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  • 1.
    Al Hakeem, Haidar
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjuksköterskors erfarenhet av följsamhet till basala hygienrutiner inom slutenvården med fokus på handhygien: En litteraturstudie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Healthcare-related infections (VRIs) compose a global patient safety risk. One third of all healthcare injuries in Sweden are healthcare-related infections. The most common VRI are urinary tract infections (UTI) and postoperative wound infections of varying severity, which account for about 50% of all VRIs in Sweden. The hands are the largest source of infection for diseases in health care and therefore it is important that the registered nurse works preventively and follows hand hygiene routines to reduce the risk of infections in health care. Aim: The purpose of this literature study is to describe the undergraduate nurses' experience of adherence to basic hygiene routines in inpatient care with a focus on hand hygiene. Method: This literature study used 10 qualitative scientific articles. The articles were taken from two databases PubMed and CINAHL focusing on nurses. Articles reviewed according to SBU guidelines and were analyzed to identify relevant articles that serve the aims of the study. Results: The results of the study have been compiled into four headings. The four headings were: knowledge and skills deficiencies, environmental and organizational factors, attitudes and social behavior technology. Conclusion: Nurses think that there is a shortage of hand hygiene products, staff and knowledge, which has a negative impact on compliance to hand hygiene.

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  • 2.
    Almström, Anna
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Stein, Mia
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hur påverkar arbetsmiljön patientsäkerheten - sjuksköterskans erfarenheter: En litteraturstudie2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Årligen i Sverige uppskattas tio procent av patienterna drabbas av vårdskada. Inom hälso- och sjukvården är resursbrist och hög arbetsbelastning vanligt förekommande samtidigt som sjuksköterskan befinner sig i en arbetsmiljö med krav på att upprätthålla patientsäkerheten. Det är av vikt att den grundutbildade sjuksköterskan har förståelse för på vilket sätt arbetsmiljön påverkar patientsäkerheten för att kunna bedriva säker vård som tillgodoser patientens grundläggande behov. Syfte: Studiens syfte var att belysa hur sjuksköterskan erfar att arbetsmiljön påverkar patientsäkerheten.Metod: Litteraturstudien bygger på tolv vetenskapliga artiklar med kvalitativ ansats. Artiklarna är hämtade från databaserna Cinahl, PubMed och Psykinfo. Analysen har utgått från innehållsanalys och artiklarna har kvalitetsgranskats. Resultat: Fyra teman identifierades: Organisation och ledning, Fysisk och Psykisk påverkan, Bemanning och arbetsbelastning samt Teamarbete och kommunikation.Konklusion: Studien lyfter flera olika faktorer i sjuksköterskans arbetsmiljö som påverkar patientsäkerheten. Utmärkande var framförallt personalbrist och hög arbetsbelastning, vidare betonas att god kommunikation och fungerande teamarbete har positiv påverkan som bidrar till att sjuksköterskan kan tillgodose patientens grundläggande behov. För att förbättra sjuksköterskans arbetsmiljö och upprätthålla god och säker vård krävs åtgärder på såväl organisatorisk nivå som på individnivå. Litteraturstudien genererar en ökad förståelse för arbetsmiljöns betydelse för såväl sjuksköterskans personliga hälsa som patientens säkerhet. 

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  • 3.
    Awad, Eman
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Ramji, Rathi
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Cirovic, Stefan
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University.
    Developing and evaluating non-invasive healthcare technologies for a group of female participants from a socioeconomically disadvantaged area2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 23896Article in journal (Refereed)
    Abstract [en]

    When compared to the general population, socioeconomically disadvantaged communitiesfrequently experience compromised health. Monitoring the divide is challenging since standardizedbiomedical tests are linguistically and culturally inappropriate. The aim of this study was to developand test a unique mobile biomedical testbed based on non-invasive analysis, as well as to explorethe relationships between the objective health measures and subjective health outcomes, asevaluated with the World Health Organization Quality of Life survey. The testbed was evaluated in asocioeconomically disadvantaged neighborhood in Malmö, which has been listed as one of the twelvemost vulnerable districts in Sweden. The study revealed that compared to conventional protocolsthe less intrusive biomedical approach was highly appreciated by the participants. Surprisingly, thecollected biomedical data illustrated that the apparent health of the participants from the ethnicallydiverse low-income neighborhood was comparable to the general Swedish population. Statisticallysignificant correlations between perceived health and biomedical data were disclosed, even thoughthe dependences found were complex, and recognition of the manifest complexity needs to beincluded in further research. Our results validate the potential of non-invasive technologies incombination with advanced statistical analysis, especially when combined with linguistically andculturally appropriate healthcare methodologies, allowing participants to appreciate the significanceof the different parameters to evaluate and monitor aspects of health.

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  • 4.
    Bacaksizlar, Ecenur
    Malmö University, Faculty of Culture and Society (KS), School of Arts and Communication (K3).
    U-Med: A Mobile Application and a Reverse Vending Machine for Individuals to Reduce Unused Medication Waste2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 5. Baudin, Katarina
    et al.
    Gustafsson, Christine
    Frennert, Susanne
    Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT). Malmö University, Internet of Things and People (IOTAP).
    Views of Swedish Elder Care Personnel on Ongoing Digital Transformation: Cross-Sectional Study2020In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, no 6, article id e15450Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Swedish municipalities are facing demographic challenges due to the growing number of older people and the resulting increased need for health care services. Welfare technologies are being launched as possible solutions for meeting some of these challenges.

    OBJECTIVE: The aim of this study was to explore the perception, experimentation, evaluation, and procurement of welfare technology practices among professionals working in municipal elder care in relation to their gender, age, and profession.

    METHODS: Data for this explorative cross-sectional study were collected from 393 responses to a web-based survey on municipal elder care in Sweden. Chi square tests were performed to determine the associations.

    RESULTS: The results revealed gender, age, and professional differences in perspectives of municipal elder care workers. Differences were particularly evident in attitudes toward technology, both the use of technology in general and in the workplace, and involvement and participation in decision making regarding the procurement of new welfare technologies. Men (37/53, 70%) expressed a more positive attitude toward and curiosity regarding new technologies than women (157/336, 46.7%) (P=.03). Regarding age, the younger respondents (18-24 years old) perceived the digital transformation in the workplace as "too slow" (4/4, 100%), whereas the majority of older respondents (65-74 years old) perceived it as happening at the "right pace" (4/7, 57%). The elder care personnel felt encouraged by management to explore and experiment with new welfare technologies, but never did so either for management or with patients. Even though the majority of the respondents were women, more men (4/7, 57%) were involved in the procurement process for welfare technology devices and solutions than women (98/336, 29.2%) (P<.001).

    CONCLUSIONS: Personnel working within municipal elder care were generally very positive toward new technologies. However, both gender and age differences may influence these perspectives such as the personnel's resistance to welfare technology and patients' participation in welfare technology usage and deployment. Different levels of participation in the decision-making process regarding new technology deployment may negatively affect the overall digital transformation within municipal elder care.

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  • 6.
    Bäckström, Sara
    Malmö University, Faculty of Health and Society (HS).
    ”Inte ens preventivmedel handlar om sex": En fenomenologisk studie om sexologisk stöttning efter en vaginal förlossning.2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Since 2015, the Swedish government has invested more money in the post-partum care to make it more accessible. The number of Swedish qualitative studies, which highlight women's experiences of sexological support after childbirth since 2015, is limited. This means that we do not know how adequate the government's investments have been in terms of patients' access to sexological support after childbirth. The purpose of the study is to gain an increased understanding of what sexological support, from healthcare, people feel they need after childbirth. The author has conducted ten qualitative semi-structured interviews with respondents who had a vaginal birth in the last two years. Analyzed through Merleau-Ponty's (1945/2006) and Ahmed's (2014) phenomenological theories the results show that the respondents' sexual health was affected by the interaction of the changes in their physical body and life situation. These aspects were also influenced by their partner and the post-partum care. During the follow-up, several respondents felt that their midwife focused too much on their physical body instead of changes related to their sexual health. Participants expressed a need for more information and confirmation regarding the physical, psychological, and social changes that affected their sexual health. The participants also wished to have more sexological support for their partner. This result indicates that the government's investment in the post-partum care has not been sufficient in terms of sexual health after childbirth, which means that parts of this care remain unavailable.

    Key words: childbirth, partner, post-partum, postnatal care, sexual health, sexual function, sexual satisfaction, sexological support.

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  • 7.
    Dalingwater, Louise
    et al.
    Sorbonne University.
    Mangrio, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Strange, Michael
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    The well-being of marginalized migrants in Europe duing the Covid-19 epidemic: evidence from France, Sweden, and the UK2022In: The Unequal Costs of Covid-19 on Well-being in Europe / [ed] Louise Dalingwater,Vanessa Boullett, Iside Costantini & Paul Gibbs, Springer Nature, 2022, p. 177-202Chapter in book (Refereed)
    Abstract [en]

    International guidance set forth recommendations to protect marginalized migrant populations during Covid-19 given the significant inequalities in terms of social and economic well-being reported in the literature. However, a cross-country study of three European countries with high rates of Covid-19 infections and deaths has shown that migrant well-being has significantly decreased since the outbreak of Covid-19 in Europe from March 2020 and that policy measures to help those marginalized populations have been insufficient. The conclusions on migrant well-being during Covid-19 draw on interviews with prominent civil society organizations in all three countries that work specifically on migrant health and welfare. All interviews were semi-structured and conducted between October and November 2020. The analysis mainly focuses on objective/material measures of well-being related to access to health care, information on prevention of infection, housing and exclusion by host population.

  • 8. Folke, Solgun
    et al.
    Fridlund, Bengt
    Paulsson, Gun
    Views of xerostomia among health care professionals: a qualitative study.2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 791-8Article in journal (Refereed)
    Abstract [en]

    AIM: To explore and describe views of xerostomia among health care professionals.

    BACKGROUND: Xerostomia (dry mouth) is caused by changes in quality and quantity of saliva due to poor health, certain drugs and radiation therapy. It is a common symptom, particularly among older people and has devastating consequences with regard to oral health and general well-being.

    METHODS: Data were obtained and categorised by interviewing 16 health care professionals. Qualitative content analysis was chosen as the method of analysis.

    DESIGN: Qualitative.

    RESULTS: The latent content was formulated into a theme: xerostomia is a well-known problem, yet there is inadequate management of patients with xerostomia. The findings identified three categories expressing the manifest content: awareness of xerostomia, indifferent attitude and insufficient support.

    CONCLUSIONS: Although xerostomia was recognised as commonly occurring, it was considered to be an underestimated and an ignored problem. Proper attention to conditions of xerostomia and subsequent patient management were viewed as fragmentary and inadequate. Additional qualitative studies among patients with xerostomia would be desirable to gain further understanding of the problems with xerostomia, its professional recognition and management.

    RELEVANCE TO CLINICAL PRACTICE: A holistic view, positive professional attitudes and enhanced knowledge of xerostomia seem essential to augment collaboration among health care professionals and to improve compassion for and support of patients with xerostomia.

  • 9.
    Franzén, Cecilia
    et al.
    Malmö University, Faculty of Odontology (OD).
    Nilsson, Eva-Lotta
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Supporting first-time parents in their homes: an informal setting enabling interprofessional collaboration2024In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 545Article in journal (Refereed)
    Abstract [en]

    Background 

    Home visiting programmes aiming to support parents and promote more equal health amongst youngchildren have grown in Sweden and in other countries. These programmes involve interprofessional teams. Teamworkin interprofessional contexts often requires setting boundaries, but professionals’ boundary work in the home settingis unexplored. Therefore, this article focuses on interprofessional teams comprising child healthcare nurses, midwives,social workers, and dental hygienists in a home visiting programme for first-time parents in Sweden; it aims to explorehow the professionals performed boundary work that enabled collaboration and to investigate important contextualconditions for this kind of boundary work.

    Methods

    The data were drawn from semi-structured interviews with twelve professionals from the four differentdisciplines. Content analysis was used to explore their boundary work.

    Results

    The findings show that the professionals performed three forms of collaborative boundary work. They maintained boundaries by clarifying their distinct roles and expertise. However, the differences were viewed ascomplementary, and the professionals worked together humbly to complement each other’s knowledge andperspectives. Lastly, they tended to drop perceptions of prestige and blurred the boundaries to accommodate theiroverlapping knowledge. Important conditions for the success of collaborative boundary work were meetings prior tothe home visits, the opportunities for discussion and reflection after the home visits, and the informal character of thehome setting. Consequently, the professionals were able to jointly contribute to a holistic view of the visited families,which increased the possibilities to meet these families’ needs.

    Conclusions 

    This study contributes knowledge on boundary work in interprofessional collaborations in thehome setting. The informal character of the home setting seemed to facilitate collaboration and contributed tocreating informal professional roles. The findings suggest that having interprofessional teams in the home settingenabled collaboration as well as reinforced support for first-time parents, which emphasizes the merit of home visitprogrammes

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  • 10.
    FREDRIKSSON, FREDRIK
    et al.
    Malmö University, Faculty of Education and Society (LS).
    Moa, Schörling
    Malmö University, Faculty of Education and Society (LS).
    Barns förutsättningar för fysisk aktivitet2023Independent thesis Basic level (degree of Bachelor of Fine Arts), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    We will be presenting a categorized and thematically analyzed overview of factors that facilitate/inhibit children's physical activity outside the context of compulsory school. The intent is to attempt to make an inventory of possible influencing factors for our client Innovation Skåne and it's our hope that this work could act as a guide in their work.

    The purpose of this work is to examine children's conditions for physical activity outside of school.

    The method consisted of a literature study and child interviews which underwent a thematic analysis. After which a triangulation was carried out between the two empirical collection methods. The methods were compared to each other to see if the children's perspective from the child interviews differ compared to the research from the literature and the adults' perspective on the children's needs.

    The result is that the children have very different perceptions of what physical activity is, the children's perspective on physical activity differs from the research's broad definitions to the extent that sports and performance are in focus. The main area and results of the thematic analysis touched on important impact areas such as the enabling of self-selected activities and autonomy. Safety when transporting by bicycle, parental presence, group community or self-selected privacy in your own "bubble" to name a few examples.

    The conclusion is that there is a difference in the children's rights perspective regarding outdoor environments and the opportunities that the children have to be able to have somewhere to be after school because the schools are not allowed to stay in until the school days are over when you go to upper secondary school. Last and most importantly. Children do not control their physically active free time. The adults do.

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  • 11.
    Frennert, Susanne
    Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT). Malmö University, Internet of Things and People (IOTAP).
    Approaches to welfare technology in municipal eldercare2020In: Journal of technology in human services, ISSN 1522-8835, E-ISSN 1522-8991, Vol. 38, no 3, p. 226-246Article in journal (Refereed)
    Abstract [en]

    Welfare technologies have been proposed in Scandinavian countries as way to ensure accessible and efficient care to those who need it. Significant investments have been made to develop and deploy these technologies. This study used a multiple case study design to explore how welfare technologies are implemented in Swedish eldercare practices. The multiple case study generated detailed knowledge and insights from a broad perspective on the employment of welfare technologies within various municipalities. The study revealed three approaches for integrating welfare technologies into municipal eldercare services: as an end-product, as a project, and as a strategy. Findings indicate that municipal welfare technology practices are diverse and multifaceted, yet implementing such practices is a complex process. This study proposes a focus shift, from technological solutions to organizational context, eldercare personnel, and care receivers.

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  • 12.
    Frennert, Susanne
    Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT). Malmö University, Internet of Things and People (IOTAP).
    Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation.2023In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 18, no 2, p. 156-165Article in journal (Refereed)
    Abstract [en]

    AIM: Technology affects almost all aspects of modern eldercare. Ensuring ethical decision-making is essential as eldercare becomes more digital; each decision affects a patient's life, self-esteem, health and wellness.

    METHODS: We conducted a survey and interviews with eldercare professionals to better understand the behavioural ethics and decision making involved in the digital transition of eldercare.

    CONCLUSION: Our qualitative analysis showed three recurrent roles among eldercare professionals in regard to digital service transformation; makers, implementers and maintainers. All three encountered challenging and stressful ethical dilemmas due to uncertainty and a lack of control. The matter of power relations, the attempts to standardize digital solutions and the conflict between cost efficiency and if digital care solutions add value for patients, all caused moral dilemmas for eldercare professionals. The findings suggest a need for organizational infrastructure that promotes ethical conduct and behaviour, ethics training and access to related resources. Implications for rehabilitation The transition to digital care service is not neutral, but value-laden. Digital transformation affects ethical behaviour and decision-making. The decision as to which digital services should be developed and deployed must include eldercare professionals and not lay solely in the hands of managers, technologists and economists. We must move away from attempting to fit standardized solutions to a heterogenous group of older patients; accommodating the pluralism of patients' needs and wants protects their dignity, autonomy and independence. As digital care practices evolve, so too must organizational structures that promote ethical conduct.

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  • 13. Fridberg, Helena
    et al.
    Wallin, Lars
    Wallengren, Catarina
    Forsman, Henrietta
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tistad, Malin
    Development of an instrument for evaluating implementation efforts and benchmarking regarding person centered care2020In: Implementation Science, E-ISSN 1748-5908, Vol. 15, no S1, article id A62Article in journal (Other academic)
  • 14.
    Gaber, Sophie N.
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden.;Marie Cederschiold Univ, Dept Hlth Care Sci, Stockholm, Sweden..
    Thalen, Liv
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Malinowsky, Camilla W.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Margot-Cattin, Isabel
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden.;Univ Appl Sci & Arts Western Switzerland HES SO D, Sch Social Work & Hlth, Dept Occupat Therapy, Lausanne HETSL, Delemont, Switzerland..
    Seetharaman, Kishore
    Simon Fraser Univ, Dept Gerontol, Burnaby, BC, Canada..
    Chaudhury, Habib
    Simon Fraser Univ, Dept Gerontol, Burnaby, BC, Canada..
    Cutchin, Malcolm
    Pacific Northwest Univ Hlth Sci, Yakima, WA USA..
    Wallcook, Sarah
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Brorsson, Anna
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Biglieri, Samantha
    Ryerson Univ, Sch Urban & Reg Planning, Toronto, ON, Canada..
    Nygard, Louise
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia2022In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 41, no 11, p. 2362-2373Article in journal (Refereed)
    Abstract [en]

    There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada (n = 58), Sweden (n = 69), Switzerland (n = 70), and the United Kingdom (n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation (p < .01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.

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  • 15. Gaber, Sophie Nadia
    et al.
    Nygård, Louise
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Charlesworth, Georgina
    Wallcook, Sarah
    Malinowsky, Camilla
    Perceived risks, concession travel pass access and everyday technology use for out-of-home participation: cross-sectional interviews among older people in the UK2020In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, no 1, article id 192Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The health-promoting qualities of participation as an opportunity for social and cognitive engagement are well known. Use of Everyday Technology such as Smartphones or ATMs, as enabling or disabling factors for out-of-home participation is however under-researched, particularly among older people with and without dementia. Out-of-home participation involves participation in places and activities outside of a person's home, in public space. Situated within the context of an increasingly technological society, the study investigated factors such as perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK.

    METHODS: One hundred twenty-eight older people with and without dementia in urban and rural environments in the UK, were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) Questionnaire and the Everyday Technology Use Questionnaire (ETUQ). Associations between Everyday Technology use, perceived risk of falling, functional impairment, access to a concession travel pass and out-of-home participation were investigated using ordinal regression.

    RESULTS: A higher probability of Everyday Technology use (Odds Ratio [OR] = 1.492; 95% Confidence Interval [CI] = 1.041-1.127), perceived risk of falling outside home (OR = 2.499; 95% CI = 1.235-5.053) and, access to a concession travel pass (OR = 3.943; 95% CI = 1.970-7.893) were associated with a higher level of out-of-home participation. However, other types of risk (getting lost; feeling stressed or embarrassed) were not associated with out-of-home participation. Having a functional impairment was associated with a low probability of a higher level of out-of-home participation (OR = .470; 95% CI = .181-1.223). Across the sample, 'outside home' Everyday Technologies were used to a higher degree than 'portable' Everyday Technologies which can be used both in and outside home.

    CONCLUSIONS: The study provides insights into perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK. Increased knowledge about factors associated with out-of-home participation may help to guide targeted health and social care planning.

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  • 16.
    Gullberg, Joanna
    et al.
    Malmö University, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö University, Faculty of Odontology (OD).
    Axtelius, Björn
    Malmö University, Faculty of Odontology (OD).
    Horner, Keith
    Devlin, Hugh
    Povlsen, Lene
    Osteoporosis risk assessment in primary dental care-The attitudes of Swedish dentists, patients and medical specialists2020In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 37, no 2, p. 208-216Article in journal (Refereed)
    Abstract [en]

    Objective To explore and identify the attitudes of dentists, patients and medical specialists regarding implementation of osteoporosis risk assessment into Swedish primary dental care. Background Osteoporosis is a major health problem leading to fragility fractures. As shown in academic-based research, dental radiological examination can be used for osteoporosis risk assessment. A substantial number of patients undergo radiographic examinations in primary dental care each year, but little is known about implementation of osteoporosis risk assessment in this setting. Materials and methods A qualitative research approach using focus group discussions and manifest content analysis was applied. Five focus groups with dentists and representatives from patient support groups and a single individual interview with one medical specialist were included in the sample. Results From the manifest content analysis, three categories emerged: (a) barriers to change in practice, (b) benefits to change in practice, and (c) needs and requirements prior to change in practice. Most participants felt that there was insufficient knowledge of osteoporosis as well as a heavy existing workload. A concern was expressed about medical practitioners' willingness to take on responsibility for patients referred by dentists. Representatives from patient support groups highlighted a lack of knowledge about osteoporosis among both the general public and the medical professionals. Clear guidelines and improved communication channels between stakeholders would have to be established to ensure a smooth treatment path for patients. Conclusion Despite interest in osteoporosis risk assessment in primary dental care, there are political, workflow and educational barriers that must be overcome for successful implementation.

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  • 17.
    Harvey, B.
    et al.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    Barenfeld, E.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    Ohlen, J.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    Bergholtz, J.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    Orre, Carljohan
    Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT).
    Lindroth, T.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    Gyllensten, H.
    Univ Gothenburg, Gothenburg, Region Vastra G, Sweden..
    A CORE OUTCOME SET FOR THE EVALUATION OF NEW HEALTHCARE PROGRAMS IN SWEDEN2023In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 26, no 12, p. S501-S501Article in journal (Other academic)
  • 18.
    Jönsson, Karl-Ebbe
    et al.
    StruSoft, Malmö, Sweden.
    Ornstein, Kajsa
    HiQ, Malmö, Sweden.
    Christensen, Jonas
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Eriksson, Jeanette
    Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT).
    A reminder system for independence in dementia care: a case study in an assisted living facility2019In: PETRA '19 Proceedings of the 12th ACM International Conference on PErvasive Technologies Related to Assistive Environments, ACM Digital Library, 2019, p. 176-185Conference paper (Refereed)
    Abstract [en]

    By 2050, the population share aged over 80 will double. Considering the number of older adults and the wide range of chronic conditions, health systems need to assure that care is adapted to the individuals' different needs and enables the elderly to be active and involved. This article is about introducing a food reminder system into the domain of dementia care. The aim is to explore and describe whether and how such a system, built with existing technology, can be valuable, and how caregivers adopted it in a real-world environment. The system is built with Android® tablets and is called iRemember.® The research is done as a case study at a care facility in Simrishamn, Sweden. Domain knowledge is gained by reviewing previous research and by conducting interviews with professionals at the facility. The system is developed, deployed, and evaluated at a care facility home for persons with dementia. Data about usage and perception of the value of the system is collected through observations and interviews. Results indicate that a food reminder system can be valuable to and empower people with dementia. They also indicate that caregivers can readily adopt such a solution, including both management and people working directly with persons with dementia.

  • 19.
    Köster, Antonia Milena
    Malmö University, Faculty of Culture and Society (KS), Department of Urban Studies (US).
    Temporary Agency Work in Elderly Care in Germany: A qualitative study of deciding factors and their significance for organizations.2022Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Over the last two decades, more and more elderly care nurses, specialists and untrained, have chosen to go into temporary agency work rather than insitutionalized care. This qualitative study investigated the factors that attract elderly care nurses to temporary employment and possible adjustments organizations can make, to enhance their competitiveness over agencies. A structured literature review and the Job Demand-Resource Theory were used as the backdrop for qualitative interviews with temporary agency nurses, temporary agents and leaders of elderly care homes. The factors that attract elderly care nurses in Germany to temporary agency work are expectations of greater flexibility, higher salaries and a different balance of demands and resources. The expected flexibilities are however limited and higher salaries arequestionable. Temporary agency nurses are engaging in a form of job crafting behavior that has larger implications for the field. Organizations might enhance their competitiveness with changes to internal structures, in large part changes to internal communication, and external changes the organizations might support

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  • 20.
    Lundberg, Chris
    et al.
    Malmö University, Faculty of Health and Society (HS).
    Kataja, Fredrik
    Malmö University, Faculty of Health and Society (HS).
    Socialpsykiatrins tillblivelse och fortlevnad: Att lära av historien kring vårdbemötande2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background. Prior to the undertaking of radical changes in Swedish psychiatry, various psychological theories permeated mental healthcare that would subsequently become essential components at the very heart of the “care-cultural revolution.” This subsequently resulted in the creation of Swedish social psychiatry through which trial establishments’ well-functioning praxis and knowledge have, so it seems, been forgotten over the years.

    Method. How, when and why has it gone from the fact that the caregiver/client-relationship has previously been considered as “good” to in these days feel as though it has become “dehumanized”? How was this relationship in the past, how is it as of today, and how can it be made better for the future? In order to answer this, a closer look, through manifest qualitative content analysis with conventional (inductive) approach, is taken on Swedish health care throughout the 1960s–1980s as well as an elaborate deep dive down into the “new psychiatry” of the 1970s and social psychiatric trial establishments.

    Result. The paths to the formation of a care-ensuring relationship between caregiver and client are found within caregivers’ attitude and approach towards their clients. What is required is a trusting atmosphere and that both parties maintain continuous contact (Gustafsson, 2010) wherein time provides good conditions in the formation of functional and developing alliances (Topor & Denhov, 2012). In order for user influence to function during preventive work, in line with addressing clients’ problems as much as possible, a crisis psychotherapeutic approach and knowledge of mental crisis is required through which genuine presence is achi-eved (Cullberg, 1974). Research also clearly shows that what is needed during care meetings is genuine presence, compassionate understanding, and straightforward communication: not only to see the person, but also to understand what this particular crisis means for this particular individual as well as that his or her behavior in itself and what is not being expressed says so much more than words can ever describe.

    Conclusion. Empirical data suggests that current research remarks on what works well and less well, if not at all, in relation to care treatment is certainly good. But what about the pioneers of Nordic social psychiatry like Berggren, Cullberg, and Haugsgjerd? Current research refers to neither and their legacies seem to have been forgotten. So, what about all the know-ledge and insight that was acquired and incorporated in previous experimental activities such as Cullberg's crisis theory and crisis psychotherapy? Current research refers, likewise, to neither and everything seems to have gone down the drain. What is clear, however, is that their visions were applied with very good results in, amongst other things, the Nacka Project as well as that said theory and psychotherapy seem to have faded away following the trial establishment’s closure. Psychology and psychiatry, ultimately, move in a borderland between science and the humanities wherein they, in conjunction with the code of ethics that all treatment is to be based on “science and proven experience,” coexist in line with fumble attempts to capture life’s complexities. But where exactly should the line be drawn between “scientific professionalism” and “personal insight” when meeting someone with mental ill-health, a fellow human being in a mental crisis?

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  • 21.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hellström, Lisa
    Malmö University, Faculty of Education and Society (LS), Department of School Development and Leadership (SOL).
    Nilsson, Eva-Lotta
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Ivert, Anna-Karin
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    An Extended Home Visit Programme Within the Swedish Child Healthcare System for First-Time Parents in Scania, Sweden: A Study Protocol2021In: Frontiers In Public Health, ISSN 2296-2565, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Background: The Swedish Child Healthcare (CHC) system aims to provide equal and fair health care for all children and families in Sweden. Currently in Sweden, the CHC offers every family two home visits during the child's 1st year of life. During 2019, an extended home visit programme, called Grow Safely, was started in the region of Scania for first-time parents. The aim of the extended home visit programme was to provide support for first-time parents in order to improve the overall health of the child and family and contribute to better conditions for equal health. Instead of two home visits during the 1st year, a subsample of first-time parents would receive six visits during the child's first 15 months. These six visits would be conducted by CHC nurses and social workers, midwives, and dental assistants. In the present paper, we describe a research project related to the regional extended home visit programme; the project aims to illuminate the experiences of the participants and to investigate the perceived benefits of the programme in relation to improved health, social and emotional interaction between parent and child, and attitudes toward authorities and surrounding society.

    Method/Analysis: In order to evaluate the introduction of the intervention, three qualitative interview studies and one quantitative study with follow-up questionnaires will be conducted. Since the research project also comprises studies focusing on the implementation and expectations of politicians, civil servants, organizational managers, and professionals working within the programme, interviews within these fields will be conducted.

    Discussion: Sweden has a well-established CHC programme, but improvements are always possible. Previous research has shown that home visits are an effective tool to improve both the child's physical and mental health as well as the parents' well-being. However, this kind of intervention involves a significant investment from all organizations involved in the home visits; hence, it is important that the intervention is evaluated. The research project described in the present paper intends to examine the impact of the intervention, and its findings will aid decisionmakers in determining the future of the home visit programme.

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  • 22.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hjortsjö, Maria
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Health, social, and dental professionals’ experiences of working within an extended home-visit program in the child healthcare: A qualitative interview study in Sweden2023In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, article id 820Article in journal (Refereed)
    Abstract [en]

    Background

    The goal of the Swedish child healthcare system is to reach all children with health-promotive actions and to create equal health opportunities for all children. In that context, an extended home-visit program – called Grow Safely – for first-time parents, with an interprofessional collaboration between child healthcare nurses, midwives, social workers, and dental assistants, was initiated. The current study aims at illuminating and evaluating the health, social, and dental professionals’ experiences of working within this program and how such collaboration could benefit the professions.

    Methods

    A qualitative method was chosen, and 13 interviews were carried out with professionals working within child healthcare centers that participated in an extended home-visit program in the southernmost part of Sweden. The interviews were analyzed via Burnard’s approach to content analysis.

    Results

    The results showed that it was satisfying for the health, social, and dental professionals to work with the home-visit program and that they encountered positive feelings among the parents receiving it. The creation of deep conversations and parents opening up about feelings that could otherwise be shameful to express, was a positive aspect of the home visits. A negative aspect was the difficulty of handling the (sometimes necessary) interpretation over the phone during the visits, and another one was the fact that the visits were time-consuming and required logistical planning. Overall, the professionals were positive about the home-visit program in that they felt that they were able to give the families what they needed and to have discussions on sensitive issues. They also appreciated the fact that different professions collaborated in order to reach the same goal. 

    Conclusions

    This study showed that the health, social, and dental professionals enjoyed working with the home-visit program and that they encountered positive feelings among the parents regarding the collaborative visits being conducted within the home, where the families felt safe and relaxed. Despite the extended time required and the logistical challenges involved, the professionals expressed that the home visits created a deeper collaboration amongst them. 

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  • 23.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Norberg, Johan
    Malmö University, Faculty of Education and Society (LS), Department of Sport Sciences (IDV).
    Växa tryggt: Slutrapport från Malmö universitets forskargrupp2023Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under åren 2019–2022 genomfördes en satsning på ett utökat hembesöks-program för förstagångsföräldrar inom barnhälsovården i Skåne. Satsningen hade namnet Växa tryggt och baserades på erfarenheter av ett liknande program i Rinkeby. I Växa tryggt erbjöds förstagångsföräldrar sammanlagt sex hembesök under barnets första 15 månader. Besöken genomfördes i ett sam-arbete mellan barnmorskor, barnhälsovårdssjuksköterskor, föräldrastödjare och tandsköterskor/tandhygienister.En tvärvetenskaplig forskargrupp från Malmö universitet har på uppdrag av Region Skåne forskat om Växa tryggts genomförande och effekter. Forsk-ningen har inkluderat intervjuer och enkäter riktade till deltagande familjer, de professioner som genomförde hembesöken, verksamhetschefer och politiska beslutsfattare.I denna rapport redovisas forskargruppens övergripande resultat. Resultaten visar genomgående att både professioner och deltagande familjer var mycket nöjda med de utökade hembesöken. För professionerna, främst familjestöd-jaren och tandsköterskan/tandhygienisten, har Växa tryggt inneburit möj-ligheter att tidigt komma i kontakt med barnfamiljer i upptagningsområdet. Utöver stöd och support i enskilda frågor har professionerna även kunnat informera om ytterligare stöd som barnhälsovården, socialtjänsten och tand-vården kan erbjuda. För familjerna har de utökade hembesöken varit ett stöd i den intiala osäkerhet som ofta präglar ett nyblivet föräldraskap. Samtidigt har Växa tryggt främjat möjligheten att bygga tillitsfulla relationer med välfärds-professioner som utifrån sina skilda kompetenser är experter på barn- och familjeliv. Hemmet har i det föreliggande projektet visat sig vara en bra arena för att kunna individanpassa råd och stöd. Ytterligare en positiv effekt av Växa tryggt har varit att fera professioner samverkat i hembesöken och därmed kunnat komplettera och stärka varandra i dialoger med familjerna.

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  • 24.
    Munetsi, Dennis
    et al.
    Dalarna University, Falun.
    Ugarte, William
    Uppsala University.
    Intervening factors in health care professionals’ attitudes and behaviours towards comprehensive abortion care in the workplace: a comparative case study of Tanzania and Ethiopia2022In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 27, no 3, p. 221-229, article id 2039910Article in journal (Refereed)
    Abstract [en]

    Purpose

    Health care professionals’ attitudes and behaviours play a fundamental role in the provision of timely comprehensive abortion care as a maternal health intervention and save hundreds of thousands of women’s lives, annually. Hence, this study explores underlying factors influencing their attitudes and behaviours towards comprehensive abortion care between 2015 and 2020.

    Materials and methods

    The study inductively explored Ethiopian and Tanzanian health care professionals’ behaviours using a comparative case study design and a textual analytical approach. Published and unpublished literature, documents and newspapers were used as data sources. The two cases were selected because of their different approaches towards the governance of abortion care, one gradually legalising while the other persistently restricting.

    Results

    Results demonstrated that there are both subjective (beliefs, attitudes, images, pre-dispositions) and objective (institutional incapacity) factors that impact the actions of health care professionals in the work environment.

    Conclusions

    The study concluded that the intervention of subjective factors results from the institutional failure to effectively bridge the divide between governance and accessibility of safe abortion care.

  • 25.
    Patomella, Ann-Helen
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Mälstam, Emelie
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Eriksson, Christina
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Bergström, Aileen
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Åkesson, Elisabet
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Asaba, Eric
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Primary prevention of stroke: randomised controlled pilot trial protocol on engaging everyday activities promoting health2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 11, article id e031984Article in journal (Refereed)
    Abstract [en]

    Introduction Stroke is a globally common disease that has detrimental effects on the individual and, more broadly, on society. Lifestyle change can contribute to reducing risk factors for stroke. Although a healthy lifestyle has direct benefits, sustaining and incorporating healthy activities into everyday life is a challenge. Engaging everyday activities have the potential to support lifestyle change and to promote sustainable activity patterns. Current healthcare is failing to reduce modifiable risk factors in people at risk, and in addition to current practice, there is a need for systematic and efficient non-pharmacological and non-surgical stroke-prevention strategies. The aim of the pilot study was to increase knowledge about the effects of a prevention programme and its feasibility to promote sustainable and healthy activity patterns among persons at risk of stroke. Methods and analysis The proposed pilot study will be a two-armed randomised, assessor-blinded, parallel pilot trial. The study will include feasibility data, investigating acceptability and delivery of the intervention. Persons at risk of stroke (n=60) will be included in a mobile phone-supported prevention programme. The 10-week programme will be conducted at primary healthcare clinics, combining group meetings and online resources to support self-management of lifestyle change. Main outcomes are stroke risk, lifestyle habits and healthy activity patterns. Assessments will be performed at baseline and at follow-up (immediately following the end of the programme and at 6 and 12 months). Effects of the programme will be analysed using inferential statistics. Feasibility will be analysed using both qualitative and quantitative methods.

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  • 26.
    Pekkari, C
    et al.
    Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Eastman Institute, Folktandvården Stockholm AB, Stockholm, Sweden.
    Lund, B
    Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Davidson, T
    Malmö University, Faculty of Odontology (OD). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Naimi-Akbar, Aron
    Malmö University, Faculty of Odontology (OD). Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Eastman Institute, Folktandvården Stockholm AB, Stockholm, Sweden.
    Marcusson, A
    Maxillofacial Unit in Linköping, and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Weiner, C K
    Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Surgery, Gävle Hospital, Folktandvården Gävleborg, Gävleborg, Sweden.
    Cost analysis of orthognathic surgery: outpatient care versus inpatient care.2024In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, article id S0901-5027(24)00053-5Article in journal (Refereed)
    Abstract [en]

    With limited healthcare resources, it is important to provide the right level and form of care. The aim of this study was to determine whether selected single-jaw orthognathic surgery in outpatient care (OPC) generates lower healthcare costs than in inpatient care (IPC). The costs of surgically assisted rapid maxillary expansion (SARME), Le Fort I osteotomy (LFI), and bilateral sagittal split osteotomy (BSSO) were calculated for 165 patients, 107 treated in OPC and 58 in IPC. Additionally, costs for revisits, emergency visits, emergency phone calls, re-operations, and plate removal during the first 12 months postoperatively were recorded. The total mean costs of the different operations including revisits, emergency visits, and phone calls were 34.2-48.8% lower in OPC than in IPC at 12 months postoperatively. Operation costs were lower for LFI in OPC (P = 0.009) and for SARME in IPC (P = 0.007). Anaesthesia costs were lower for LFI (P < 0.001) and BSSO (P < 0.001) in OPC, and there were fewer revisits (P = 0.001) and lower costs (P = 0.002) after LFI in OPC compared to IPC. This study showed that selected single-jaw orthognathic surgeries in outpatient care are associated with lower healthcare costs compared to inpatient care.

  • 27.
    Persson, Sofia
    et al.
    Jönköping University; Region Jönköping.
    Andersson, Ann-Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Jönköping University.
    Kvarnefors, Annmargreth
    Region Jönköping.
    Thor, Johan
    Jönköping University.
    Andersson Gäre, Boel
    Jönköping University; Region Jönköping.
    Quality as strategy, the evolution of co-production in the Region Jönköping health system, Sweden: a descriptive qualitative study2021In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 33, no Supplement 2, p. ii15-ii22Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pursuing the vision 'for a good life in an attractive region,' the Region Jönköping County (RJC) in Sweden oversees public health and health-care services for its 360 000 residents. For more than three decades, RJC has applied 'quality as strategy,' which has included increasing involvement of patients, family and friends and citizens. This practice has evolved, coinciding with the growing recognition of co-production as a fundamental feature in health-care services. This study views co-production as an umbrella term including different methods, initiatives and organizational levels. When learning about co-production in health-care services, it can be helpful to approach it as a dynamic and reflective process.

    OBJECTIVE: This study aims to describe the examples of key developmental steps toward co-production as a system property and to highlight 'lessons learned' from a Swedish health system's journey.

    METHOD: This qualitative descriptive study draws on interviews with key stakeholders and on documents, such as local policy documents, project reports, meeting protocols and presentations. Co-production initiatives were defined as strategies, projects, quality improvement (QI) programs or other efforts, which included persons with patient experience and/or their next of kin (PPE). We used directed manifest content analysis to identify initiatives, timelines and methods and inductive conventional content analysis to capture lessons learned over time.

    RESULTS: The directed content analyses identified 22 co-production initiatives from 1997 until today. Methods and approaches to facilitate co-production included development of personas, storytelling, person-centered care approaches, various co-design methods, QI interventions, harnessing of PPEs in different staff roles, and PPE-driven improvement and networks. The lessons learned included the following aspects of co-production: relations and structure; micro-, meso- and macro-level approaches; attitudes and roles; drivers for development; diversity; facilitating change; new perspectives on current work; consequences; uncertainties; theories and outcomes; and regulations and frames.

    CONCLUSIONS: Co-production evolved as an increasingly significant aspect of services in the RJC health system. The initiatives examined in this study provide a broad overview and understanding of some of the RJC co-production journey, illustrating a health system's approach to co-production within a context of long-standing application of QI and microsystem theories. The main lessons include the constancy of direction, the strategy for improvement, engaged leaders, continuous learning and development from practical experience, and the importance of relationships with national and international experts in the pursuit of system-wide health-care co-production.

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  • 28.
    Randell, Anna
    Malmö University, Faculty of Health and Society (HS).
    Sexuell Hälsa vid Långvarig Smärta: En Scoping Review2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Förekomsten av sexuella problem och dysfunktioner är hög hos patienter med långvarig smärta. Syfte: Syftet med studien var att undersöka vad som finns beskrivet i tidigare forskning om sexualitet och sexuella problem i relation till långvarig smärta. Metod: En scoping review utfördes för att identifiera litteratur som beskriver långvarig smärta och sexualitet, med fokus på patienters upplevelse av sin sexualitet och hur de upplevde att vårdgivare pratade med dem om sexualitet. Litteratursökning i databaser identifierade 16 artiklar, med utgång av muskuloskeletal smärta och migrän vilka bedömdes vara relevanta för studien. Resultat: 11 teman identifierades, vilka beskriver hur sexualiteten påverkas vid långvarig smärta. Med hjälp av cripteori och genusteori analyserades resultatet. Slutsats: Vårdgivare behöver ge patienter med långvarig smärta kunskap om hur sexualiteten kan påverkas, för att minska patienters upplevelse av av fysisk funktionsnedsättning. Litteraturen visar också att det finns skillnader mellan kön när det kommer till hur patienter upplever och hanterar smärta, sexualitet och relationer.

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  • 29.
    Samuelsson, Maria
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Wennick, Anne
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jakobsson, Jenny
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bengtsson, Mariette
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Models of support to family members during the trajectory of cancer: a scoping review protocol.2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 9, article id e037633Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: A cancer diagnose, for example, colorectal cancer, not only affects the cancer-person stricken, but also the surrounding family. Thus, this scoping review intends to identify appropriate models of support that will guide the development of a model of support to family members during the trajectory of colorectal cancer.

    METHODS AND ANALYSIS: , and described by the Joanna Briggs Institute. All the stages will be conducted iteratively and reflexively. First, a search strategy will be developed with a librarian and applied in the following peer-reviewed databases: PubMed, Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Additional searches will be performed in Google Scholar and SwePub for identification of grey literature and hand searched in the reference lists. Searches will be conducted from December 2019 to February 2020. A draft of the preliminary search strategy was performed in PubMed in November 2019. Subsequently, three members of the research team will independently screen all abstracts for relevance, as well as the full-text articles. Studies meeting the inclusion criteria will be critically evaluated using the Joanna Brigg Institute Critical Appraisal Tools. A descriptive summary of study characteristics and of the scoping review process will be presented, including a visual flow diagram. Lastly, a thematic analysis as presented by Braun and Clarke will be conducted. To enhance validity, contact nurses of persons with colorectal cancer will be provided an overview of the preliminary results.

    ETHICS AND DISSEMINATION: Being a secondary analysis, ethical approval is not needed for this study. The findings of the analysis will be used to inform the design of a future study aiming to develop a model of support and an upcoming scoping review, which will be published in a scientific journal and presented at relevant conferences.

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  • 30.
    Skyttberg, Niclas
    et al.
    Karolinska Inst, Hlth Informat Ctr, Dept Learning Informat Management & Ethics, Solna, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Alenius, Lisa Smeds
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Med Management & Ethics, Solna, Sweden..
    Sound psychometric properties of a short new screening tool for patient safety climate: applying a Rasch model analysis2023In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 742Article in journal (Refereed)
    Abstract [en]

    Background: WHO recommends repeated measurement of patient safety climate in health care and to support monitoring an 11 item questionnaire on sustainable safety engagement (HSE) has been developed by the Swedish Association of Local Authorities and Regions. This study aimed to validate the psychometric properties of the HSE.

    Methods: Survey responses (n = 761) from a specialist care provider organization in Sweden was used to evaluate psychometric properties of the HSE 11-item questionnaire. A Rasch model analysis was applied in a stepwise process to evaluate evidence of validity and precision/reliability in relation to rating scale functioning, internal structure, response processes, and precision in estimates.

    Results: Rating scales met the criteria for monotonical advancement and fit. Local independence was demonstrated for all HSE items. The first latent variable explained 52.2% of the variance. The first ten items demonstrated good fit to the Rasch model and were included in the further analysis and calculation of an index measure based on the raw scores. Less than 5% of the respondents demonstrated low person goodness-of-fit. Person separation index > 2. The flooring effect was negligible and the ceiling effect 5.7%. No differential item functioning was shown regarding gender, time of employment, role within organization or employee net promotor scores. The correlation coefficient between the HSE mean value index and the Rasch-generated unidimensional measures of the HSE 10-item scale was r = .95 (p < .01).

    Conclusions: This study shows that an eleven-item questionnaire can be used to measure a common dimension of staff perceptions on patient safety. The responses can be used to calculate an index that enables benchmarking and identification of at least three different levels of patient safety climate. This study explores a single point in time, but further studies may support the use of the instrument to follow development of the patient safety climate over time by repeated measurement.

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  • 31.
    Strange, Michael
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Three different types of AI hype in healthcare2024In: AI and Ethics, ISSN 2730-5953, E-ISSN 2730-5961Article in journal (Refereed)
    Abstract [en]

    Healthcare systems are the embodiment of big data – as evident in the logistics of resource management, estate maintenance, diagnoses, patient monitoring, research, etc. – such that human health is often heralded as one of the fields most likely to benefit from AI. Yet, the prevalence of hype – both positive and negative – risks undermining that potential by distracting healthcare policy makers, practitioners, and researchers from many of the non-AI factors that will determine its impact. Here we categorise AI hype in healthcare into three types that include both utopian and dystopian narratives and plot a series of more productive paths ahead by which to realise the potential of AI to improve human healthcare.

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  • 32.
    Strange, Michael
    et al.
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Gustafsson, Hilda
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Mangrio, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Rapport #1 PHED-kommissionen för framtiden för hälso-och sjukvård efter Covid-19: Ojämlikhet i samhället gör oss sårbara för pandemier2021Report (Other academic)
    Abstract [sv]

    Under hösten 2020 organiserade PHED-projektet i ett samarbete mellan Malmö och Lunds universitet en kommission och bjöd in till muntliga och skriftliga vittnesmål om framtiden för hälso- och sjukvården efter covid-19. Efter att initialt ha fokuserat på Region Skåne, utvidgades diskussionerna till att omfatta ett bredare nationellt fokus liksom internationella jämförelser med Frankrike och Storbritannien. Undersökningen omfattade vittnesmål från såväl yrkesverksamma inom hälso- och sjukvård som tjänstemän, civilsamhället och forskare. Överlag framställde vittnesmålen covid-19 som både en tragedi och ett lärotillfälle som skulle kunna stärka samhället. Flera centrala rekommendationer för att skydda och förbättra folkhälsan togs fram.

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  • 33.
    Strange, Michael
    et al.
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS).
    Tucker, Jason
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS).
    AI and the everyday political economy of global health2023In: Handbook of Critical Studies of Artificial Intelligence / [ed] Simon Lindgren, Edward Elgar Publishing, 2023, 1, p. 367-377Chapter in book (Refereed)
    Abstract [en]

    In the last few years, we have seen an explosion in the scale and scope of AI health, a trend only exacerbated by COVID-19. Due to the uptake of AI applications in health, the global health landscape has seen significant shifts. To help understand this development and how best to achieve the potential of AI health technologies, it is necessary to critically look at the global political economy through which AI health technologies are made possible. There is a need to see this political economy as embedded in the everyday relations through which healthcare functions. The everyday level of how patients and healthcare professionals engage with AI health technology is essential to knowing how these new tools can help tackle forms of discrimination and other obstacles currently preventing universal health coverage.

  • 34.
    Stylianides, Kristina Carlsson
    et al.
    Lund Univ, Sch Social Work, Lund, Sweden..
    Bejerholm, Ulrika
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Denvall, Verner
    Lund Univ, Sch Social Work, Lund, Sweden..
    Knutagård, Marcus
    Lund Univ, Sch Social Work, Lund, Sweden..
    Johanson, Suzanne
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Implementation structures at work. Exploring implementation and de-implementation attempts regarding Housing First and Individual Placement and Support2022In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 56, no 4, p. 617-631Article in journal (Refereed)
    Abstract [en]

    Research shows that resistance to change might occur in organisations that implement new evidence-based practices (EBP). Formal and informal structures may work to retain traditional interventions, potentially counteracting the implementation process. Little is known about the de-implementation of traditional practices to leave room for and enhance the implementation of EBPs. This study uses implementation structures as a theoretical framework with the aim of analysing implementation and de-implementation factors among Swedish municipalities that provide support to vulnerable clients through the Housing First (HF) or Individual Placement and Support (IPS) interventional programmes. This cross-sectional study is based on a digital survey and collects descriptive and qualitative data from three organisational levels in each responding municipality in Sweden. The descriptive statistics and qualitative texts were analysed using content analysis. The results show the incidence of HF and IPS, if and to what extent the interventions are going to be developed further, and partially, describe the organisational settings of HF and IPS. Organisational factors shown to have a negative impact on the implementation of HF and IPS were identified. The mapping of professional experiences from the intersection between HF or IPS and organisations such as the Swedish Health Insurance Office, the social services, and other similar welfare organisations, indicates that the realisation of HF and IPS requires expanded collaboration, which raises the consideration as to whether it is necessary to de-implement broader frameworks and guidelines in these organisations to provide the prerequisites that enable the implementation of EBPs.

  • 35. Triliva, Sofia
    et al.
    Ntani, Spyridoula
    Giovazolias, Theodoros
    Kafetsios, Konstantinos
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bockting, Claudi
    Buysse, Ann
    Desmet, Mattias
    Dewaele, Alexis
    Hannon, Dewi
    Haukenes, Inger
    Hensing, Gunnel
    Meganck, Reitske
    Rutten, Kris
    Schønning, Viktor
    Van Beveren, Laura
    Vandamme, Joke
    Øverland, Simon
    Healthcare professionals' perspectives on mental health service provision: a pilot focus group study in six European countries2020In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 14, article id 16Article in journal (Refereed)
    Abstract [en]

    Background: The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it.

    Methods: Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Cross-country consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners.

    Results: The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative 'chain of care'. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence.

    Conclusions: The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people's needs throughout their lives is an essential aspect of optimal care provision.

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  • 36.
    Zdravkovic, Slobodan
    et al.
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jonsson, C.
    Digitalisering IT & MT, VO Data & Analys, Lund, Region Skane, Sweden..
    Annersten Gershater, Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ericsson, A.
    Novo Nordisk Scandinavia AB, Natl Market Access, Malmo, Sweden..
    Grahn, M.
    Unit Stat & Anal, Malmo, Sweden..
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Dozet, A.
    Dept Hlth Care Governance, Lund, Region Skane, Sweden..
    Health care costs for residents diagnosed with diabetes type 2 in Malmo, Sweden between 2011 and 20182021In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 31, no S3Article in journal (Other academic)
    Abstract [en]

    Background

    During the last decade, type 2 diabetes (T2D) prevalence has increased worldwide, especially among children and young adults. Diabetes is a chronic disease that if not diagnosed in time can lead to serious health complications and put pressure on the societal resources. The aim of this study was to evaluate the economic impact of the increased T2D prevalence in Malmö over time on the regional health care organization.

    Methods

    A longitudinal population-based study in Malmö, within the Cities Changing Diabetes project. Data was collected from the Patient Administrative System in Region Skåne, classifying T2D by the ICD E11 code. The health care cost (HCC) has been adjusted by the Consumer Price Index (CPI) to 2020 prices.

    Results

    The prevalence of T2D increased from 2,5% in 2011 to 4,3% in 2018. The increase in T2D prevalence was most noticeable for residents 18 - 64 years. The overall HCC for treating residents with T2D was approximately €47,2 million in 2011 and €90,7 million in 2018. The HCC in 2018 was higher for males than for females (€54,6 million vs €36,2 million). In 2018, the cost was €49,9 million for those 18 - 64 years and €40,5 million for those being 65 years or older. The overall HCC increased during the study period (3,3 times for those 18 - 64 years and 1,4 times for those being 65 years or older). For the age group 18 - 64 the HCC per resident was €5 000 in 2011 and €5 300 in 2018. The HCC per resident for all age groups, has not changed markedly, from €6 200 in 2011 to €6 100 in 2018 as well as the number of health care visits (23 in 2011 and 29 in 2018).

    Conclusions

    The HCC for T2D has increased markedly since 2011. This increase is most noticeable for people under 65 years. The overall HCC for these patients and its change over time puts an increased strain on the health care provider Region Skåne, mainly due to increased prevalence.

    Key messages 

    • The overall HCC during 2011 – 2018 has increased 2 times for residents with T2D and 1.5 times for residents without T2D. This increase is likely to continue if the current trend remains.
    • The main driving force behind the increase in HCC over time is the increase in T2D prevalence and not in HCC per resident.
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