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  • 1. Abrahamsson, Agneta
    et al.
    Vibeke, Bing
    Löfström, Mikael
    University of Borås, School of Business and IT.
    Familjecentraler i Västra Götaland2009Report (Other academic)
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    FULLTEXT01
  • 2.
    Ahonen, Hanna
    et al.
    Jönköping University, HHJ. ADULT.
    Kvarnvik, Christine
    Folktandvården Region Jönköpings län.
    Broström, Anders
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Fransson, Eleonor I.
    Jönköping University, HHJ, Avdelningen för naturvetenskap och biomedicin.
    Nygårdh, Annette
    Jönköping University, HHJ, Avdelningen för omvårdnad.
    Stensson, Malin
    Jönköping University, HHJ, Avdelningen för naturvetenskap och biomedicin.
    Lindmark, Ulrika
    Jönköping University, HHJ, Avdelningen för naturvetenskap och biomedicin.
    Oral hälsa och obstruktiv sömnapné- protokoll för en longitudinell studie2019Conference paper (Refereed)
  • 3.
    Axelsson, Christer
    et al.
    University of Borås, School of Health Science.
    Bremer, Anders
    University of Borås, School of Health Science.
    Hagiwara, Magnus
    University of Borås, School of Health Science.
    Herlitz, Johan
    University of Borås, School of Health Science.
    Nationella regler krävs för ambulanssjukvård2011In: Svenska Dagbladet, ISSN 1101-2412Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ambulanssjukvården i Sverige saknar nationella riktlinjer. En konsekvens av detta är brister i tillgängligheten vilket fått allvarliga konsekvenser för flera personer under den senaste tiden. En av dem är Maximilian och hans mamma som blev påkörda på trottoaren av en 23-årig förare som hade tappat kontrollen över sin bil. Det tog nästan en timme innan pojken flögs till sjukhus med helikopter från olycksplatsen på Tjörn utanför Stenungsund. Maximilian blev bara tio veckor.

  • 4.
    Axelsson, Christer
    et al.
    University of Borås, School of Health Science.
    Bremer, Anders
    University of Borås, School of Health Science.
    Hagiwara, Magnus
    University of Borås, School of Health Science.
    Herlitz, Johan
    University of Borås, School of Health Science.
    Englund, Lotta
    University of Borås, School of Health Science.
    Så skapas världens bästa ambulanssjukvård2011In: Göteborgsposten, ISSN 1103-9345Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Tiden från larm till dess att ambulans kommer har ökat dramatiskt de senaste tio åren i Västra Götaland. Samtidigt bedöms allt fler i behov av snabb utryckning. Kompetens finns att råda bot på detta – om den tillåts styra utvecklingen, skriver bland andra professor Johan Herlitz.

  • 5. Binfa, Lorena
    et al.
    Robertson, Eva
    University of Borås, School of Health Science.
    Ransjö-Arvidson, Anna-Berit
    Chilean Women's Reflections About Womanhood and Sexuality During Midlife in a Swedish or Chilean Context2009In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 30, no 12, p. 1093-1110Article in journal (Refereed)
    Abstract [en]

    In order to learn about Chilean women's reflections about womanhood and sexuality during midlife, we held focus group discussions (FGDs) with middle-aged Chilean women living in Stockholm, Sweden, or in Santiago, Chile. We used thematic content analysis for the qualitative data. Emerging themes follow; societal expectations on women, perceptions about sexual relationships, and women's social stigmatization. The women had since childhood been strongly influenced by a gender-imbalanced world, which had made them socially, economically, and biologically at higher risk for exploitation during life. More focus should be directed to middle-aged women's life situation and promotion of gender equity in society.

  • 6. Bjerke, Ulrika
    et al.
    Frändin, Kerstin
    University of Borås, School of Health Science.
    Formkontroll för äldre. En randomiserad, kontrollerad studie2013Report (Other academic)
    Download full text (pdf)
    FULLTEXT01
  • 7.
    Björk Brämberg, Elisabeth
    University of Borås, School of Health Science.
    Att vara invandrare och patient i Sverige2008Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This thesis focuses on immigrants in Sweden. What experiences from the meeting with Swedish society do immigrants have and what meaning does the immigrant background have when they have been patients within the Swedish health and medical service? Former research about patients with an immigrant background can be divided into two perspectives. One which illuminates ethnically demarcated immigrant groups and specific needs. The other perspective has an individually adopted approach independently of the patients’ ethnical background. Here it is mainly the communication problems that are stressed, since these make it hard to understand the individual’s needs. The two empirical studies of the thesis start from an individualised perspective, a life world perspective. Research data have been collected through open interviews. The overall purpose was to develop a deepened understanding of what it means to live as an immigrant in Sweden and receive care. The aim of the pre-study was to examine immigrants’ experiences of participation in municipal home care. In the main study the overall purpose was used and two research questions were asked: What do persons with an immigrant background have to tell us about their situation in Swedish society? How does the situation as an immigrant in Sweden influence the experience of being a patient in Swedish health and medical care? The pre-study shows that participation means making demands and meeting caregivers who view the patient as an actor with the right to make his or her own decisions. One important postulate seems to be access to a good interpreter. To refrain from participation seems to be about adopting a passive attitude as a patient. It seems as if it is the caregivers who are the active ones and the ones setting the standards for the contents of the care. To experience not being invited to participation mainly seems to originate from the fact that the interviewees could neither understand nor make themselves understood. One consequence is that patients are just looked upon as carriers of a symptom. The main study shows that the interviewees’ existential existence as patients involves the whole life situation. Different forms of unsurmountable difficulties might reinforce each other. The ambition to establish oneself in a new home country might therefore be passivised. For patients with immigrant background earlier experiences from exposed situations seem to influence how the patients feel about their treatment. The additional knowledge is that problems seem to reinforce each other. Patients with an immigrant background must be treated as individuals. Every individual’s story has to be made visible. The thesis shows that caregivers ought to endeavour to understand the individual. To encourage dialogue, despite language problems, is of importance for the patient to be able to express his or her needs. The use of an interpreter may have a positive influence on these patients’ possibilities to exert an influence. This means that caregivers who consult an interpreter should build up their competence to communicate through an interpreter.

  • 8.
    Bremer, Anders
    University of Borås, School of Health Science.
    Ambulanspersonalen måste ha utrymme för de närstående2012In: Vårdfokus, ISSN 2000-5717, no 3, p. 48-Article in journal (Other (popular science, discussion, etc.))
  • 9.
    Bremer, Anders
    University of Borås, School of Health Science.
    Caring for families at sudden cardiac death: A balance between closeness and distance2012Conference paper (Refereed)
    Abstract [en]

    Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects more than half a million people in the United States and Europe each year. As resuscitation attempts are unsuccessful in most of the cases, ambulance professionals often face the needs of bereaved family members. Decisions to continue or terminate resuscitation attempts at OHCA are influenced by factors other than patient clinical characteristics, such as the personnel’s knowledge, attitudes, and beliefs regarding family emotional preparedness. Research exploring how ambulance personnel are affected by family dynamics and the emotional context, and how they are able to provide care for bereaved family members is sparse. It is also a lack of research into why ambulance professionals sometimes administer physiologically futile cardiopulmonary resuscitation (CPR) to patients with cardiac arrest to benefit family members. This way of meeting families’ grief reactions implies ethical problems. Based on an empirical study of ambulance professional’s experiences of caring for families when patients suffer cardiac arrest and sudden death, and an ethical analysis exploring arguments for providing physiologically futile CPR, the issue of caring for bereaved family members in ethical good and bad ways is explored. The empirical study results show that ambulance personnel experience a concomitant responsibility, sometimes failing to prioritize between responsibilities as a result of their own perceptions, feelings and reactions. Moving from patient care to family care imply a movement from well-structured guidance to a situational response where the personnel are forced to balance between interpretive reasoning and a more direct emotional response at their own discretion. With such affective response in decision-making, the personnel risk erroneous conclusions and care relationships with elements of dishonesty, misguided benevolence and false hopes. The ability to recognize and respond to people’s existential questions and needs is essential, and dependent on the ambulance personnel’s balance between closeness and distance, and on their courage to meet emotional expressions of the families, as well as the personnel’s own vulnerability. A need for ethical competence is invoked by the presence of family members, placing great demands on mobility in the decision-making process, between medical care of the patient and caring for family members. The conclusion is that the strategy of ambulance professionals in the care of bereaved family members should be to avoid additional suffering by focusing on the relevant care needs of the family members and provide support, arrange for a peaceful environment and administer acute grief counseling at the scene, which might call for a developed ethical caring competence. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Ambulance personnel also need training in awareness of the needs of families suffering sudden bereavement, as well as support and help to deal with personal discomfort.

  • 10.
    Bremer, Anders
    University of Borås, School of Health Science.
    En andra chans2012In: Forskning för hälsa, ISSN 1653-9753, no 3, p. 18-19Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Överlevare av plötsligt hjärtstopp utanför sjukhus är en unik och växande patientgrupp. Men hur blir livet efteråt? Frågeställningen finns med i den forskning Anders Bremer bedriver och som tidigare i år utmynnade i en avhandling. I syfte att beskriva samtliga inblandades erfarenheter vid plötsligt hjärtstopp intervjuade han överlevare, närstående och ambulanspersonal, som inte sällan ställs inför etiska frågeställningar vid hjärtstopp.

  • 11.
    Bångsbo, Angela
    et al.
    University of Borås, School of Health Science.
    Björklund, Anita
    Professional views on patient education in osteoporosis2010In: Archives of Osteoporosis, ISSN 1862-3522, Vol. 5, no 1-2, p. 101-110Article in journal (Refereed)
    Abstract [en]

    Summary The aim of this study was to investigate patient education in osteoporosis, with a consensus-building Delphi survey. The results showed that the purposes of osteoporosis schools are to reduce the risk of falling, facilitate empowerment, increase levels of function and activity and teach participants to master or reduce pain. Introduction According to the World Health Organization, osteoporosis is a major health problem. The morbidity is caused by fractures associated with pain and decreased physical function, social function and well-being. The aim of this study was to investigate and reach consensus about how so-called osteoporosis schools are run by professionals in Sweden with a focus on intervention and evaluation. Method The study design was a consensus-building, threeround Delphi survey. Questionnaires were sent by web and post to an expert panel comprising 15 nurses, occupational therapists and physiotherapists. In round 1, they were asked to write descriptions within the frame of eight domains related to intervention and evaluation. In the second and third rounds, the Delphi panel was asked to mark on a Likert scale the importance of 40 statements within these domains. Results The answers showed that the purposes of osteoporosis schools are to reduce the risk of falling, facilitate empowerment, increase levels of function and activity and teach participants to master or reduce pain. The schools comprise theoretical elements as well as practical exercises. Patients with fractures related to osteoporosis are offered participation. There is a lack of a theoretical basis, as well as of evidence, for present treatment models. Evaluation ought to be done systematically, and for this purpose, different questionnaires are used. Experts assert that evaluations show that patients gain increased activity levels, function, knowledge about osteoporosis, empowerment and pain reduction. Conclusions Consensus was reached in 29 of 40 items.

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  • 12. Båsjö, Sara
    et al.
    Möller, Claes
    Widén, Stephen
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kähäri, Kim
    Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children.2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 10, p. 587-596Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Investigate hearing function and headphone listening habits in nine-year-old Swedish children.

    DESIGN: A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis.

    STUDY SAMPLE: A total of 415 children aged nine years.

    RESULTS: The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones.

    CONCLUSION: The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children's hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.

  • 13. Carlsson, Marcus
    et al.
    Wittsten, Jens
    University of Borås, Faculty of Textiles, Engineering and Business.
    Söderberg-Nauclér, Cecilia
    A note on variable susceptibility, the herd-immunity threshold and modeling of infectious diseases2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, article id e0279454Article in journal (Refereed)
    Abstract [en]

    The unfolding of the COVID-19 pandemic has been very difficult to predict using mathematical models for infectious diseases. While it has been demonstrated that variations in susceptibility have a damping effect on key quantities such as the incidence peak, the herd-immunity threshold and the final size of the pandemic, this complex phenomenon is almost impossible to measure or quantify, and it remains unclear how to incorporate it for modeling and prediction. In this work we show that, from a modeling perspective, variability in susceptibility on an individual level is equivalent with a fraction θ of the population having an “artificial” sterilizing immunity. We also derive novel formulas for the herd-immunity threshold and the final size of the pandemic, and show that these values are substantially lower than predicted by the classical formulas, in the presence of variable susceptibility. In the particular case of SARS-CoV-2, there is by now undoubtedly variable susceptibility due to waning immunity from both vaccines and previous infections, and our findings may be used to greatly simplify models. If such variations were also present prior to the first wave, as indicated by a number of studies, these findings can help explain why the magnitude of the initial waves of SARS-CoV-2 was relatively low, compared to what one may have expected based on standard models. 

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  • 14. Carlsson, Per
    et al.
    Garpenby, Peter
    Nedlund, Ann-Charlotte
    Sandman, Lars
    University of Borås, School of Health Science.
    Öppna prioriteringar i vård och omsorg: var står vi idag och hur ska vi komma vidare?2014Report (Other academic)
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    FULLTEXT01
  • 15.
    Claesson, Andreas
    et al.
    University of Borås, School of Health Science.
    Karlsson, Tomas
    Thorén, Ann-Britt
    Herlitz, Johan
    University of Borås, School of Health Science.
    Delay and performance of cardiopulmonary resuscitation in surf lifeguards after simulated cardiac arrest due to drowning.2011In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 29, no 9, p. 1044-1050Article in journal (Refereed)
    Abstract [en]

    Abstract PURPOSE: To describe time delay during surf rescue and compare the quality of cardiopulmonary resuscitation (CPR) before and after exertion in surf lifeguards. METHODS: A total of 40 surf lifeguards at the Tylösand Surf Lifesaving Club in Sweden (65% men; age, 19-43 years) performed single-rescuer CPR for 10 minutes on a Laerdal SkillmeteÔ Resusci Anne manikin. The test was repeated with an initial simulated surf rescue on an unconscious 80-kg victim 100 m from the shore. The time to victim, to first ventilation, and to the start of CPR was documented. RESULTS: The mean time in seconds to the start of ventilations in the water was 155 ± 31 (mean ± SD) and to the start of CPR, 258 ± 44. Men were significantly faster during rescue (mean difference, 43 seconds) than women (P = .002). The mean compression depth (millimeters) at rest decreased significantly from 0-2 minutes (42.6 ± 7.8) to 8-10 minutes (40.8 ± 9.3; P = .02). The mean compression depth after exertion decreased significantly (44.2 ± 8.7 at 0-2 minutes to 41.5 ± 9.1 at 8-10 minutes; P = .0008). The compression rate per minute decreased after rescue from 117.2 ±14.3 at 0 to 2 minutes to 114.1 ± 16.1 after 8 to 10 minutes (P = .002). The percentage of correct compressions at 8 to 10 minutes was identical before and after rescue (62%). CONCLUSION: In a simulated drowning, 100 m from shore, it took twice as long to bring the patient back to shore as to reach him; and men were significantly faster. Half the participants delivered continuous chest compressions of more than 38 mm during 10 minutes of single-rescuer CPR. The quality was identical before and after surf rescue. Copyright © 2011 Elsevier Inc. All rights reserved.

  • 16.
    Claesson, Andreas
    et al.
    [external].
    Svensson, Leif
    Silfverstolpe, Johan
    Herlitz, Johan
    [external].
    Characteristics and outcome among patients suffering out-of-hospital cardiac arrest due to drowning.2008In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 76, no 3, p. 381-387Article in journal (Refereed)
    Abstract [en]

    Abstract AIM: To describe the characteristics and outcome among patients with out-of-hospital cardiac arrest (OHCA) caused by drowning as compared with OHCA caused by a cardiac etiology (outside home). PATIENTS AND METHODS: All the patients included in the Swedish OHCA Registry between 1990 and 2005 which were not crew witnessed, in whom cardio-pulmonary resuscitation (CPR) was attempted, were evaluated for inclusion. Those caused by drowning were compared with those with a cardiac etiology (outside home). RESULTS: Patients with OHCA due to drowning (n=255) differed from patients with OHCA with a cardiac etiology (n=7494) as they were younger, less frequently suffered a witnessed OHCA, more frequently received bystander CPR and less frequently were found in a shockable rhythm. Patients with OHCA due to drowning had a prolonged ambulance response time as compared with patients with OHCA with a cardiac etiology. Patients with OHCA due to drowning had a survival rate to 1 month of 11.5% as compared with 8.8% among patients with OHCA due to a cardiac etiology (NS). Among patients with OHCA due to drowning, only one independent predictor of survival was defined, i.e. time from calling for an ambulance until the arrival of the rescue team, with a much higher survival among patients with a shorter ambulance response time. CONCLUSION: Among patients with OHCA 0.9% were caused by drowning. They had a similar survival rate to 1 month as compared with OHCA outside home with a cardiac etiology. The factor associated with survival was the ambulance response time; a higher survival with a shorter response time.

  • 17.
    Cruz, Maria Araceli Diaz
    et al.
    Research School of Health and Welfare, School of Health and Welfare, University of Jönköping, Jönköping, Sweden.
    Ulfenborg, Benjamin
    Department of Biology and Bioinformatics, School of Bioscience, University of Skövde, Skövde, Sweden.
    Blomstrand, Peter
    Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Clinical Physiology, County Hospital Ryhov, Jönköping, Sweden; Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Faresjö, Maria
    Department of Biology and Biology Engineering, Chalmers University of Technology, Gothenburg, Sweden.
    Ståhl, Fredrik
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Karlsson, Sandra
    Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Characterization of methylation patterns associated with lifestyle factors and vitamin D supplementation in a healthy elderly cohort from Southwest Sweden2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 12670Article in journal (Refereed)
    Abstract [en]

    Numerous studies have shown that lifestyle factors, such as regular physical activity and vitamin D intake, may remarkably improve overall health and mental wellbeing. This is especially important in older adults whose vitamin D deficiency occurs with a high prevalence. This study aimed to examine the influence of lifestyle and vitamin D on global DNA methylation patterns in an elderly cohort in Southwest of Sweden. We also sought to examine the methylation levels of specific genes involved in vitamin D's molecular and metabolic activated pathways. We performed a genome wide methylation analysis, using Illumina Infinium DNA Methylation EPIC 850kBeadChip array, on 277 healthy individuals from Southwest Sweden at the age of 70–95. The study participants also answered queries on lifestyle, vitamin intake, heart medication, and estimated health. Vitamin D intake did not in general affect methylation patterns, which is in concert with other studies. However, when comparing the group of individuals taking vitamin supplements, including vitamin D, with those not taking supplements, a difference in methylation in the solute carrier family 25 (SCL25A24) gene was found. This confirms a previous finding, where changes in expression of SLC25A24 were associated with vitamin D treatment in human monocytes. The combination of vitamin D intake and high physical activity increased methylation of genes linked to regulation of vitamin D receptor pathway, the Wnt pathway and general cancer processes. To our knowledge, this is the first study detecting epigenetic markers associated with the combined effects of vitamin D supplementation and high physical activity. These results deserve to be further investigated in an extended, interventional study cohort, where also the levels of 25(OH)D3 can be monitored.

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  • 18.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    I have to Turn Myself Inside Out”: Caring for Immigrant Families of Children With Asthma2012In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 21, no 2, p. 224-242Article in journal (Refereed)
    Abstract [en]

    In multicultural societies, health care professionals encounter immigrant families of children with asthma. They play an important role in supporting these families, but few studies have focused on this phenomenon. The aim of the present study is to gain a broader understanding of the challenges health care professionals face in their encounters with non-Western immigrant parents of children with asthma. Seventeen professional caregivers were interviewed, and their narratives were analyzed using qualitative content analysis. The results show that health care professionals’ main challenges when encountering immigrant parents can be described by the theme, “Turning oneself inside out.” This theme is characterized by five categories: gender and professional issues, impact on professional relationships, communication challenges, unfamiliar disease and treatment perceptions, and time issues. The results highlight the importance of providing health care professionals with support and organizational conditions that increase opportunities to understand the unique situation of these families

  • 19.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Andreasson, Jörgen
    University of Borås, School of Health Science.
    Jutengren, Göran
    University of Borås, School of Health Science.
    Hur kan stödresurser understödja hållbart ledarskap bland chefer i vården?2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 6, p. 866-877Article in journal (Refereed)
    Abstract [sv]

    Chefer kan ha stor betydelse för anställdas hälsa, stress, engagemang i arbetet och prestation. Få tidigare studier har undersökt vilket stöd chefer behöver för ett hållbart och bra ledarskap. Artikeln presenterar resultat från en prospektiv studie om betydelsen av chefers stödresurser för hållbart ledarskap. I studien, som är en del av Chefios-projektet, ingår chefer i kommunal vård och omsorg (n=344). Data från enkätstudier med instrumentet ”Gothenburg Manager Stress Inventory” har analyserats. Resultatet visar att ett stödjande privatliv och en personlig inställning till chefsuppdrag har stor betydelse för chefers hållbarhet över tid. Chefens kontrollspann och erfarenhet som chef påverkade betydelsen av stödresurser. För chefer med kortare chefserfarenhet eller fler underställda (>30) har även stöd från ledning, chefskollegor och externt stöd betydelse.

  • 20.
    Dellve, Lotta
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lagerström, M
    Hagberg, M
    Assessment of work system risk factors among home care workers2001Conference paper (Refereed)
  • 21. Eliasson, K
    et al.
    Eriksson, Erik
    Chalmers University of Technology.
    Tänk om de tar mina barn: Om att vara mamma i ett nytt land2018In: Mamma hursomhelst: berättelser om moderskap / [ed] Margaretha Fahlgren; Anna Williams, Gidlunds förlag, 2018Chapter in book (Refereed)
  • 22. Eriksson, Andrea
    et al.
    Orvik, Arne
    Dellve, Lotta
    University of Borås, School of Health Science.
    Organisatorisk hälsa och värdebaserat ledarskap: Behovet av systemperspektiv2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. Tema Ledarskap, no 6, p. 848-856Article in journal (Refereed)
    Abstract [sv]

    Anställda inom hälso- och sjukvården rapporterar ökade hälsoproblem. Syftet med denna artikel är att ge exempel på systemperspektiv på hälsoutmaningar inom hälso- och sjukvården utifrån begreppen organisatorisk hälsa och värdebaserat ledarskap. En tillämpning av begreppet organisatorisk hälsa inom hälso- och sjukvården innebär att hälsoproblem hos anställda och chefer ses i relation till de värdekonflikter som är kopplade till rådande styrningsideal. Organisatorisk hälsa är ett exempel på ett begrepp som har ett tydligt systemperspektiv och kan definierats som en organisations förmåga att hantera spänningar mellan olika konkurrende värden på ett sätt som gynnar både patienter och anställda, och därmed organisationen som helhet. En tillämpning av begreppet organisatorisk hälsa inom sjukvården skulle kunna hjälpa chefer inom sjukvård att syna de värdekonflikter som finns och kunna bidra till reflektion kring hur dessa värdekonflikter skulle kunna hanteras. Vi menar att ett hälsofrämjande och hållbart ledarskap inom hälso- och sjukvården i större utsträckning kräver ett värdebaserat ledarskap som medvetet, tydligt och öppet hanterar de värdekonflikter som finns i vården.

  • 23. Eriksson, Andrea
    et al.
    Skagert, Katrin
    Dellve, Lotta
    University of Borås, School of Health Science.
    Utveckling av hälsofrämjande ledarskap och medarbetarskap: Erfarenheter av att arbeta med interventioner utifrån ett arbetsmaterial2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. Temanummer Ledarskap, no 6, p. 793-798Article in journal (Refereed)
    Abstract [sv]

    Forskning pekar på är att ledarskap har stor betydelse för anställdas välmående och att ledarskapsutveckling därför bör vara huvudfokus för framtida interventioner inom arbetsmiljö- och hälsoarbete. Den här artikeln syftar till att beskriva våra erfarenheter och lärdomar från att arbeta med hälsofrämjande ledarskapsinterventioner. Interventionerna utgår från arbetsmaterialet ”Hälsofrämjande ledarskap och medarbetarskap”. I arbetsmaterialet presenteras olika forskningsbaserade metoder och verktyg som kan användas för analys, reflektion och utveckling av hälso- och arbetsmiljöarbetet på den enskilda arbetsplatsen eller för hela organisationen. Utvärderingar av interventioner utifrån arbetsmaterialet pekar på att chefer som deltagit fått ökade förmågor att vara hälsofrämjande ledare, men att organisatoriskt stöd är avgörande för långsiktigta resultat.

  • 24.
    Eriksson, Erik
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Chalmers University of Technology.
    What they talk about when they talk about motherhood: Perceptions of motherhood among Somali-born and Swedish-born mothers, and child health nurses2015Conference paper (Other academic)
  • 25. Eriksson, Erik
    et al.
    Eliasson, K
    Chalmers University of Technology.
    Hellström, A
    Määttä, S
    Vaughn, L
    When they talk about motherhood: A qualitative study of three groups’ perceptions in a Swedish child health center context2016In: International Journal for Equity in Health, E-ISSN 1475-9276Article in journal (Refereed)
  • 26.
    Eriksson, Erik
    et al.
    Chalmers University of Technology.
    Lau, M
    Jönsson, C
    Zhang, C
    Risö Bergerlind, L-L
    Miao Jonasson, J
    Strander, B
    Participation in a Swedish cervical cancer screening program among women with psychiatric diagnoses: A population-based cohort study2019In: BMC Public Health, E-ISSN 1471-2458Article in journal (Refereed)
  • 27.
    Flobrant, Douglas
    University of Borås, School of Education and Behavioural Science.
    Skolelevers arbetsmiljö sett ur ett hälsoperspektiv2002Report (Other academic)
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  • 28.
    Hallberg, Maria
    et al.
    University of Borås, School of Health Science.
    Höglund, Eva
    FoU-projektet Social dokumentation: redogörelse för arbetet 2006-20082009Report (Other academic)
    Abstract [sv]

    Projektet startades 2004, då Sjuhäradskommunerna (Borås, Bollebygd, Herrljunga, Mark, Svenljunga,Tranemo, Ulricehamn) ville ha stöd i sitt arbete att dokumentera de sociala insatserna i äldreomsorgen. Syftet har varit att utveckla ökade kunskaper i social dokumentation, som i sin tur förväntades ge en kvalitetsutveckling i hjälpinsatserna och stödinsatserna i äldreomsorgen. Projektets mål var att utarbeta en eller flera modeller för social dokumentation och att implementera den framtagna modellen i kommunerna som medverkade. I denna rapport koncentrerar vi oss på implementeringen av arbetsmodellen som togs fram i projektet. Aktiviteter har varit: * Grundläggande utbildning för dokumentationsombud. * Löpande information om projektet. * Målstyrt arbetssätt * Föreläsningar om ”Ett socialt synsätt” * Broschyr till brukarna. * Nätverksbyggande. * Inspirationsdag för att coacha andra * Förläsning i ”Samtalet – vårt viktiga arbetsredskap i social dokumentation.” * 5 dagars utbildning i social dokumentation för enhetschefer. * Introduktionsfilm för nyanställda.

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  • 29. Hogström, Lars
    et al.
    Johansson, Marianne
    University of Borås, School of Health Science.
    Janson, Per Olof
    Berg, Marie
    Francis, Jynfiaf
    Sogn, Jan
    Hellström, Anna-Lena
    Adolfsson, Annsofie
    Quality of life after adopting compared with childbirth with or without assisted reproduction.2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, no 9, p. 1077-1085Article in journal (Refereed)
    Abstract [en]

    Objective. This study compares quality of life among couples who had adopted a child 4–5.5 years previously with couples whose conception was spontaneous, as well as with couples who had successful or unsuccessful in vitro fertilization (IVF) treatment. Design. Cross-sectional study. Setting. Tertiary level university hospital. Sample. From the following groups, 979 responses were obtained: adoption; successful IVF; unsuccessful IVF–living with children; unsuccessful IVF–living without children; and childbirth after spontaneous conception (controls). Methods. Quality of life was studied with the Psychological General Well Being (PGWB) and Sense of Coherence (SOC) instruments. Demographic, socio-economic and health data were obtained with additional questionnaires. Multiple variance analysis was applied. Main outcome measures. The PGWB and SOC scores. Results. After adjustment for seven confounders, the adoption group had higher PGWB scores than the unsuccessful IVF–living without children and the controls and higher SOC scores than all other groups. The unsuccessful IVF–living without children had lower PGWB and SOC scores than all other groups. The PGWB and SOC scores among controls did not differ from those with successful IVF or unsuccessful IVF–living with children. Conclusions. Adjusted PGWB and SOC scores revealed a high quality of life in the adoption group. However, the group unsuccessful IVF–living without children had low quality of life scores. Quality of life appears to be independent of the outcome of IVF treatment as long as there are children in the family.

  • 30.
    Illueca Fernández, Eduardo
    et al.
    Department of Informatics and Systems, University of Murcia, Murcia, Spain.
    Fernández Llatas, Carlos
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Jara Valera, Antonio Jesús
    Research and Development, HOP Ubiquitous S.L. (Libelium Murcia), Ceutí, Spain .
    Fernández Breis, Jesualdo Tomás
    Department of Informatics and Systems, University of Murcia, Murcia, Spain .
    Seoane, Fernando
    University of Borås, Faculty of Textiles, Engineering and Business. University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden, Department of Medical Technology, Karolinska University Hospital, Stockholm, Sweden, Department of Textile Technology, University of Borås, Borås, Sweden, Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
    Sequence-oriented sensitive analysis for PM2.5 exposure and risk assessment using interactive process mining2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 8, p. e0290372-e0290372Article in journal (Refereed)
    Abstract [en]

    The World Health Organization has estimated that air pollution will be one of the most significant challenges related to the environment in the following years, and air quality monitoring and climate change mitigation actions have been promoted due to the Paris Agreement because of their impact on mortality risk. Thus, generating a methodology that supports experts in making decisions based on exposure data, identifying exposure-related activities, and proposing mitigation scenarios is essential. In this context, the emergence of Interactive Process Mining—a discipline that has progressed in the last years in healthcare—could help to develop a methodology based on human knowledge. For this reason, we propose a new methodology for a sequence-oriented sensitive analysis to identify the best activities and parameters to offer a mitigation policy. This methodology is innovative in the following points: i) we present in this paper the first application of Interactive Process Mining pollution personal exposure mitigation; ii) our solution reduces the computation cost and time of the traditional sensitive analysis; iii) the methodology is human-oriented in the sense that the process should be done with the environmental expert; and iv) our solution has been tested with synthetic data to explore the viability before the move to physical exposure measurements, taking the city of Valencia as the use case, and overcoming the difficulty of performing exposure measurements. This dataset has been generated with a model that considers the city of Valencia’s demographic and epidemiological statistics. We have demonstrated that the assessments done using sequence-oriented sensitive analysis can identify target activities. The proposed scenarios can improve the initial KPIs—in the best scenario; we reduce the population exposure by 18% and the relative risk by 12%. Consequently, our proposal could be used with real data in future steps, becoming an innovative point for air pollution mitigation and environmental improvement.

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  • 31.
    Jakobsson, Malin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    ”Jag vill sova, men kan inte”: Ungdomars perspektiv på faktorer som försvårar och främjar deras sömn2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Sleeping difficulties have become increasingly prevalent among adolescents and have negative consequences on their health, well-being, and education.

    Aim and methods: The overall aim of this thesis was to explore adolescents’ sleep and the factors that impede and promote their sleep. Study I describes the prevalence of self-reported sleep duration and sleeping difficulties and explores their associations with school stress, self-perception, and technology use among adolescents based on a questionnaire of n = 937 adolescents, aged 15–16. Study II describes reasons for sleeping difficulties as perceived by adolescents based on an open-ended question answered by n = 475 adolescents, aged 15–16. Study III illuminates adolescents’ lived experiences of sleeping difficulties based on narrative interviews with n = 16 adolescents, aged 14–15. Study IV explores adolescents’ suggestions on how their sleep could be supported, based on eight focus groups with n = 43 adolescents, aged 15–16.

    Results: Fifty-five percent of the adolescents slept less than the recommended eight hours per night. School stress and technology use were associated with short sleep duration, whereas school stress and self-perception were associated with sleeping difficulties (I). Stress, technology use, poor sleep habits, existential thoughts, needs, and suffering were all perceived as reasons for sleeping difficulties (II). Having sleeping difficulties makes it challenging to go through the night and cope with the following day. It also implies a feeling of being trapped by circumstances (III). To improve sleep, adolescents suggested receiving support from involved parents, achieving knowledge about on the “whys” and “hows” of sleep, and being guided into finding balance (IV).

    Conclusions: Sleeping difficulties affect adolescents’ daily lives and constitute a pressing health issue. In order to deal with sleeping difficulties, adolescents need to be encouraged to narrate their experiences and circumstances, be respectfully listened to and supported by their parents, school nurses, and other significant adults.

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  • 32.
    Jakobsson, Malin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ungdomars levda upplevelser av att ha sömnsvårigheter2021Conference paper (Refereed)
    Abstract [sv]

    Bakgrund 

    Det är idag välkänt att en stor del av världens ungdomar sover mindre än de borde. Andelen ungdomar som får tillräckligt med sömn varierar över hela världen (32-86%) [1]. Att ha en bristande sömn påverkar ungdomars möjligheter till hälsa, välbefinnande och utbildning. Forskning utifrån olika perspektiv behövs för att inhämta ytterligare kunskap och förståelse för ungdomars sömn. Hittills finns det få studier med kvalitativ ansats. Syftet med denna studie var därför att belysa innebörden av ungdomars levda upplevelse av sömnsvårigheter. 

    Metod

    Data samlades in via enskilda intervjuer med 16 ungdomar i årskurs nio, 14-15 år, med självupplevda sömnsvårigheter. De transkriberade intervjuerna analyserades med fenomenologisk hermeneutisk metod.

    Resultat

    Fyra teman som belyser innebörden av ungdomars upplevelse av sömnsvårigheter uppstod: att känna sig uppgiven av att inte somna, att uppleva natten som en kamp, att söka efter bättre sömn och att påverkas nästa dag. Den övergripande förståelsen belyser att ungdomar med sömnsvårigheter kan uppleva natten som en obarmhärtigt lång väntan på att somna. Det blir en kamp där de behöver hantera känslor som frustration, irritation, oro, stress, sorg och rädsla. Ungdomarna upplever även att det blir en kamp att hantera nästa dag då sömnbristen gör sig påmind. Att ha sömnsvårigheter upplevs vanligt, som att det tillhör åldern, därför berättar de inte om sömnsvårigheterna eller ber om råd utan provar olika strategier på egen hand. Ungdomar upplever också att det finns omständigheter, så som familj, vänner, skola, betyg, sociala medier, ideal och normer påverkar deras sömn i positiv eller negativ riktning, och kan känns sig fångade i dessa omständigheter.

    Slutsats

    För att förstå ungdomars sömnsvårigheter behövs en förståelse för det sammanhang där ungdomarna lever. Ungdomar måste navigera och hitta balans i förhållande till de omständigheter som kan påverka deras sömn, och som ofta ligger utanför deras kontroll. Genom att verkligen lyssna på ungdomars berättelser om deras sömnsvårigheter och sammanhang kommer föräldrar, professionella vårdgivare och forskare att öka sin förståelse.

    [1]. Gariepy, G. et al. (2020). How Are Adolescents Sleeping? Adolescent Sleep Patterns and Sociodemographic Differences in 24 European and North American Countries. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2020.03.013

  • 33.
    Jakobsson, Malin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Vad uppfattar ungdomar stör deras sömn?2021Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    De senaste åren har forskningen alarmerat om ungdomars sömnsvårigheter och att ungdomar får för få timmars sömn per natt, vilket kan medföra många negativa konsekvenser för hälsa, välbefinnande och utbildning. Denna utveckling är bekymrande och det är av största vikt att arbeta hälsofrämjande och förebyggande med ungdomars sömnsvårigheter. För att tillföra ytterligare kunskap i det hälsofrämjande och förebyggande arbetet behövs forskning där ungdomar ges utrymme att berätta. Vad uppfattar ungdomar själva stör deras sömn?

    Metod

    Data samlades in med hjälp av en öppen fråga i ett frågeformulär; Om du upplever att du sover för lite, har svårt att somna, vaknar på natten eller att sömnen inte gör dig utvilad så skriv gärna vad du tror att dina sömnsvårigheter kan bero på. Deltagarna bestod av 475 ungdomar i årskurs nio. Data analyserades med kvalitativ och kvantitativ innehållsanalys.

    Resultat

    Resultatet beskrivs i ett tema och sex kategorier. På en tematisk nivå kan anledningarna till sömnsvårigheterna förstås som en obalans mellan krav och förutsättningar. Krav handlade om att prestera i skolan, ha aktiviteter, att vara sociala både digitalt och i verkligheten, att alltid ha roligt, att duga och lägga sig i tid. Förutsättningar handlade om att ha tid, struktur, föräldrastöd och en förmåga att sätta sina egna gränser, till exempel för mobilanvändning eller hur olika sociala ideal tilläts påverka dem. När förutsättningarna inte var tillräckliga för att väga upp kraven uppstod en obalans som störde ungdomarnas sömn. De sex kategorier som framkom i analysen och beskriver vad ungdomarna själva uppger stör deras sömn var; stress, följt av teknikanvändning, dåliga sovvanor, existentiella tankar, behov och lidande.

    Slutsats

    Utifrån studiens resultat kan ungdomar behöva stöd för att hitta balans i vardagen och för att kunna hantera stress, teknikanvändning, icke-existerande sömnvanor, existentiella tankar, behov och olika former av lidande. Eftersom hälsovanor ofta etableras i familjen, bör hälsofrämjande arbete även omfatta en dialog med föräldrar. Även om ungdomar verkligen behöver stöd från sina föräldrar, kan de också behöva bli lyssnade till och få stöd från skolsköterskan eller annan vårdande instans

  • 34.
    Jakobsson, Malin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Josefsson, Karin
    Karlstad universitet.
    Högberg, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Adolescents’ own suggestions on how to support their sleep2021Conference paper (Refereed)
    Abstract [en]

    Objectives:

    Now recognized as a public health issue, sleeping difficulties among adolescents, mainly involving insufficient sleep, are common (Gradisar et al., 2011; Louzada, 2019; Saxvig et al., 2020). To avoid persistent sleeping difficulties, health-related problems, and school failure, it is of utmost importance to promote good sleep among adolescents. This study explores adolescents’ suggestions on how their sleep could be supported.

    Methods:

    Data were collected via eight focus group interviews with 43 adolescents aged 15–16 from different demographic areas in a Swedish city, 42% boys and 58% girls. Data were analyzed using qualitative content analysis (Lindgren et al., 2020). 

    Results:

    The results describes the adolescents’ suggestions about how their sleep can be supported in three themes. 

    Being supported by involved parents

    Even though adolescents are starting to become independent individuals, they want support to sleep better. Above all, they want support from their parents in the form of routines, security, and knowledge about sleep.

    Being supported to achieve knowledge on the “whys” and “hows” of sleep

    Adolescents value knowledge and advice that they receive from those they trust because it is then perceived as targeted and personal. Adolescents also want school education about sleep to be more activity-based, as they find that learning and motivation increase with this type of pedagogy.

    Being guided into finding balance 

    By being encouraged into activity, learning to deal with silence, as well as by receiving support by structures in school, the adolescents believe they can be guided to finding balance. 

    Conclusions:

    Designing interventions and health promotions in line with what the adolescents suggest will create the conditions to successfully support adolescents’ sleep. These suggestions should be used by parents, health professionals, and the school, all of whom have the opportunity to influence adolescents; these strategies also need to be evaluated

  • 35.
    Jakobsson, Malin
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Sundin, Karin
    Umeå Universitet.
    Högberg, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    En obarmhärtigt lång väntan på att somna2021In: Skolhälsan, ISSN 0284-284X, no 1Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    En vanlig uppfattning i samhället är att ungdomar som sover för lite är slarviga med rutiner och att skärmarna tar deras tid. Men är problematiken så enkel? Hur är det egentligen att ha sömnsvårigheter? En ny studie från Högskolan Borås ger en inblick i ungdomars egna upplevelser.

  • 36.
    Kalyanasundaram, M.
    et al.
    Division of Environmental Health and Epidemiology, ICMR – National Institute for Research in Environmental Health, Bhopal, 462 030, India.
    Sabde, Y.
    Division of Environmental Health and Epidemiology, ICMR – National Institute for Research in Environmental Health, Bhopal, 462 030, India.
    Annerstedt, K. S.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Singh, S.
    Division of Environmental Monitoring and Exposure Assessment (Water & Soil), ICMR – National Institute for Research in Environmental Health, Bhopal, 462 030, India.
    Sahoo, K. C.
    ICMR- Regional Medical Research Centre, Bhubaneshwar, 751023, India.
    Parashar, V.
    Department of Public Health and Environment, RD Gardi Medical College, Ujjain, 456006, India.
    Purohit, M.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Pathak, A.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Lundborg, C. S.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Rousta, Kamran
    University of Borås, Faculty of Textiles, Engineering and Business.
    Bolton, Kim
    University of Borås, Faculty of Textiles, Engineering and Business.
    Atkins, S.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Diwan, V.
    Department of Global Public Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Effects of improved information and volunteer support on segregation of solid waste at the household level in urban settings in Madhya Pradesh, India (I-MISS): protocol of a cluster randomized controlled trial2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 694Article in journal (Refereed)
    Abstract [en]

    Background: Segregation of household waste at the source is an effective and sustainable strategy for management of municipal waste. However, household segregation levels remain insufficient as waste management approaches are mostly top down and lack local support. The realisation and recognition of effective, improved and adequate waste management may be one of the vital drivers for attaining environmental protection and improved health and well-being. The presence of a local level motivator may promote household waste segregation and ultimately pro-environmental behaviour. The present cluster randomized control trial aims to understand if volunteer based information on waste segregation (I-MISS) can effectively promote increased waste segregation practices at the household level when compared with existing routine waste segregation information in an urban Indian setting.

    Methods: This paper describes the protocol of an 18 month two-group parallel,cluster randomised controlled trialin the urban setting of Ujjain, Madhya Pradesh, India. Randomization will be conducted at ward level, which is the last administrative unit of the municipality. The study will recruit 425 households in intervention and control groups. Assessments will be performed at baseline (0 months), midline (6 months), end line (12 months) and post intervention (18 months). The primary outcome will be the comparison of change in proportion of households practicing waste segregation and change in proportion of mis-sorted waste across the study period between the intervention and control groups as assessed by pick analysis. Intention to treat analysis will be conducted. Written informed consent will be obtained from all participants.

    Discussion: The present study is designed to study whether an external motivator, a volunteer selected from the participating community and empowered with adequate training, could disseminate waste segregation information to their community, thus promoting household waste segregation and ultimately pro-environmental behaviour. The study envisages that the volunteers could link waste management service providers and the community, give a local perspective to waste management, and help to change community habits through information, constant communication and feedback.

    Trial registration: The study is registered prospectively with Indian Council of Medical Research- Clinical Trial Registry of India (CTRI/2020/03/024278). 

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  • 37.
    Koskinen, Monika
    et al.
    Åbo Akademi University.
    Hilli, Yvonne
    Nord University.
    Keskitalo, Tuulikki
    Lapland University of Applied Sciences.
    Talvik, Merle
    Tallinn Health Care College.
    Sandvik, Ann-Helén
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. University of Borås.
    Thorkildsen, Kari Marie
    Western Norway University of Applied Sciences.
    Skyvell-Nilsson, Maria
    University West.
    Koivula, Meeri
    Tampere University.
    Šteinmiller, Jekaterina
    Tallinn Health Care College.
    Ethical dilemmas faced by healthcare teachers during the COVID-19 pandemic2023In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed)
    Abstract [en]

    Background

    Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence.

    Research aim

    This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic.

    Research design

    This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews were conducted and analysed thematically.

    Participants and research context

    Healthcare teachers (n = 20) from eight universities and universities of applied sciences in the Nordic and Baltic countries participated.

    Ethical considerations

    This study was based on the research ethics of the Norwegian National Research Ethics Committee for Medicine and Health Sciences and approved by the Norwegian Agency for Shared Services in Education and Research.

    Findings

    Healthcare teachers faced several ethical dilemmas due to restrictions during the COVID-19 pandemic. The analysis revealed three main themes: How should I deal with students’ ill-being, and what can I as a teacher do?; What can I demand from myself and my students, what is good teaching?; How do I manage the heavy workload and everyone’s needs, and who gets my time?

    Conclusions

    This study highlights the importance of healthcare teachers’ continuous need for pedagogic and didactic education, especially considering new technology and ethical issues. During the pandemic, the ethical consequences of remote teaching became evident. Ethical values and ethical dilemmas should be addressed in healthcare education programmes at different levels, especially in teacher education programmes. In the coming years, remote teaching will grow. Therefore, we need more research on this issue from an ethical perspective on its possible consequences for students and healthcare teachers.

     

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  • 38.
    Lidén, Eva
    University of Borås, School of Health Science.
    Vård och omsorgsplaneringsmötet: erfarenheter ur ett tvärprofessionellt perspektiv2009Report (Other academic)
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  • 39.
    Lindahl, Berit
    et al.
    University of Borås, School of Health Science.
    Sandman, P-O
    Rasmussen, Birgit
    On being dependent of home mechanical ventilation: depictions of patients' experiences over time2006In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 16, no 7, p. 33-42Article in journal (Refereed)
    Abstract [en]

    In this study, the authors describe the meanings of experiences of being dependent on a ventilator (HMV) and living at home as narrated by 13 people who had been using a ventilator via a mask or tracheostomy for half a year. The analyses revealed various movements across time toward the goal of using the ventilator successfully, and some narratives depicted suffering caused by care. The analyses also yielded different representations of embodiment. These findings were abstracted into two contrasting meanings of the experience of using HMV over time: a closing in or an opening up of the lived body, oneself, to other people and to the world. The authors illustrate this interpretation with two images. Ignorance and negative attitudes on the part of professionals working and/or managing care in the patients’ homes are interpreted as causing suffering and intensifying a closed-in mode of being.

  • 40.
    Mosallanezhad, Zahra
    et al.
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Sotoudeh, Gholam Reza
    Department of Health Sciences, Mid Sweden University.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Salavati, Mahyar
    Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran.
    Harms-Ringdahl, Karin
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Wikmar, Lena Nilsson
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Frändin, Kerstin
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people.2017In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 70, p. 123-129, article id S0167-4943(17)30020-1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIM: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling.

    METHODS: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit.

    RESULTS: The measurement model yielded a reasonable fit to the data, χ2=110.93, df=38; CFI=0.97; RMSEA=0.047, with 90% C.I.=0.037-0.058. The model fit for the conceptual model was acceptable; χ2=271.64, df=39; CFI=0.91; RMSEA=0.084, with 90% C.I.=0.074-0.093. SES itself was not a direct predictor of HS (β=0.13, p=0.059) but it was a predictor of HS either through affecting PA (β=0.31, p<0.001) or I (β=0.57, p<0.001).

    CONCLUSION: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL.

  • 41. Persson Waye, K
    et al.
    van Kamp, I
    Dellve, L
    University of Borås, School of Health Science.
    Validation of a questionnaire measuring preschool children's reactions to and coping with noise in a repeated measurement design2013In: BMJ Open, E-ISSN 2044-6055, Vol. 3, no 5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the study was to explore and describe the reliability and validity of an instrument to measure preschool children's reactions to and coping with indoor noise at preschools or day care centres. DESIGN: Data were derived from an acoustical before and after intervention study providing repeated measurements. SETTING: The study was performed at seven preschools in Mölndal, Sweden. PARTICIPANTS: Children were recruited from these preschools and the final sample comprised 61 and 59 preschool children aged 4-5 years, with a response rate of 98% and 48% girls and 52% boys. Two children were excluded from analysis because they fell outside the age range. PRIMARY AND SECONDARY OUTCOME MEASURES: The instrument was developed based on a qualitative study performed in Swedish preschools. Questions pertained to preschool children's perception of noise when at school, their bodily and emotional reactions to it, non-specific symptoms and the coping strategies used by them to diminish the detrimental effects of the noise. RESULTS: Confirmative factor analysis yielded a three-factor model fitted to 10 items pertaining to angry reactions, symptoms and coping. The model fit was moderate to good (standardised root mean square residual=0.08, 0.12; adjusted goodness of fit=0.97/0.91) in the before and after conditions, respectively. The scales showed moderate to good reliability in terms of internal consistency, with an α ranging between 0.52 and 0.67, and was stronger in the before condition. Concurrent validity was strongest for symptoms by comparing groups based on bodily reaction (general and sound specific). CONCLUSIONS: Young children's emotional and bodily reactions to coping with noise can be reliably measured with this instrument. Like adults and older children, young children are able to distinguish between emotional reactions, bodily reactions, coping and unwell-being. Future research on larger groups of preschool children is needed to further refine the questions, in particular the questions pertaining to well-being.

  • 42. Samulowitz, A
    et al.
    Gremyr, I
    Eriksson, Erik
    Chalmers University of Technology.
    Hensing, G
    “Brave men” and “emotional women”: A theory-guided literature review of gender bias in health care and gendered norms towards patients with chronic pain2018In: Pain Research and ManagementArticle in journal (Refereed)
  • 43.
    Sandman, Lars
    University of Borås, School of Health Science.
    Developing a context-specific ethics framework for HTA2014Conference paper (Refereed)
  • 44.
    Sandman, Lars
    et al.
    University of Borås, School of Health Science.
    Broqvist, Mari
    Gustafsson, Erik
    Arvidsson, Eva
    Ekerstad, Niklas
    Carlsson, Per
    Vård som inte kan anstå: Tolkning i relation till den etiska plattformen och nationella modellen för prioriteringar.2014Report (Other academic)
    Abstract [sv]

    Uppdraget från Socialstyrelsen består av tre sammanhängande delar. I den första delen presenteras olika tolkningar av begreppet vård som inte kan anstå utifrån en analys av hur begreppet används i den aktuella propositionen och lagtexten. Dessa tolkningar specificeras i ett antal kriterier. I den andra delen analyseras dessa tolkningar utifrån den etiska plattformen. Den tredje delen syftar till att analysera hur begreppet vård som inte kan anstå förhåller sig till den nationella modellen för öppna prioriteringar inom hälso- och sjukvård och diskutera om denna kan användas för att ge stöd vid prioritering och ransonering. Den teoretiska analysen kompletteras med några exempel på praktiska beslutssituationer avseende vård av papperslösa hämtade från kliniskt verksamma personer.

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  • 45.
    Sandman, Lars
    et al.
    University of Borås, School of Health Science.
    Heintz, Emelie
    Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?2014In: GMS Health Technology Assessment, ISSN 1861-8863, E-ISSN 1861-8863, Vol. 10Article in journal (Refereed)
    Abstract [en]

    An essential component of health technology assessment (HTA) is the assessment of ethical aspects. In some healthcare contexts, tasks are strictly relegated to different expert groups: the HTA-agencies are limited to assessment of the technology and other actors within the health care sector are responsible for appraisal and recommendations. Ethical aspects of health technologies are considered with reference to values or norms in such a way that may be prescriptive, or offer guidance as to how to act or relate to the issue in question. Given this internal prescriptivity, the distinction between assessment and appraisal seems difficult to uphold, unless the scrutiny stops short of a full ethical analysis of the technology. In the present article we analyse the distinction between assessment and appraisal, using as an example ethical aspects of implementation of GPS-bracelets for people with dementia. It is concluded that for HTA-agencies with a strictly delineated assessment role, the question of how to deal with the internal prescriptivity of ethics may be confusing. A full ethical analysis might result in a definite conclusion as to whether the technology in question is ethically acceptable or not, thereby limiting choices for decision-makers, who are required to uphold certain ethical values and norms. At the same time, depending on the exact nature of such a conclusion, different action strategies can be supported. A positive appraisal within HTA could result in a decision on mandatory implementation, or funding of the technology, thereby making it available to patients, or decisions to allow and even encourage the use of the technology (even if someone else will have to fund it). A neutral appraisal, giving no definite answer as to whether implementation is recommended or not, could result in a laissez-faire attitude towards the technology. A negative appraisal could result in a decision to discourage or even prohibit implementation. This paper presents an overview of the implications of different outcomes of the ethical analysis on appraisal of the technology. It is considered important to uphold the distinction between assessment and appraisal, primarily to avoid the influence of preconceived values and political interests on the assessment. Hence, as long as it is not based on the subjective value judgments of the HTA-agency (or its representative), such an appraising conclusion would not seem to conflict with the rationale for the separation of these tasks. Moreover, it should be noted that if HTA agencies abstain from including full ethical analyses because of the risk of issuing an appraisal, they may fail to provide the best possible basis for decision-makers. Hence, we argue that as long as the ethical analysis and its conclusions are presented transparently, disclosing how well-founded the conclusions are and/or whether there are alternative conclusions, the HTA-agencies should not avoid taking the ethical analysis as close as possible to a definite conclusion.

  • 46.
    Sandman, Lars
    et al.
    University of Borås, School of Health Science.
    Heintz, Emelie
    Hultkrantz, Monica
    Jacobsson, Stella
    Lintamo, Laura
    Levi, Ragnar
    Munthe, Christian
    Tranaeus, Sofia
    Östlund, Pernilla
    Etiska aspekter på åtgärder inom hälso- och sjukvården. En vägledning för att identifiera relevanta etiska frågor.2014Report (Other academic)
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  • 47.
    Sandsjö, Leif
    et al.
    University of Borås, School of Engineering.
    Jensen, Lena-Marie
    University of Borås, Swedish School of Textiles.
    Medicinska tillämpningar av smarta textilier: Triple Helix -samverkan mellan Smart Textiles och MedTech West2012Conference paper (Other academic)
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  • 48.
    Scheffer, M
    et al.
    Department of Care and Participation of People with Chronic Conditions, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.
    Menting, J
    Department of Care and Participation of People with Chronic Conditions, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.
    Roodbeen, R
    Department of Research, Breuer&Intraval Research and Consultancy, Groningen, The Netherlands.
    van Dulmen, Sandra
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Communication in Healthcare, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
    van Hecke, M
    Department of Ophthalmology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
    Schlingemann, R
    Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Bergman Clinics Ogen, Amsterdam, The Netherlands; Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
    van Nispen, R
    Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
    Boeije, H
    Department of Care and Participation of People with Chronic Conditions, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.
    Patients' and health professionals' views on shared decision-making in age-related macular degeneration care: A qualitative study2022In: Ophthalmic & physiological optics, ISSN 0275-5408, E-ISSN 1475-1313, Vol. 42, no 5, p. 1015-1022Article in journal (Refereed)
    Abstract [en]

    Background Age-related macular degeneration (AMD) is one of the principal causes of irreversible visual impairment in the older adult population. Recent evidence indicates that there are signs of undertreatment and overtreatment, underdiagnosis and insufficient information provision in AMD care. Shared decision-making (SDM) can aid information sharing between patients and health professionals and enhances high-quality care. This research aimed to gain insight into patients' and professionals' views on SDM in AMD care. Methods Semi-structured interviews were conducted with 20 patients with AMD and 19 health professionals in June and July 2020. Participants were recruited through hospitals, professional and patient associations and (social) networks. Sample representativeness was ensured in terms of sociodemographic and disease characteristics for patients, and profession-related characteristics for health professionals. Interviews were analysed according to a predetermined coding framework. Results Although SDM is receiving attention in AMD care, health professionals and patients experienced barriers in making shared decisions. The most common barriers reported included limitations in treatment options, time constraints, strict treatment guidelines and patients' comorbidity. Furthermore, most patients indicated that they were not (fully) informed about all aspects of AMD trajectory, such as the possibility to discontinue therapy or the long-term and invasive character of treatment. Some patients expressed the need for a more empathic and person-centred communication style from their health professional. Conclusion The concerns raised by patients and health professionals suggest that there is room for improvement in delivery of SDM in AMD care. Findings from this study indicate that information provision and communication can be improved.

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  • 49.
    Smith, Frida
    et al.
    Chalmers University of Technology.
    Hellström, Andreas
    Chalmers University of Technology.
    Gunnarsdóttir, Katrín Ásta
    Regional Cancer Centre West, Western Sweden Healthcare Region.
    Genell, Anna
    Regional Cancer Centre West, Western Sweden Healthcare Region.
    Eriksson, Erik
    Chalmers University of Technology.
    Mannefred, Carina
    Regional Cancer Centre West, Western Sweden Healthcare Region.
    Björk-Eriksson, Thomas
    Department of Oncology, Sahlgrenska Academy, Gothenburg.
    Vaughn, Lisa
    University of Cincinnati, USA.
    Exploring the meaning, role and experiences of a patient-led social innovation for people affected by cancer: a new collaborative care model complementing traditional cancer rehabilitation in Sweden2021In: BMJ Open Quality, E-ISSN 2399-6641Article in journal (Refereed)
    Abstract [en]

    Objective: Kraftens Hus is the first support centre in Sweden designed by and for people affected by cancer, including patients, family, friends, staff members and local community representatives (collectively ‘stakeholders’). The purpose of this study was to explore the meaning, role and experiences of Kraftens Hus stakeholders using a patient and public involved methodology.

    Methods: To understand and map the experiences of visitors to Kraftens Hus, we applied concept mapping (CM), a mixed methods approach where data are collected and analysed in four structured steps designed to capture the diverse perspectives of multiple stakeholders. Qualitative interviews with relevant stakeholders supplemented the CM findings.

    Results: The final concept map contained six clusters of ideas. Within the clusters, there was a recurring theme that cancer-affected people value accessible and long-term psychosocial support (PSS). The intended emotional, social and practical needs identified in a previous design process seem to have been addressed and appreciated by Kraftens Hus visitors.

    Conclusion: Kraftens Hus is an example of a new patient-led social innovation based on a life-event perspective and integration of resources from different sectors in society. By focusing on life, not the disease, the care continuum expands, and long-term PSS is provided alongside cancer treatment. The evaluation confirms that PSS should focus on health and well-being in the broadest sense.

  • 50.
    Sundberg, Fredrika
    et al.
    Research and Development Centre, Skaraborg Hospital Skövde, Region Västra Götaland, Sweden; The School of Health Sciences, University of Skövde, Sweden.
    Dahlborg, Elisabeth
    Department of Health Sciences, Section for Nursing, University West, Sweden.
    Lindahl, Berit
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Health Sciences and the Institute for Palliative Care Lund University and Region Skåne, HSC, Lund, Sweden.
    Spatial isolation and health during the Covid-19 pandemic: A critical discourse analysis2023In: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 83, article id 103080Article in journal (Refereed)
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