit
    Jönköping University.
    Lindmark, Ulrika
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Jönköping University.
    "The terrible dryness woke me up, I had some trouble breathing"-Critical situations related to oral health as described by CPAP-treated persons with obstructive sleep apnea2022Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 31, nr 6, artikel-id e13670Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Continuous positive airway pressure is a common and effective treatment for obstructive sleep apnea, but adherence remains an issue. Both obstructive sleep apnea and oral diseases are associated with cardiovascular diseases, and as oral dryness contributes to treatment abandonment, oral health is of importance for this patient group. The aim was therefore to explore how persons with continuous positive airway pressure-treated obstructive sleep apnea experience situations associated with their oral health, and which actions they take to manage these. An explorative and descriptive design was adopted using the critical incident technique. Based on a purposeful selection, 18 adults with long-term experience of continuous positive airway pressure-treatment were interviewed using a semi-structured interview guide. Both negative and positive situations were described. Negative situations consisted of challenges with breathing, including mouth-breathing, choking sensations, problems with night-time and daytime oral dryness, changes in the saliva composition, and deteriorating oral health. Positive situations included experiences of reduced mouth-breathing and oral dryness. The situations were often successfully managed by mimicking daytime movements, changing sleeping position, adjusting the CPAP-device and mask, increasing oral hygiene efforts, drinking water, using a humidifier or chinstrap, or contacting their oral healthcare clinic. Long-term experience of persons with continuous positive airway pressure-treated obstructive sleep apnea regard situations and actions from everyday life. Successful management can contribute to long-term adherence and decrease negative effects on oral health. More interdisciplinary collaborations could enable identification and adequate recommendations for persons who experience negative situations during their continuous positive airway pressure treatment.

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  • 2.
    Akner, John
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Medborgares inställning till vård vianätet: En studie om upplevelser av digital vård2021Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Digitala hälsotjänster har de senaste åren ökat i popularitet bland svenska medborgare. Dessa tjänster kan användas som komplement till traditionella fysiska vårdcentraler för att bli undersökt av en läkare, sjuksköterska med flera. Under de första månaderna under Covid-19 pandemin kan digitala hälsotjänster ha blivit ännu mer populära på grund av att de erbjuder ett kontaktlöst (smittofritt) sätt att få medicinska råd. Den här studien, genomförd maj 2020, undersöker hur aktiva svenska medborgare är i användning av digitala hälsotjänster för vård via nätet och deras inställning samt vad som påverkar deras inställning. För att ta reda på detta användes en enkät för att samla in empiri. 166 svar samlades in. Studiens resultat framhäver att ungdomar är mycket mer aktiva användare av digitala hälsotjänster för vård än äldre. Resultatet visar även att medborgare som testat digitalahälsotjänster för vård har en mer positiv inställning till digitala hälsotjänster än medborgare som inte testat digitala hälsotjänster. Detta kan tolkas som att de som har en positiv inställning har det rent generellt gentemot digitalisering av vård, eller som att användares inställning påverkas positivt (i flesta fall) redan efter ett besök. De faktorer som hade störst betydelse för medborgarnas inställning till digitala hälsotjänster för vård var lättillgänglighet, säkerhet och ekonomiska aspekter. En stor andel av respondenterna som inte testat digitala hälsotjänster hade önskat rekommendationer om hälsotjänster från staten eller en statlig hälsotjänst för att de skulle testa tjänsterna.

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  • 3.
    Alkire (nee Nasr), Linda
    et al.
    Texas State Univ, Dept Mkt, San Marcos, TX 78666 USA..
    Mooney, Christine
    Northern Illinois Univ, De Kalb, IL 60115 USA..
    Gur, Furkan A.
    Northern Illinois Univ, De Kalb, IL 60115 USA..
    Kabadayi, Sertan
    Fordham Univ, Gabelli Sch Business, Dept Mkt, New York, NY 10023 USA..
    Renko, Maija
    Depaul Univ, Driehaus Coll Business, Chicago, IL 60604 USA..
    Vink, Josina
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013). Cty Council Varmland, Experio Lab, Karlstad, Sweden.;Oslo Sch Architecture & Design, Oslo, Norway..
    Transformative service research, service design, and social entrepreneurship An interdisciplinary framework advancing wellbeing and social impact2020Ingår i: Journal of Service Management, ISSN 1757-5818, E-ISSN 1757-5826, Vol. 31, nr 1, s. 24-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The purpose of this paper is to provide an interdisciplinary framework bridging service design and social entrepreneurship with transformative service research (TSR) to create greater synergetic effects to advance wellbeing and drive social impact. Design/methodology/approach This research provides an interdisciplinary review and synthesis of literature to establish a basis for a conceptual framework advancing human wellbeing and driving social impact. Findings The overarching framework created incorporates various concepts, methods and tools across the three research domains. At the core of the framework is the ultimate goal of multilevel wellbeing and social impact. The core is subsequently supported by established social entrepreneurship concepts and strategies: prosocial motivation, hybrid identity, social bricolage, entrepreneurial thinking, community engagement, business model design and innovative delivery. The implementation of these concepts could benefit from the methods and tools used in service design, such as: design probes, service blueprints, appreciative inquiry, contextual interviews, actor maps, sustainable business model canvas and service prototyping. Originality/value By bridging literature in TSR, service design and social entrepreneurship, this paper provides service managers with a framework to guide scalable systemic solutions for service organizations interested in advancing human wellbeing and driving social impact.

  • 4.
    Andersson, Henrik
    et al.
    CNRS, UT1C, Toulouse Sch Econ LERNA, F-31015 Toulouse 5, France..
    Hole, Arne Risa
    Univ Sheffield, Sheffield S10 2TN, S Yorkshire, England..
    Svensson, Mikael
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan. Univ Gothenburg, Sahlgrenska Acad, Hlth Metr, Gothenburg, Sweden..
    Valuation of small and multiple health risks: A critical analysis of SP data applied to food and water safety2016Ingår i: Journal of Environmental Economics and Management, ISSN 0095-0696, E-ISSN 1096-0449, Vol. 75, s. 41-53Artikel i tidskrift (Refereegranskat)
  • 5.
    Andersson, Peter
    et al.
    Stockholm University, Sweden.
    Schön, Ulla-Karin
    Stockholm University, Sweden.
    Svedberg, Petra
    Halmstad University, Sweden.
    Grim, Katarina
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013).
    Exploring stakeholder perspectives to facilitate the implementation of shared decision-making in coordinated individual care planning: [Utforskande av stakeholderperspektiv för att stödja implementeringen av delat beslutsfattande i samordnad individuell vårdplanering]2023Ingår i: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article explores conditions for implementing shared decision-making (SDM) in coordinated individual care planning (CIP) with individuals with complex mental health needs. SDM in CIP are described as central, although such user centred collaboration still remains to be realised. Research underlines the need for a changed way of working, where user expertise is valued and a balance of power is promoted. The aim of the present study is to investigate the conditions for implementing SDM in connection with CIP for and with people with mental illness. To better understand the context and conditions that can promote such an implementation, altogether 15 participants were interviewed in three regions in Sweden within the scope of a stakeholder analysis. Both hindering and supporting factors were identified with respect to an implementation process, such as staff turnover, differences in work culture and committed leadership. Further focus should be directed specifically towards professionals working more closely with CIP and towards in-depth analysis of the construct of culture in terms of implementation processes. 

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  • 6. Asmussen, L.
    et al.
    Nyren, Andersson M.
    Kane, Bridget
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    The Experience of Healthcare Workers Following the Implementation of an IT-System in a Home for the Aged2017Ingår i: Irish Journal of Medical Science, ISSN 0021-1265, E-ISSN 1863-4362, Vol. 186, nr Suppl.4, s. S161-S161Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We report on how health personnel at a home for the aged wereaffected by the introduction of an IT-system to help when nursedocumentation of patient activity and condition. The design of ITsystems for documentation by care-givers in healthcare is topicalbecause of the challenges posed by the need for high levels of safety,confidentiality and ethical responsibility. Health care staff work underextreme time-pressure including emergency situations. It is criticallyimportant to have IT-systems that are easy to use: to find informationand make records.This qualitative study utilises observation and interviews to gaindeep understanding. Observation data guide the interviews. Interviewswith nurses (10) and an IT analyst (1) are reported.Lack of time is a contributing factor as to why health personnel donot have a positive attitude to the use of IT documentation systems.Nurses feel that the lack of time does not afford them the opportunityto learn properly about the IT-system, and many of the staff haveworked with paper for over 20 years. It is also seen as a problem thatthere are many steps (clicks) before one can make a note or findinformation. One of the advantages reported with using IT-systems isthat all information is at one site. Everything is safety copied andconfidentiality is easier to secure.Using IT documentation systems facilitates the use of careplansthat are individualized for patient needs, instead treating all patientswith a particular disease, e.g. dementia, in the same way

  • 7.
    Asp, M.
    et al.
    School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Simonsson, B.
    Competence Centre for Health, Region Västmanland, Västerås, Sweden.
    Larm, P.
    School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden; Centre for Clinical Research, Uppsala University, Region Västmanland, Västerås, Sweden.
    Molarius, Anu
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Competence Centre for Health, Region Västmanland, Västerås, Sweden.
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017Ingår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, s. 84-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly. Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 8. Ballangrud, Randi
    et al.
    Husebo, Sissel Eikeland
    Aase, Karina
    Aaberg, Oddveig Reiersdal
    Vifladt, Anne
    Berg, Geir Vegard
    Hall-Lord, Marie Louise
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    "Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach2017Ingår i: BMC Nursing, E-ISSN 1472-6955, Vol. 16, artikel-id 34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Effective teamwork and sufficient communication are critical components essential to patient safety in today's specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel's perception of teamwork in hospitals (Part 1). Further to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2). Methods: To address the aims, a descriptive, and explorative design (Part 1), and a quasi-experimental interventional design will be applied (Part 2). The study will be carried out in five different hospitals (A-E) in three hospital trusts in Norway. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, will be invited to respond to three Norwegian translated teamwork questionnaires (Part 1). An inter-professional teamwork intervention in line with the TeamSTEPPS recommend Model of Change will be implemented in a surgical ward at Hospital C. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) will be invited to to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit will be invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 month. Moreover, anonymous patient registry data from local registers and data from patients' medical records will be collected (Part 2). Discussion: This study will help to understand the impact of an inter-professional teamwork intervention in a surgical ward and contribute to promote healthcare personnel's team competences with an opportunity to achieve changes in work processes and patient safety.

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  • 9.
    Bonander, Carl
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för miljö- och livsvetenskaper (from 2013). Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Centrum för personsäkerhet (from 2013).
    Gustavsson, Johanna
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för miljö- och livsvetenskaper (from 2013). Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Centrum för personsäkerhet (from 2013).
    Nilson, Finn
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för miljö- och livsvetenskaper (from 2013). Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Centrum för personsäkerhet (from 2013).
    Can the provision of a home help service for the elderly population reduce the incidence of fall-related injuries?2016Ingår i: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, nr Suppl.2, s. A181-A181Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Fall-related injuries are a global public health problem, especially in elderly populations. In this study, the effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention, which involves home hazards reduction by providing a minor home help service, is provided in the majority of Swedish municipalities.

    Methods Intention-to-treat effect estimates were derived using quasi-experimental time series intervention (ITS) analysis for immediate effects and a difference-in-discontinuity (RD) design for long term effects, and community-level estimates were pooled using meta-analysis. The outcome measure was the incidence of fall-related hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).

    Results We found no statistically significant reductions in injury incidence in the ITS (IRR 1.01 [95% CI: 0.98–1.05]) or RD (IRR 1.00 [95% CI: 0.97–1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.

    Conclusions It is unclear whether absence of an effect is due to a low efficacy of the home hazards modifications provided, or a result of low utilisation. Additional studies of the effects on other quality of life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help services

  • 10.
    Bonander, Carl
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Centrum för personsäkerhet (from 2013). Karlstad Univ, Ctr Publ Safety, Karlstad, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Hlth Metr Unit, Gothenburg, Sweden..
    Holmberg, Robin
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Centrum för personsäkerhet (from 2013). Karlstad Univ, Ctr Publ Safety, Karlstad, Sweden..
    Estimating the effects of a studded footwear subsidy program on pedestrian falls among older adults in Gothenburg, Sweden2019Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 132, artikel-id UNSP 105282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We study the effects of a studded footwear subsidy program in Gothenburg, Sweden, where a free pair of anti-slip devices was distributed to all residents aged over 65 years as a pedestrian falls prevention measure. Using a difference-in-differences approach with internal age-based controls, we find evidence of a short-term effect on emergency department visits due to slips on snow and ice during the first year of the intervention ( -45% [95% CI: - 54, - 9] in 2013), which equates to 21.8 injuries prevented (95% CI: 3.34, 39.4). A cost-benefit analysis based on this result suggests that the short-term benefits outweigh the total costs of the intervention (benefit-cost ratio: 6.9 [95% CI: 1.05-12.46]), indicating that this type of subsidy program may be an important tool for the prevention of pedestrian falls among older adults during icy weather conditions. However, replication at other sites is recommended before drawing any strong and general conclusions.

  • 11.
    Brodén, Karin
    et al.
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013). Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för tjänsteforskning (from 2013).
    Snyder, Kristen
    Mid Sweden University, Sweden .
    Sörensen, Helle
    Municipality of Oestersund, Sweden .
    Zingmark, Magnus
    Municipality of Oestersund, Sweden .
    Determining Value in Welfare-Technology: The Need for a Multi-Perspective Framework2023Ingår i: International Journal of Health Economics and Policy, ISSN 2578-9295, Vol. 8, nr 4, s. 76-88Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Stakeholders in health and social care are implementing digital solutions to facilitate person-centred care for citizens. One problem is choosing which digital solution to implement. Ordinary cost-benefit analysis implicates the measurable parts of the value, leaving the immeasurable without any trace in an analysis. Results: We used design thinking to design a framework that implicates what to add as valuable factors on individual, organisational, and governmental levels. The design is based on empirical material from workshops and literature reviews on systems thinking, quality management, and value factors. The valuable factors at an individual level could include independence, autonomy, and empowerment, and the factors at the organisational level accessibility, competence, and independence. On a central level, the factors are related to person-centred care and its value proposals, such as autonomy and independence. Conclusions: While conducting a cost-benefit analysis, focusing on a standard definition of the value concept is essential. The designed framework needs to be dynamic due to the broad range of welfare technology. The created rubrics cube model, including strategic, organisational-operational and individual levels, should be used by decision-making groups as a flexible foundation. Forthcoming research will test this framework, including the proposed scale for measurement and focusing on welfare technology for older citizens.

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  • 12.
    Brorström, Björn
    et al.
    Göteborg University School of Public Administration, Sweden.
    Siverbo, Sven
    Göteborg University School of Public Administration, Sweden.
    Deeply rooted traditions and the will to change: Problematic conflicts in three Swedish health care organizations2004Ingår i: Journal of Economic Issues, ISSN 0021-3624, Vol. 38, nr 4, s. 939-952Artikel i tidskrift (Refereegranskat)
  • 13.
    Bruhn, Linnea
    Karlstads universitet.
    Motiverande samtal -En dynamisk process i arbetet med barn och ungdomar med övervikt: - En kvalitativ studie om professionella inom hälso- och sjukvårdens upplevelser av att använda MI tillsammans med överviktiga barn och ungdomar2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Ohälsosamma levnadsvanor så som dålig kost och brist på fysisk aktivitet leder till övervikt och fetma hos barn och ungdomar idag. För att inte de ohälsosamma levnadsvanorna ska ge framtida komplikationer är det viktigt att se till att barn och ungdomar får den hjälp de behöver för att motiveras till en beteendeförändring så tidigt som möjligt. Motiverande samtal (MI) är en samtalsmetod för att få individer motiverade till en förändring. Denna studie kommer att fokusera på just hälsosamma levnadsvanor. Olika hälso- och sjukvårds professioners använder motiverande samtal som metod för att stödja en beteendeförändring hos överviktiga ungdomar. Därutifrån har syftet till denna studie skapats vilket är att undersöka professionernas upplevelser av hur metoden fungerar på barn och ungdomar med övervikt. Studien har en kvalitativ insats som inkluderade intervjuer med sex stycken professioner. Intervjuerna spelades in och analyserades. Resultatet av studien visade att professionerna upplevde MI som en mycket positiv och användbar samtalsmetod och att kontinuitet behövdes för att upprätthålla kunskapen. Möjligheterna med att använda MI menar de professionella är att de ofta kan se en positiv förändring hos patientens beteende samt att de ser positivt på användningen av MI i framtiden. Författaren anser att det är viktigt att fortsätta utbilda personal som jobbar med människor inom MI då samhället troligtvis kan “spara” både pengar och tid hos personalen genom att använda MI i exempelvis primärvården. 

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  • 14.
    Bäccman, Charlotte
    et al.
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för tjänsteforskning (from 2013).
    Bergkvist, Linda
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för tjänsteforskning (from 2013).
    Wästlund, Erik
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för tjänsteforskning (from 2013).
    Personalized Coaching via Texting for Behavior Change to Understand a Healthy Lifestyle Intervention in a Naturalistic Setting: Mixed Methods Study2023Ingår i: JMIR Formative Research, E-ISSN 2561-326X, Vol. 7, artikel-id e47312Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Digital health interventions, such as personalized SMS coaching, are considered affordable and scalable methods to support healthy lifestyle changes. SMS, or texting, is a readily available service to most people in Sweden, and personalizedSMS coaching has shown great promise in supporting behavior changes.

    Objective: This study aims to explore the effectiveness of highly personalized SMS coaching for behavior change according to the Capability, Opportunity, Motivation–Behavior (COM-B) model on a sample of physically inactive adults in a nonprofit fitness organization in Sweden.

    Methods: The study used a mixed methods design in which clients acted as their own controls. The participants were clients(n=28) and fitness consultants (n=12). Three types of data were collected: (1) quantitative data at baseline and after the SMS intervention and the waitlist from the clients, (2) qualitative data from semistructured interviews with the fitness consultants, and(3) pseudonymized texting conversations between the fitness consultants and clients.

    Results: Overall, the results showed that personalized SMS coaching was effective in supporting the clients’ behavior changes. The quantitative analysis showed how the clients’ capabilities (Cohen d=0.50), opportunities (Cohen d=0.43), and relationship with the fitness consultants (Cohen d=0.51) improved during the SMS intervention in comparison with baseline. Furthermore, the qualitative analysis revealed how personalized texts added value to existing work methods (eg, increasing continuity and flexibility) and how the relationship between the clients and fitness consultants changed during the intervention, which helped motivate the clients.

    Conclusions: Personalized SMS coaching is an effective method for supporting healthy behavior changes. The human connection that emerged in this study needs to be further explored to fully understand the effectiveness of a digital health intervention.

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  • 15.
    Bärkås, Annika
    et al.
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Kharko, Anna
    Uppsala University, Sweden; Uppsala University Hospital, Sweden; University of Plymouth, United Kingdom.
    Blease, Charlotte
    Uppsala University, Sweden; Uppsala University Hospital, Sweden; Harvard Medical School, Boston, USA .
    Cajander, Åsa
    Uppsala University, Sweden.
    Johansen Fagerlund, Asbjørn
    University Hospital of North Norway, Norway.
    Huvila, Isto
    Uppsala University, Sweden.
    Johansen, Monika Alise
    University Hospital of North Norway, Norway; Arctic University of Norway, Norway.
    Kane, Bridget
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Kujala, Sari
    Aalto University, Finland.
    Moll, Jonas
    Örebro University, Sweden.
    Rexhepi, Hanife
    University of Skövde, Sweden.
    Scandurra, Isabella
    Örebro University, Sweden.
    Wang, Bo
    University Hospital of North Norway, Norway.
    Hägglund, Maria
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden2023Ingår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, artikel-id e47841Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records. 

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  • 16. Chalmers, J. R.
    et al.
    Thomas, K. S.
    Apfelbacher, C.
    Williams, H. C.
    Prinsen, C. A.
    Spuls, P. I.
    Simpson, E.
    Gerbens, L. A. A.
    Boers, M.
    Barbarot, S.
    Stalder, J. F.
    Abuabara, K.
    Aoki, V.
    Ardeleanu, M.
    Armstrong, J.
    Bang, B.
    Berents, T. L.
    Burton, T.
    Butler, L.
    Chubachi, T.
    Cresswell-Melville, A.
    DeLozier, A.
    Eckert, L.
    Eichenfield, L.
    Flohr, C.
    Futamura, M.
    Gadkari, A.
    Gjerde, E. S.
    van Halewijn, K. F.
    Hawkes, C.
    Howells, L.
    Howie, L.
    Humphreys, R.
    Ishii, H. A.
    Kataoka, Y.
    Katayama, I.
    Kouwenhoven, W.
    Langan, S. M.
    Leshem, Y. A.
    Merhand, S.
    Mina-Osorio, P.
    Murota, H.
    Nakahara, T.
    Nunes, F. P.
    Nygaard, U.
    Nygardas, M.
    Ohya, Y.
    Ono, E.
    Rehbinder, E.
    Rogers, N. K.
    Romeijn, G. L. E.
    Schuttelaar, M. L. A.
    Sears, A. V.
    Simpson, M. A.
    Singh, J. A.
    Srour, J.
    Stuart, B.
    Svensson, A.
    Talmo, G.
    Talmo, H.
    Teixeira, H. D.
    Thyssen, J. P.
    Todd, G.
    Torchet, F.
    Volke, A.
    von Kobyletzki, Laura B.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Karolinska Institutet; Lund University; University Hospital Schleswig-Holstein, Kiel, Germany.
    Weisshaar, E.
    Wollenberg, A.
    Zaniboni, M.
    Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)2018Ingår i: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 178, nr 5, s. E332-E341Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to pre-defined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.

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  • 17.
    Chauca Strand, G.
    et al.
    University of Gothenburg.
    Bonander, C.
    University of Gothenburg.
    Jakobsson, Niklas
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Johansson, N.
    Örebro University.
    Svensson, M.
    University of Florida, United States .
    Assessment of the clinical and cost-effectiveness evidence in the reimbursement decisions of new cancer drugs2022Ingår i: ESMO Open, E-ISSN 2059-7029, Vol. 7, nr 5, artikel-id 100569Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This study aimed to describe the clinical and cost-effectiveness evidence supporting reimbursementdecisions of new cancer drugs and analyze the influence of trial characteristics and the cost per quality-adjusted lifeyears (QALYs) on the likelihood of reimbursement in Sweden.Patients and methods: Data were extracted from all appraisal dossiers for new cancer drugs seeking reimbursement inSweden and claiming added therapeutical value between the years 2010 and 2020. The data were analyzed usingdescriptive statistics, and logistic regression models were also used with the cost per QALY, study design,comparator, and evidence on final outcomes in the clinical trials as predictors of reimbursement.Results: All 60 included appraisals were based on trial evidence that assessed at least one final outcome (overallsurvival [OS] or quality of life [QoL]), although rarely as a primary outcome. Of the appraisals with a final decision(n ¼ 58), 79% were approved for reimbursement. Among the reimbursed drugs, only half had trial evidencedemonstrating improved OS or QoL. Only one drug had trial evidence supporting improvements in both OS andQoL. The average cost per QALY for reimbursed cancer drugs was estimated to be 748 560 SEK (V73 583). A highercost per QALY was found to decrease the likelihood of reimbursement by 9.4% for every 100 000 SEK (V9830)higher cost per QALY (P ¼ 0.03). For cost-effectiveness models without direct evidence of improvements in finaloutcomes, a larger QALY gain was observed compared with those with evidence mainly relying on intermediate andsurrogate outcomes.Conclusions: There are substantial uncertainties in the clinical and cost-effectiveness evidence underlyingreimbursement decisions of new cancer drugs. Decision makers should be cautious of the limited evidence onpatient-centered outcomes and the implications of allocating resources to expensive treatments with uncertainvalue for money.

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  • 18.
    Chauca Strand, Gabriella
    et al.
    University of Gothenburg, Sweden.
    Johansson, Naimi
    University of Gothenburg, Sweden; Örebro University, Sweden.
    Jakobsson, Niklas
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Bonander, Carl
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Centrum för forskning om samhällsrisker, CSR (från 2020). University of Gothenburg, Sweden.
    Svensson, Mikael
    University of Gothenburg, Sweden; University of Florida, USA.
    Cancer Drugs Reimbursed with Limited Evidence on Overall Survival and Quality of Life: Do Follow-Up Studies Confirm Patient Benefits?2023Ingår i: Clinical drug investigation, ISSN 1173-2563, E-ISSN 1179-1918, Vol. 43, nr 8, s. 621-633Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and ObjectiveCancer drug costs have increased considerably within healthcare systems, but many drugs lack quality-of-life (QoL) and overall survival (OS) data at the time of reimbursement approval. This study aimed to review the extent of subsequent literature documenting improvements in OS and QoL for cancer drug indications where no such evidence existed at the time of reimbursement approval.MethodsDrug indications with claims of added therapeutical value but a lack of evidence on OS and QoL that were reimbursed between 2010 and 2020 in Sweden were included for review. Searches were conducted in PubMed and ClinicalTrial.gov for randomized controlled trials examining OS and QoL.ResultsOf the 22 included drug indications, seven were found to have at least one trial with conclusive evidence of improvements in OS or QoL after a mean follow-up of 6.6 years. The remaining 15 drug indications either lacked subsequent randomized controlled trial data on OS or QoL (n = 6) or showed no statistically significant improvements (n = 9). Only one drug demonstrated evidence of improvement in both OS and QoL for its indication.ConclusionsA considerable share of reimbursed cancer drug indications continue to lack evidence of improvement in both OS and QoL. With limited healthcare resources and an increasing cancer burden, third-party payers have strong incentives to require additional post-reimbursement data to confirm any improvements in OS and QoL.

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  • 19.
    Englund, Liselotte
    et al.
    Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT, Avdelningen för medie- och kommunikationsvetenskap. P.
    Michel, Per-Olof
    Researcher and Programme Director at the National Centre for Disaster Psychiatry.
    Riddez, Louis
    Reader and Surgeon at Karolinska University Hospital.
    Örtenwall, Per
    Senior Consultant Surgeon and Chief Emergency Medical Officer for the Västra Götaland region.
    The bomb attack in Oslo and the shootings at Utøya, 2011: Kamedo report 972012Rapport (Övrigt vetenskapligt)
    Abstract [en]

    The Kamedo observer reports study the medical, psychological, organizational and social aspects of disasters. This report summaries experiences from the bomb attack in Oslo and the shootings at Utøya, 2011. That may be valuable for the further development of the Swedish disaster preparedness system.

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    Kamedo_97
  • 20. Eriksson, Andrea
    et al.
    Orvik, Arne
    Strandmark K, Margaretha
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Nordsteien, Anita
    Torp, Steffen
    Management and leadership approaches to health promotion and sustainable workplaces: A scoping review2017Ingår i: Societies, E-ISSN 2075-4698, Vol. 7, nr 2, artikel-id 14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Whole-system approaches linking workplace health promotion to the development of a sustainable working life have been advocated. The aim of this scoping review was to map out if and how whole-system approaches to workplace health promotion with a focus on management, leadership, and economic efficiency have been used in Nordic health promotion research. In addition, we wanted to investigate, in depth, if and how management and/or leadership approaches related to sustainable workplaces are addressed. Eighty-three articles were included in an analysis of the studies' aims and content, research design, and country. For a further in-depth qualitative content analysis we excluded 63 articles in which management and/or leadership were only one of several factors studied. In the in-depth analysis of the 20 remaining studies, four main categories connected to sustainable workplaces emerged: studies including a whole system understanding; studies examining success factors for the implementation of workplace health promotion; studies using sustainability for framing the study; and studies highlighting health risks with an explicit economic focus. Aspects of sustainability were, in most articles, only included for framing the importance of the studies, and only few studies addressed aspects of sustainable workplaces from the perspective of a whole-system approach. Implications from this scoping review are that future Nordic workplace health promotion research needs to integrate health promotion and economic efficiency to a greater extent, in order to contribute to societal effectiveness and sustainability.

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  • 21.
    Finkel, Deborah
    et al.
    Indiana University Southeast, USA.
    Johansson, Linda
    Jönköping University.
    Westerlind, Björn
    Linköping University.
    Lindmark, Ulrika
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Ernsth-Bravell, Marie
    Jönköping University.
    Age and site differences in planned and performed actions in response to identified risks in older adults2022Ingår i: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, nr Supplement_1, s. 840-840Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    The Swedish health care system focuses on allowing older adults to “age in place”; however, that approach assumes that home health services are adequate to support health and prevent unnecessary decline. Data from the Senior Alert national quality register in Sweden were examined to compare the quality of care across care locations. First registration in Senior Alert was available for 2914 adults aged 57–109 (median age = 81): 3.6% dementia unit, 7.8% home health care, 4.4% rehabilitation unit, 62.8% hospital, 21.4% care home. There were significant differences across units in the number of identified risks in 4 categories: falls, malnutrition, oral health, and pressure ulcer. Individuals in rehabilitation units averaged 2.4 risks, individuals in dementia and care homes averaged 2.0 risks, and individuals in home health care and hospitals averaged 1.4 risks. For individuals with identified risks, the differences between planned and performed actions for each risk independently were greatest for those in home health care. Moreover, the correlation between total planned and performed actions in home health care was .79 for adults aged 65–80 years and .39 for adults aged 81 and over. The correlation did not differ across age for the other care units. Results suggest that individuals most in need of actions to address health risks (older adults in home health care) are least likely to have the actions performed. Training and support of workers responsible for home health care need to be improved if the “age in place” policy is to continue.

  • 22.
    Granrud, Marie Dahlen
    et al.
    Inland Norway University of Applied Sciences, Norway.
    Grondahl, Vigdis Abrahamsen
    Østfold University College, Norway.
    Helgesen, Ann Karin
    Østfold University College, Norway.
    Bååth, Carina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Østfold University College, Norway.
    Olsson, Cecilia
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Lovisenberg Diaconal University College, Norway.
    Tillfors, Maria
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013).
    Melin-Johansson, Christina
    Mid Sweden University, Sweden.
    Osterlind, Jane
    Marie Cederschiöld University, Sweden.
    Larsson, Maria
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Hov, Reidun
    Hamar Municipality, Norway.
    Sandsdalen, Tuva
    Inland Norway University of Applied Sciences, Norway.
    Health Care Personnel's Perspectives on Quality of Palliative Care During the COVID-19 Pandemic - A Cross-Sectional2023Ingår i: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 16, s. 2893-2903Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The provision of high-quality palliative care is challenging, especially during a pandemic like COVID-19. The latter entailed major consequences for health care systems and health care personnel (HCP) in both specialist and community health care services, in Norway and worldwide. The aim of this study was to explore how the HCP perceived the quality of palliative care in nursing homes, medical care units, and intensive care units during the COVID-19 pandemic. Methods: This study had a cross-sectional design. A total of 290 HCP from Norway participated in the study (RR = 25.8%) between October and December 2021. The questionnaire comprised items concerning respondents' demographics and quality of care, the latter measured by the short form of the Quality from the Patient's Perspective-Palliative Care instrument, adapted for HCP. The STROBE checklist was used. Results: This study shows that the HCP scored subjective importance as higher in all dimensions, items and single items than their perception of the actual care received. This could indicate a need for improvement in all areas. Information about medication, opportunity to participate in decisions about medical and nursing care and continuity regarding receiving help from the same physician and nurse are examples of areas for improvement. Conclusion: Study results indicate that HCP from nursing homes, medical care units, and intensive care units perceived that quality of palliative care provided was not in line with what they perceived to be important for the patient. This indicate that it was challenging to provide high-quality palliative care during the COVID-19 pandemic.

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  • 23.
    Grenard, Alain
    Karlstads universitet, Estetisk-filosofiska fakulteten.
    Kan kost Påverka koncentrationsförmågan?: Elevernas hälsa på gymnasiet2007Självständigt arbete på grundnivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats
    Abstract [sv]

    Trötta och okoncentrerade elever på mina lektioner har varit grunden till min frågeställning om kosten eller missbruk av kosten kunde vara anledning till det återkommande beteende hos mina elever, samt riktade misstankar mot godis och läskkonsumtion. Kan kost påverka koncentrationsförmåga hos gymnasieelever?

    Genom en enkät till gymnasieelever från tre olika program, har jag kartlagt elevernas kostvanor i och utanför skolan samt mätt inköpsfrekvensen av olika livsmedel i skolans kafeteria. Vidar går studien ut på att undersöka om elevernas trötthet och svårighet att bibehålla god koncentration dagen igenom kunde härledas utifrån deras kostvanor. Många elever har - särkilt strax före lunch och sista lektionstimmarna på eftermiddagen - tappat koncentrationen, så om dessa elever inte är förberedda med frukt eller vatten, utan bara försöker ”hålla ut”, kan detta leda till sämre prestation. Det är svårt att visa med denna enkät att elevers koncentrationssvårigheter grundar sig i dåliga kostvanor trots att hälften av eleverna anger hunger som orsak till sina koncentrationsproblem. Men genom litteraturen hänvisad i litteraturlistan har det framgått att en generellt sund kosthållning ger bättre koncentrationsmöjligheter

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    FULLTEXT01
  • 24.
    Gustavsson, Anders
    et al.
    I3 Innovus, Stockholm.
    Svensson, Mikael
    Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT, Avdelningen för nationalekonomi och statistik.
    Jacobi, Frank
    Allgulander, Christer
    Alonso, Jordi
    Beghi, Ettore
    Dodel, Richard
    Ekman, Mattias
    Faravelli, Carlo
    Fratiglioni, Laura
    Gannon, Brenda
    Jones, David Hilton
    Jennum, Poul
    Jordanova, Albena
    Jönsson, Linus
    Karampampa, Korinna
    Knapp, Martin
    Kobelt, Gisela
    Kurth, Tobias
    Lieb, Roselind
    Linde, Mattias
    Ljungcrantz, Christina
    Maercker, Andreas
    Melin, Beatrice
    Moscarelli, Massimo
    Musayev, Amir
    Norwood, Fiona
    Preisig, Martin
    Pugliatti, Maura
    Rehm, Juergen
    Salvador-Carulla, Luis
    Schlehofer, Brigitte
    Simon, Roland
    Steinhausen, Hans-Christoph
    Stovner, Lars Jacob
    Vallat, Jean-Michel
    Van den Bergh, Peter
    den Bergh, Peter Van
    van Os, Jim
    Vos, Pieter
    Xu, Weili
    Wittchen, Hans-Ulrich
    Jönsson, Bengt
    Olesen, Jes
    Cost of disorders of the brain in Europe 2010.2011Ingår i: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 21, nr 10, s. 718-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.

    AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.

    METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.

    RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.

    DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.

    RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.

  • 25.
    Gustavsson, Johanna
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    Nilson, Finn
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    Andersson, Ragnar
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    Stötabsorberande golv som fallskadepreventiv åtgärd – resultat efter ett år2012Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    I april 2011 lades ett stötabsorberande golv, framtaget för att förhindra skador vid fall, in på ett särskilt boende i Sunne kommun. Sedan 1 oktober 2011 har data om fallhändelser samlats in för att följa upp effekter av golvet. Det som undersöks är konsekvenser av fall på olika golvunderlag samt om risken att ramla påverkas.

    Under den tid som studien pågått (12 mån) har 21 fall registrerats på det stötabsorberande golvet, ingen har skadats sig allvarligt och en har skadats lindrigt som en följd av dessa fall. På övriga golvytor med fler boende har 156 fall registrerats, varav fem lett till fraktur och 30 till lindrig skada. Resultaten hittills tyder på att golvet kan ha den eftersträvade effekten.

    Det stötabsorberande golvet bidrar också till en dämpad ljudnivå vilket personalen upplever som positivt.

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  • 26.
    Gåård, Anneli
    Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT.
    Möt mig med respekt: En kvalitativ studie om vårdrelationens betydelse ur ett brukarperspektiv2012Självständigt arbete på grundnivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 27.
    Hagström, Josefin
    et al.
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Sweden.
    Blease, Charlotte
    Uppsala University, Sweden; Uppsala University Hospital, Sweden; Harvard Medical School, United States.
    Cajander, Åsa
    Uppsala University, Sweden.
    Rexhepi, Hanife
    University of Skövde, Sweden.
    Moll, Jonas
    Örebro University, Sweden.
    Kane, Bridget
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Scandurra, Isabella
    Örebro University, Sweden.
    Hägglund, Maria
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Security and Privacy of Online Record Access: A Survey of Adolescents’ Views and Experiences in Sweden2024Ingår i: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Ensuring security of online health records and patients’ perceptions of security are concerns in adolescent healthcare. Little is known about adolescents’ perceptions about healthcare’s ability to protect online health records. This article explores adolescents’ perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems. 

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  • 28.
    Hyyppä Bennet, Katarina
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Vad har covid-19 kostat Värmland?: En cost-of-illness studie över hälsorelaterade kostnader till följd av covid-192023Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Covid-19 har efter utbrottet i slutet av 2019 medfört omfattande konsekvenser på såväl ekonomiska som sociala aspekter. Ett stort antal individer har smittats och många har avlidit till följd av viruset, vilket resulterat i kostnader i form av minskad livskvalité, sjukhusvistelse, produktionsbortfall i och med sjukfrånvaro samt förlorade levnadsår. Detta arbete ämnar värdera delar av kostnaderna för covid-19 för hälso- och sjukvården i region Värmland 2020–2021. Analysen utförs genom en cost-of-illness studie (COI) vilket beaktar indirekta och direkta kostnader. Indirekta kostnader från covid-19 som analyseras är förlorad kvalitetsjusterande levnadsår (QALY) till följd av försämrad livskvalité genom sjukdom och förlorad QALY för dödsfall. Samt produktionsbortfall vid frånvaro från arbete. Direkta kostnader är kostnader som överskridit budget för inhyrd personal, material samt vaccination, provtagning och analys samt kostnader för varje enskilt vårdtillfälle. Utöver detta har covid-19 påverkat utbud och efterfrågan på övrig vård, vilket genererat ett uppdämt vårdbehov. Denna studie lyfter det monetära värdet av vårdkö. Studien begränsas till värdet av att invänta planerad åtgärd för två typer av ingrepp, gallstensoperation och höftledsoperation. Därav framkommer i studiens resultat skilda totala kostnader beroende på vilken operation som beaktats. Gallstensoperation representerar minimivärdet som ger en total kostnad på 4 668 miljoner kr varav indirekta kostnader uppgår till 3 452 miljoner kr. Medan höftledsoperation representerar maximivärdet och i sin tur ger en total kostnad på 4 691 miljoner kr där indirekta kostnader uppgår till 3 475 miljoner kr. Slutligen visar resultatet att direkta kostnader till följd av covid-19 uppgår till 1 216 miljoner kr oberoende av vilken åtgärd som patienten väntar på.

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  • 29.
    Hägglund, Maria
    et al.
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Kharko, Anna
    Uppsala University, Sweden; Uppsala University Hospital, Sweden; University of Plymouth, United Kingdom .
    Hagström, Josefin
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Bärkås, Annika
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Blease, Charlotte
    Uppsala University, Sweden; Uppsala University Hospital, Sweden; Harvard Medical School, United States .
    Cajander, Åsa
    Uppsala University, Sweden.
    DesRoches, Catherine
    Harvard Medical School, United States.
    Fagerlund, Asbjørn Johansen
    University Hospital of North Norway, Norway.
    Haage, Barbara
    Tallinn University of Technology, Estonia.
    Huvila, Isto
    Uppsala University, Sweden.
    Hörhammer, Iiris
    Aalto University, Finland.
    Kane, Bridget
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Klein, Gunnar O.
    Uppsala University Hospital, Sweden.
    Kristiansen, Eli
    University Hospital of North Norway, Norway.
    Luks, Kerli
    Tallinn University of Technology, Estonia.
    Moll, Jonas
    Örebro University, Sweden.
    Muli, Irene
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Raphaug, Eline Hovstad
    University Hospital of North Norway, Norway.
    Rexhepi, Hanife
    University of Skövde, Sweden.
    Riggare, Sara
    Uppsala University, Sweden; Uppsala University Hospital, Sweden.
    Ross, Peeter
    Tallinn University of Technology, Estonia.
    Scandurra, Isabella
    Örebro University, Sweden.
    Simola, Saija
    Aalto University, Finland.
    Soone, Hedvig
    Tallinn University of Technology, Estonia.
    Wang, Bo
    University Hospital of North Norway, Norway.
    Ghorbanian Zolbin, Maedeh
    Aalto University, Finland.
    Åhlfeldt, Rose-Mharie
    University of Skövde, Sweden.
    Kujala, Sari
    Aalto University, Finland.
    Johansen, Monika Alise
    University Hospital of North Norway, Norway; Arctic University of Norway, Norway.
    The NORDeHEALTH 2022 Patient Survey: Cross-Sectional Study of National Patient Portal Users in Norway, Sweden, Finland, and Estonia2023Ingår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, artikel-id e47573Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients’ views and preferences. To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH. OBJECTIVE: We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia. METHODS: A cross-sectional web-based survey was distributed using the national online health portals. The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years. The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions. In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics. RESULTS: In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia. National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%). Age distributions were similar across the countries, but Finland had older users while Estonia had younger users. The highest attained education and presence of health care education varied among the national samples. In all 4 countries, patients most commonly rated their health as "fair" (11,279/29,302, 38.48%). In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings. Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%). Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%). Overall, most patients had accessed their health record "2 to 9 times" (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it "more than 20 times" (4571/13,008, 35.14%). CONCLUSIONS: This is the first large-scale international survey to compare patient users’ sociodemographics and experiences with accessing their EHRs. Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed. We will continue to investigate patients’ experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey. 

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  • 30.
    Jakobsson, Niklas
    et al.
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Svensson, Mikael
    Univ Gothenburg, Sahlgrenska Acad, Hlth Metr, S-40530 Gothenburg, Sweden..
    Copayments and physicians visits: A panel data study of Swedish regions 2003-20122016Ingår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 120, nr 9, s. 1095-1099Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This paper analyzes how primary care physician visits are affected by the level of copayment in Sweden. Data source: We use data between the years 2003-2012 from 21 Swedish health care regions that have the mandate to set their own level of copayment. The copayment per visit varies between 10 and 20 for these years and regions. Study design: Our strategy to identify the causal effect and deal with unobserved endogeneity of price changes on physician visits is based on a panel data model using fixed effects to control for region and time and regional-variation in time trends. Principal finding: We cannot reject that the copayment has no statistical or economic effect of significance, and we estimate the "zero effect" with very high precision. Conclusion: In a setting with sub-national regions with autonomy to set copayments the results points to that the copayment is not an important predictor for the number of health care visits. The result is in line with some previous studies on European data where the range of copayments used tends to be relatively low. 

  • 31.
    James, Inger
    et al.
    Örebro universitet.
    Norell Pejner, Margaretha
    Högskolan i Halmstad.
    Kihlgren, Annica
    Örebro universitet.
    Creating conditions for a sense of security during evenings and nights among older persons receiving home health care in ordinary housing: a participatory appreciative action and reflection study2019Ingår i: BMC Geriatrics, E-ISSN 1471-2318, Vol. 19, nr 1, s. 1-12, artikel-id 351Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Today many older persons in ordinary housing receive home health care. It is stipulated that the care is to provide security; however, deficiencies in home health care are reported in many countries. It may be difficult to implement a sense of security among older persons receiving home health care in ordinary housing, especially during the evenings and nights, due to a lack of knowledge.

    Methods: This study is part of a larger project with a participatory appreciative action and reflection (PAAR) approach. We invited older persons, relatives, nurse assistants, registered nurses, and their managers to co-create knowledge with us on how conditions for a sense of security can be created during evenings and nights among older persons receiving home health care in ordinary housing. We performed thematic analysis of the data.

    Results: Five subthemes were developed that gave structure to two main themes. The first main theme, To confirm the self-image, has the following subthemes: To see the home as a reflection of the person’s identity and To maintain self-determination. The second main theme, To create interaction in a sheltered place, has these subthemes: To undress the power, To create control and lifelines, and To create a good sleeping environment. The two themes interact and are each other’s conditions. The person’s self-image must be confirmed in order to create interaction in a sheltered place and through the interaction, the self-image is confirmed.

    Conclusion: Conditions necessary for older persons to have a sense of security are living in a familiar environment, having habits and routines maintained, and having self-determination. Other conditions are equality, the prevention of falls, and an individualized sleeping environment. Older people’s self-determination should be honored, and they should not being excluded from decision-making. We need to ask them if the conditions are sufficient and their sense of security is great enough to allow them to continue living in their ordinary housing. 

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  • 32.
    Johansson, N.
    et al.
    Health Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jakobsson, Niklas
    Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT, Avdelningen för nationalekonomi och statistik. Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013). Norwegian Social Res NOVA, Oslo, Norway.
    Svensson, Mikael
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013). Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT, Avdelningen för nationalekonomi och statistik. Williams Coll, Dept Econ, Williamstown, MA 01267 USA.
    Regional variation in health care utilization in Sweden: The importance of demand-side factors2018Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 18, nr 1, artikel-id 403Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Differences in health care utilization across geographical areas are well documented within several countries. If the variation across areas cannot be explained by differences in medical need, it can be a sign of inefficiency or misallocation of public health care resources. Methods: In this observational, longitudinal panel study we use regional level data covering the 21 Swedish regions (county councils) over 13 years and a random effects model to assess to what degree regional variation in outpatient physician visits is explained by observed demand factors such as health, demography and socio-economic factors. Results: The results show that regional mortality, as a proxy for population health, and demography do not explain regional variation in visits to primary care physicians, but explain about 50% of regional variation in visits to outpatient specialists. Adjusting for socio-economic and basic supply-side factors explains 33% of the regional variation in primary physician visits, but adds nothing to explaining the variation in specialist visits. Conclusion: 50-67% of regional variation remains unexplained by a large number of observable regional characteristics, indicating that omitted and possibly unobserved factors contribute substantially to the regional variation. We conclude that variations in health care utilization across regions is not very well explained by underlying medical need and demand, measured by mortality, demographic and socio-economic factors.

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  • 33.
    Johansson, Naimi
    et al.
    Örebro University, Sweden; University of Gothenburg, Sweden.
    Jakobsson, Niklas
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    Svensson, Mikael
    University of Gothenburg, Sweden; University of Florida, United States.
    Place or patient as the driver of regional variation in healthcare spending – Discrepancies by category of care2024Ingår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 342, artikel-id 116571Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We study how much regional variation in healthcare spending is driven by place- and patient-specific factors using a random sample of 53,620 regional migrants in Sweden. We find notable differences depending on the category of care, with place-specific factors having a significantly larger impact on specialized outpatient care compared to inpatient and pharmaceutical care. The place effect is estimated to 75% of variation in specialized outpatient care, but 26% or less in variations in inpatient care, and 5% in prescription drug spending. We also find that the empirical estimator has a substantial impact on the estimates of the place-specific effect. The results based on the traditional approach in the literature with two-way fixed effects and event-study models produce much larger estimates of the place-specific effect compared to results based on recently developed heterogeneity-robust models. For total healthcare spending, the traditional two-way fixed effects model estimates a place effect of 78%, while the heterogeneity-robust estimator finds a place effect around 10%. This finding indicates that previous results in this literature, all based on traditional two-way fixed-effects regressions, should be interpreted with care. 

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  • 34.
    Johansson, Sabina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013).
    Sjuksköterskors syn på Fysisk aktivitet på Recept (FaR): En studie om inställningen till FaR inom primärvården2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Titel: Fysisk aktivitet på Recept, ur sjuksköterskors synvinkel

    Nyckelord: Behandlingsmetod, FaR, Fysisk aktivitet, Hälsa, Sjuksköterska.

    Bakgrund: Stillasittande, ohälsosamma kostvanor, inaktivitet, alkohol och tobaksmissbruk har

    bidragit till en ökning av kroniska sjukdomar. Dessa sjukdomar kan till stor del minskas genom

    bättre levnadsvanor. Sjuksköterskor är en av de yrkesgrupper inom vården som har störst kontakt

    med patienter och som kan påverka patienter till en ökad hälsa och mindre risk för sjukdom. Det

    finns en behandlingsmetod som bygger på att skriva ut fysisk aktivitet på recept. Den är dock inte

    etablerad och få sjuksköterskor skriver ut denna metod.

    Syfte: Syftet med denna studie är att undersöka åsikter om FaR inom primärvården och

    genom denna information få bättre kunskap om varför det skrivs ut så få FaR

    förskrivningar av sjuksköterskor i Sverige.

    Metod: Kvalitativa intervjuer användes i denna studie. Urvalet riktades till sjuksköterskor

    inom primärvården i Värmland. Sex sjuksköterskor som arbetar inom olika områden inom

    vården intervjuades.

    Resultat: De kategorier som bildades av resultaten var: Inställning till Fysisk aktivitet och

    FaR, Ersättande metoder till FaR, Sjukvårdens inställning, Ekonomiska hinder och

    möjligheter, Information och Kommunikation, Bemötande och motivation och

    Arbetsbelastning. Det fanns en positiv inställning till FaR bland sjuksköterskor. En av de

    huvudsakliga anledningarna till att FaR inte skrevs ut i större mängd beror på att patienter

    inte vill ha fysisk aktivitet utskriven och att de är svårt att motivera dem. Det fanns flera

    förbättringsområden för att öka förskrivningen av FaR.

    Diskussion: Det verkar finnas olikheter i hur sjuksköterskor, annan vårdpersonal och

    samhället ser på vad vården ska arbeta med. I studien ansåg alla intervjuade

    sjuksköterskor att vården bör arbeta förebyggande men de upplever ibland att denna

    mening inte delas. En av slutsatserna från studien är att det behövs mer reklam om FaR

    och att behandlingsmetoden borde användas oftare än det idag gör.

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  • 35.
    Kane, Bridget
    et al.
    University of Dublin, Trinity College, Ireland.
    Groth, Kristina
    Karolinska Univ Hosp, Solna, Sweden.
    Multidisciplinary Work Practices: A Comparison of Three Major European Hospitals2014Ingår i: 2014 IEEE 27th International Symposium on Computer-Based Medical Systems, IEEE, 2014, s. 369-375Konferensbidrag (Refereegranskat)
    Abstract [en]

    This paper reviews the practices of multidisciplinary teamwork (MDT) for cancer care in three large teaching hospitals in separate jurisdictions. Ethnographic observations provide the main source of data, which are verified though interviews, and in some cases by surveys and analysis of video recordings. We demonstrate how MDT practices develop among different groups, and in different jurisdictions. Common practices are identified and differences explained. Work practice analysis is an integral part of our research, and this study provides insights into medical teamwork and decision-making. 

  • 36.
    Kane, Bridget
    et al.
    University of Dublin, Trinity College, Ireland.
    Luz, Saturnino
    Expanding the HCI Agenda in Healthcare2014Ingår i: 2014 IEEE 27th International Symposium on Computer-Based Medical Systems, IEEE, 2014, s. 382-385Konferensbidrag (Refereegranskat)
    Abstract [en]

    Designing technology for use in healthcare, and its evaluation in the healthcare setting, deserves special attention because of the nature of the special context of use. Biological hazards and the risk of infection, issues of privacy and security, system response times, as well as human factors and patient safety are identified as areas deserving of special attention. We give examples and quote from clinician interviews for illustration, and we argue that increased focus from the HCI community on these areas will bring tangible benefits of health information systems to healthcare staff, and ultimately improve patient services. 

  • 37.
    Karsberg, Fleming
    et al.
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Hedlund, Jonas
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Vi bestämmer när på dygnet du använder din smarta telefon!: En undersökning om hur svenska ungdomar som genomför värnplikten upplever att deras tillvaro påverkas av Försvarsmaktens mobilförbud.2022Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Samhällets digitalisering och utbredningen av sociala medier har under de senaste 20 åren ökat. Parallellt har införandet av IT-stöd i skolor och utvecklingen av digitala samhällstjänster skapat ett behov att undersöka om en reglering av användandet krävs. Tidigare forskning har undersökt vilken påverkan mobiltelefoner och dess användning på sociala medier har på människor, framförallt ungdomar. Forskningen har mest varit inriktad på de psykologiska faktorer användandet för med sig. Restriktioner återfinns i skolor och debatten pågår om ett mobilförbud ska införas i skolorna. Det finns mobilförbud kopplat till bilkörning och inom sjukvården är förbudet kopplat till medicinsk utrustning som påverkas av elektriska fält. Försvarsmakten har ett mobilförbud kopplat till värnpliktstjänstgöring men vilken påverkan det har på de ungdomar som rycker in är ett relativt obeforskat område. Syfte: Studiens syfte var att undersöka hur svenska värnpliktiga ungdomar upplever att deras tillvaro påverkas av Försvarsmaktens mobiltelefonförbud.Metod: En kvalitativ metod med induktiv ansats valdes och 16 värnpliktiga indelade i tre fokusgrupper intervjuades. Intervjuerna spelades in och transkriberades, därefter genomfördes en kvalitativ innehållsanalys.Resultat: Analysen av resultatet gav att omställningen från fri tillgång till mobiltelefon till ett mobilförbud upplevdes som jobbig, framförallt den första tiden av värnplikten. Långa dagar, ett högt tempo och att ha lämnat en tillvaro med en trygg kontext upplevdes påtaglig. För många ungdomar innebär värnplikten även resor till andra orter, nya intryck och att lära känna främmande människor i en begränsad och reglerad tillvaro. Det framkom även att efter anpassning till den militära tillvaron med mindre fritid, både kvällar och helger reglerar en del användandet av mobiltelefonen och det förefaller som att en prioritering sker.Slutsats: De två viktigaste slutsatserna är för det första att de värnpliktiga upplever en liten möjlighet att påverka sin tillvaro. Genom att medvetet beakta människans psykologiska grundbehov kan Försvarsmakten troligen skapa bättre förutsättningar för de värnpliktiga under den inledande delen av värnplikten. Det kan möjligen minska deras jobbiga upplevelser. För det andra tenderar kvalitén i kontakten med vänner och anhöriga att öka vilket tyder på ett fokus att vidmakthålla det sociala nätverket som betyder något. En gallring av meningslöst mobilanvändande sker. Möjligen har mobilförbudet framtvingat detta. Tidigare forskning kring rädslan att missa händelser eller att hamna utanför beskriver till del hur denna förändring sker och den inverkan det får.

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  • 38.
    Kastberg, Gustaf
    et al.
    Department of Service Management, Lund University.
    Siverbo, Sven
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013).
    The design and use of management accounting systems in process oriented health care: an explorative study2013Ingår i: Financial Accountability and Management, ISSN 0267-4424, E-ISSN 1468-0408, Vol. 29, nr 3, s. 246-270Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Process orientation has made its entrance in Health Care Organizations (HCOs). The purpose is to improve patients’ journeys through the health care system. One factor that potentially affects process orientation is the design and use of Management Accounting Systems (MAS). In the literature there are worries that process orientation often is not supported by a well designed and used MAS but, on the contrary, is counteracted by a MAS designed for other purposes than supporting processes. This study contributes to the existing knowledge in that it shows how the introduction of process orientation within health care is accompanied by the development of horizontally oriented MAS (HMAS) which is used in different ways and by different actors. Generally, the use of HMAS for diagnostic control is limited. The main use of HMAS is for the purpose of mastering the events and interactive control, and the main users are the persons connected to the processes. The observation in earlier research that the existence of vertically oriented MAS may be a threat to process orientation is to some extent corroborated in the paper.

  • 39.
    Larsson, Kristina
    Karlstads universitet.
    Motivation till livsstilsförändring: En kvantitativ studie om motivation till livsstilsförändring via gruppverksamhet2007Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats
    Abstract [en]

    Länsförsäkringar in Värmland, Sweden, had during the year 2003 a total level of 6.1 percent of people on the sick-list, which was higher than average in the business (4,5%) and for salaried employees in the private sector (3,3%). The average age of those put on sick-list was 47 years, whish is four years higher than the average for the whole LF-group. The cost for the total amount of people being on sick-list at LF-company (6,1%) was estimated to 1 500 kkr, according to a calculation model coming from Försäkringskassan. For every percent the sick level could be reduced, the company would save 239 kkr. To map out the state of health of each and every collaborator in LF, the company offered all employees to make a health profile at the company's health service, Clarahälsan AB. This health control was accomplished during May 2004 to August 2004, and almost every employee participated (99%). The purpose of this study was to find out if the stress and lifestyle handling course at Clarahälsan AB, which was offered those considered in need for it after the health control,could influence the motivation of the participants to change lifestyle in order to prevent long time sick leave. A quantitative method was used to evaluate goals for life style changes after accomplishment of the course by quastionnaire. Three women and six men participated in the study. The result shows that six out of seven (two drop-outs) had been influenced in a positive way towards a chang in lifestyle including exercise, stress management, sleep and work situation. All seven had a postive change considering food habits.

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  • 40.
    Leonardsen, Ann-Chatrin Linqvist
    et al.
    Ostfold University College, Norway; Ostfold Hospital Trust, Norway.
    Bååth, Carina
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013). Ostfold University College, Norway.
    Helgesen, Ann Karin
    Ostfold University College, Norway.
    Grøndahl, Vigdis Abrahamsen
    Ostfold University College, Norway.
    Hardeland, Camilla
    Ostfold University College, Norway.
    Person-Centeredness in Digital Primary Healthcare Services—A Scoping Review2023Ingår i: Healthcare, E-ISSN 2227-9032, Vol. 11, nr 9, artikel-id 1296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Transformation toward digital services offers unique opportunities to meet the challenges of responding to changing public healthcare needs and health workforce shortages. There is a knowledge gap regarding digital health and person or patient-centered care. Aim: The aim of the current scoping review was to obtain an overview of existing research on person or patient centeredness in digital primary healthcare services. Design: A scoping review following the five stages by Arksey and O’Malley. Methods: Literature searches were conducted in the databases PubMed, Scopus (Elsevier), APA PsychInfo (Ovid), Embase (Ovid), Cinahl (Ovid) and Cochrane Library in June 2022. The Preferred Reporting Items for Systematic reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR) Checklist was followed. Results: The electronic database searches identified 782 references. A total of 116 references were assessed in full text against the inclusion and exclusion criteria. Finally, a total of 12 references were included. The included papers represent research from 2015 to 2021 and were conducted in eight different countries, within a variety of populations, settings and digital solutions. Four themes providing knowledge about current research on patient or person centeredness and digital primary health care were identified: ‘Accessibility’, ‘Self-management’, ‘Digitalization at odds with patient centeredness’ and ‘Situation awareness’. The review underlines the need for further research on these issues.

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  • 41.
    Lexomboon, Duangjai
    et al.
    Department of Community Dentistry, Mahidol University.
    Punyasingh, Komson
    Department of Community Dentistry, Mahidol University.
    Supply projections for dentists, Thailand (2000-2030).2000Ingår i: Human Resource for Health Development Journal, Vol. 4, nr 2, s. 94-105Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract In the1970s, dental manpower in Thailand was found to be in short supply. In responseto this shortage, both the Ministry of University Affairs (MoUA) and the Office of NationalEducation Council (ONEC) proposed production plans to expand the supply of dentists. As aconsequence, the production of dentists has been increasing dramatically over the past 20 years.Experience from many countries has shown that such a rapid expansion of supply for dentists, ifnot periodically evaluated, could lead to a state of oversupply. This paper projects the supply of dentists in Thailand for the next 30 years, using theproposed first year enrollment plans of MoUA and ONEC, in order to compare future supplywith the projected requirements. WHO models for projecting workforce supply andrequirements and cohort retention rate method were used in this study. The student dropout rateused in this study was found to be approximately 2%, equal to the one used in MoUA plan.Estimated quinquennial retention rates for the dental workforce declined from 99% to 75% overthe first 34 years following completion of training, with a maximum working life of 50 years. The supply projections for dentists under the production plans of MoUA and the ONECshow that the population per dentist will decrease from 10,350 in the year 2000 to 6,072 and to3,082 in 2030. The MoUA production plan projects a supply similar to the projectedrequirement in the next 15 years but the ONEC production plan projects an oversupply state.The current economic crisis of the country coupled with health care reform, support anincreased emphasis of preventive care, which can be effectively rendered by dental nurses.Future production planning, therefore, should take into consideration the future use of auxiliarypersonnel and changes in dental health care provision.

  • 42.
    Lindmark, Ulrika
    et al.
    Högskolan i Jönköping.
    Ahlstrand, Inger
    Högskolan i Jönköping.
    Ekman, Aimée
    Högskolan i Jönköping.
    Berg, L.
    Göteborgs universitet.
    Hedén, L.
    Högskolan i Borås.
    Källstrand, J.
    Högskolan i Halmstad.
    Larsson, M.
    Högskolan i Skövde.
    Nunstedt, H.
    Högskolan i Väst.
    Oxelmark, L.
    Göteborgs universitet.
    Pennbrant, S.
    Högskolan i Väst.
    Sundler, A.
    Högskolan i Borås.
    Larsson, I.
    Högskolan i Halmstad.
    Health-promoting factors in higher education for a sustainable working life: protocol for a multicenter longitudinal study2020Ingår i: BMC Public Health, E-ISSN 1471-2458, Vol. 20, nr 1, s. 1-8, artikel-id 233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work.

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  • 43.
    Matilla-Santander, N.
    et al.
    Karolinska Institutet.
    Ahonen, E.
    Indiana University-Purdue University Indianapolis, USA.
    Albin, M.
    Karolinska Institutet.
    Baron, S.
    City University of New York, USA.
    Bolíbar, M.
    Universitat Pompeu Fabra, ESP.
    Bosmans, K.
    Vrije Universiteit Brussel, BEL.
    Burström, B.
    Karolinska Institutet.
    Cuervo, I.
    City University of New York. USA.
    Davis, L.
    City University of New York. USA.
    Gunn, V.
    University of Toronto, CAN.
    Håkansta, Carin
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Handelshögskolan (from 2013). Karolinska Institutet.
    Hemmingsson, T.
    Karolinska Institutet; Stockholms universitet.
    Hogstedt, C.
    Karolinska Institutet.
    Jonsson, J.
    Karolinska Institutet.
    Julià, M.
    Universitat Pompeu Fabra, ESP.
    Kjellberg, K.
    Karolinska Institutet.
    Kreshpaj, B.
    Karolinska Institutet.
    Lewchuk, W.
    McMaster University, CAN.
    Muntaner, C.
    University of Toronto, CAN.
    O’Campo, P.
    University of Toronto,CAN.
    Orellana, C.
    Karolinska Institutet.
    Östergren, P.-O.
    Malmö University.
    Padrosa, E.
    Universitat Pompeu Fabra, ESP.
    Ruiz, M. E.
    Pontificia Universidad Católica de Chile, CHL.
    Vanroelen, C.
    Vignola, E.
    Vrije Universiteit Brussel, BEL.
    Vives, A.
    Pontificia Universidad Católica de Chile, CHL.
    Wegman, D. H.
    University of Massachusetts, USA.
    Bodin, T.
    Karolinska Institutet.
    Consortium, All Members of the PWR Study
    COVID-19 and Precarious Employment: Consequences of the Evolving Crisis2021Ingår i: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, Vol. 5, nr 2, s. 226-228Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.

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  • 44.
    Nilsson, Jan
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Masud Rana, AKM
    Huy Loung, Duong
    Winblad, Bengt
    Nahar Kabir, Zarina
    Health-Related Quality of Life in Old Age: A Comparison Between Rural Areas in Bangladesh and Vietnam2012Ingår i: Asia Pacific Journal of Public Health, ISSN 1010-5395, Vol. 24, nr 4, s. 610-619Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study compares health-related quality of life (HRQoL) and its determinants among older people (≥60 years) in rural Bangladesh and Vietnam. Cross-sectional studies among older people were conducted in Bangladesh (n = 1031) and Vietnam (n = 870). Data on HRQoL were collected using an instrument that includes 24 items distributed into 6 dimensions. Older people in Vietnam reported more favorable HRQoL outcomes than those in Bangladesh, reporting better HRQoL on physical, psychological, social, and financial dimensions. Hierarchical linear regression analyses show that advanced age, being a woman, belonging to a poor household, and reporting poor health were significantly associated with lower HRQoL scores in both Bangladesh and Vietnam. In Bangladesh, being illiterate was additionally associated with lower HRQoL scores. The results of this explorative study underline the importance of a cross-cultural understanding of HRQoL of older people and the influence of the socioecological context.

  • 45.
    Nilsson, Johanna
    et al.
    Region Östergötland.
    Johansson, Sofi
    Praktikertjänst AB.
    Eklund, Anna Josse
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Robotic medication assistance in homecare: A scoping review2022Konferensbidrag (Refereegranskat)
  • 46.
    Nordlind, Anna
    et al.
    Örebro University, Sweden; County Hospital Karlstad, Sweden.
    Sundqvist, Ann‐Sofie
    Örebro University, Sweden.
    Anderzén‐Carlsson, Agneta
    Örebro University, Sweden.
    Almblad, Ann‐Charlotte
    Uppsala University, Sweden; Region Uppsala, Sweden.
    Ängeby, Karin
    Region Värmland, Sweden; Dalarna University, Sweden; Lund University, Sweden.
    How paediatric departments in Sweden facilitate giving children a voice on their experiences of healthcare: A cross‐sectional study2022Ingår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 25, nr 1, s. 384-393Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    In January 2020, the United Nations Convention on the Rights of the Child was incorporated into Swedish law. According to Swedish regulations, patients are to be given the opportunity to participate in quality improvement. Sometimes, the patients are children who have the right to be heard on matters concerning them, such as their experience of a hospital visit.

    Objective

    This study aimed to describe how Swedish paediatric departments facilitate children's voices on their healthcare experiences and how their perspectives are taken into account in quality improvement work.

    Methods

    This study has a descriptive cross-sectional design. Data were collected using a study-specific survey sent by e-mail to all the heads of the paediatric departments in Sweden, with both inpatient and outpatient care. The response rate was 74% (28 of 38 departments).

    Results

    The results demonstrated a variation in questionnaires used and to whom they were targeted; less than half of the participating departments reported having had questionnaires aimed at children. The results also indicated a major variation in other working methods used to allow children to voice their experiences in Swedish paediatric departments. The results indicate that the national co-ordination in facilitating the children's rights to be heard on their experiences in healthcare organisations can be improved.

    Conclusion

    Further research is required to ascertain which method is the most practically effective in paediatric departments, in what way children prefer to be heard regarding their experience of and perspectives on healthcare, and what questions need to be asked. A validated national patient-reported experience measure developed with and aimed at children could provide them with equal opportunities to voice their experiences in healthcare, regardless of their diagnoses or which paediatric department they visit.

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  • 47.
    Persson, Mattias
    et al.
    School of Business, Örebro University, Sweden.
    Wennberg, Linn
    Department of Public Health & Community Medicine, University of Gothenburg, Sweden.
    Beckman, Linda
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Salmivalli, Christina
    Department of Psychology, University of Turku, Finland.
    Svensson, Mikael
    Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    The Cost-Effectiveness of the Kiva Antibullying Program: Results from a Decision-Analytic Model2018Ingår i: Prevention Science, ISSN 1389-4986, E-ISSN 1573-6695, Vol. 19, nr 6, s. 728-737Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Bullying causes substantial suffering for children and adolescents. A number of bullying prevention programs have been advocated as effective methods for counteracting school bullying. However, there is a lack of economic evaluations of bullying prevention programs assessing the “value for money.” The aim of this study was to assess the cost-effectiveness of the Finnish bullying prevention program KiVa in comparison to “status quo” (treatment as usual) in a Swedish elementary school setting (grades 1 to 9). The cost-effectiveness analysis was carried out using a payer perspective based on a Markov cohort model. The costs of the program were measured in Swedish kronor and Euros, and the benefits were measured using two different metrics: (1) the number of victim-free years and (2) the number of quality adjusted life years (QALYs). Data on costs, probability transitions, and health-related quality of life measures were retrieved from published literature. Deterministic and probabilistic sensitivity analyses were carried out to establish the uncertainty of the cost-effectiveness results. The base-case analysis indicated that KiVa leads to an increased cost of €829 for a gain of 0.47 victim-free years per student. In terms of the cost per gained QALY, the results indicated a base-case estimate of €13,823, which may be seen as cost-effective given that it is lower than the typically accepted threshold value in Swedish health policy of around €50,000. Further research is needed to confirm the conclusions of this study, especially regarding the treatment effects of KiVa in different school contexts

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  • 48.
    Punyasingh, Komson
    et al.
    Department of Community Dentistry, Mahidol University.
    Udompanich, Suwit
    Department of Community Dentistry, Khon Kaen University.
    Lexomboon, Duangjai
    Department of Community Dentistry, Mahidol University .
    Baseline projection of requirements for dental health manpower in Thailand (1995-2015 AD.)1997Ingår i: Human Resource for Health Development Journal, Vol. 1, nr 1, s. 24-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study is intended to compare the dental health personnel supply to the requirement in each 5-year interval from 1995 to 2015. The dental health personnel supply was calculated by subtracting the annual personnel loss from the current active personnel plus the annual personnel production. The results show that there will be 10,100 dentists and 7,718 dental nurses in supply in the year 2015. The personnel requirement was calculated using 3 different techniques; the population ratio technique, the FDI/WHO technique, and the system dynamics technique. The dental personnel to population ratio of 1:5,000 was used to calculate the personnel requirement in the population ratio technique. The FDI/WHO and the system dynamics techniques calculated the personnel requirement by converting the need for service into the need for personnel. While the FDI/WHO technique calculated the need for service based on the lifetime of care for each age cohort, the system dynamics technique calculated the need for service which changed with the alternations in the input factors such as the socioeconomics of the population, the trend of oral diseases, and the structure of health care system. From these three techniques, the requirement for dentists ranges from 8,920 to 9,748 and for dental nurses ranges from 3,046 to 10,974. The results show that in the year 2015, the supply of dentists exceeds the requirement regardless of what technique is used. Similarly, the supply of dental nurses is higher than the requirement when the calculations are done using the population ratio technique and the system dynamics technique. However, the dental nurses will be in shortage according to the FDI/WHO technique. The reason for this different outcome is that dental nurses in the FDI/WHO technique provide health promotion and health education services as well as preventive and simple curative services; while in the other two techniques they provide only preventive and simple curative treatment.

  • 49.
    Rahm, GullBritt
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper.
    Rystedt, Ingrid
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Nordström, Gun
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Wilde-Larsson, Bodil
    Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), Institutionen för hälsovetenskaper (from 2013).
    Strandmark K, Margaretha
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för hälsa och miljö.
    Workplace bullying in the health and social caresystems in Sweden: A descriptive study2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    Abstract 

    Workplace bullying in the health and social care systems in Sweden. A descriptive study.

    Aims

    This study aims to map and describe the problem of bullying within the health and social care systems as a foundation for an intervention. In this presentation we will present the study and preliminary results concerning negative acts and work-place health in Sweden.   

    Methods

    Baseline data for this quantitative study was collected at nursing wards at five hospitals and five wards for eldercare in municipalities. Questionnaires were sent by post to 2810 employees.  Response-rate was 55% (n=1550).

    Bullying was measured both with an operationalized and a self-labelling method. The instrument used in the former were The Negative Acts Questionnaire, NAQ-R, and bullying was assessed according to the operational criterion suggested  by Leyman (1996) “exposure to at least one negative act/week during six months” and a stricter criterion by Mikkelsen & Einarsen, (2001)  suggesting 2 negative acts/week during six months.  

    As for the self-labelling of bullying a definition of bullying was presented and questions were asked whether the person had been bullied or had witnessed bullying the last 6 months. A further question was asked regarding previous life-time experiences of bullying.

    To assess work-place environment the Nordic Questionnaire for Psychological and Social Factors at work, QPSNordic34+ was utilized. In addition a questionnaire made for this study concerning demographic information and specific workplace related questions were included.

    Primarily descriptive statistics was used.

    Results

    Bullying measured by NAQ-R, using the operational criterion, reported results of bullying at 18,5 % (Leyman) and for the stricter criterion 6.8% (Mikkelsen & Einarsen). Four percent (4 %) reported bullying relating to the self-labelling question. A higher proportion, 22%, had witnessed bullying and an even higher proportion, 38%, reported having experienced bullying earlier in life.

     An association was shown between having been bullied earlier in life and experiencing bullying at the work-place at the present time. Also work-place environment, age, where you were born, living in a relationship, education and length of employment were, respectively, associated to more negative acts in the workplace.

    Conclusion

    The operationalized method yields a higher percent of bullying compared to the self-labelling method. This is also shown in earlier studies and might be due to bullying being stigmatizing and shameful and therefore difficult to express in a straight-forward way.

    A significant relationship was observed between being bullied earlier in life-time and current exposure. As far as we know this represents new knowledge and should be further investigated.

  • 50.
    Rolander, Bo
    et al.
    Högskolan i Jönköping.
    Lindmark, Ulrika
    Högskolan i Jönköping.
    Johnston, Venerina
    The University of Queensland, Australia.
    Wagman, Petra
    Högskolan i Jönköping.
    Wåhlin, Charlotte
    Linköpings universitet.
    Organizational types in relation to exposure at work and sickness: a repeated cross-sectional study within public dentistry2020Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, nr 2, s. 132-140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Organizations and state agencies that provide dental care continuously face various and novel demands related to the need for dental care. However, rearrangements of work tasks by reducing the number of tasks performed by dental personnel might make the work more monotonous, repetitive, and static within an organization. The aim of this study is to compare how two dental work organizations, with different staffing and clinic size, are perceived by dental personnel focusing on physical and psychosocial conditions, leadership, work ability and presenteeism in 2012 and 2014.

    Material and Methods: This repeated cross-sectional study included personnel from the Public Dental Service in Sweden. There were 282 dentists, dental hygienists, and dental nurses who answered a questionnaire 2012 and 299 in 2014.

    Results and conclusion: In 2012, nine per cent of medium clinics reported poor leadership compared with 27% in 2014. For large clinics, 17% perceived poor leadership in 2012 compared with 31% in 2014. A higher proportion of the employees reported presenteeism due to high physical load (43%) and high psychosocial load (21%) in 2014 compared with 31% and 13% in 2012. These results indicate the need for work place interventions promoting health among dental employees.

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