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Johansson, Veronica
Publications (10 of 17) Show all publications
Leisnert, L., Axtelius, B., Johansson, V. & Wennerberg, A. (2015). Diagnoses and treatment proposals in periodontal treatment: A comparison between dentists, dental hygienists and undergraduate students (ed.). Swedish Dental Journal, 39(2), 87-97
Open this publication in new window or tab >>Diagnoses and treatment proposals in periodontal treatment: A comparison between dentists, dental hygienists and undergraduate students
2015 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, p. 87-97Article in journal (Refereed)
Abstract [en]

The aim of this study is to find out how professionals in Swedish dental care perform diagnostic procedures in general. Is there a common ground between dentists and dental hygienists concerning sharing different job assignments in an effective way? Are the methods of treatment used in accordance with degree of severity of the disease and to what extent is proposed treatment in accordance with the National Guidelines? A questionnaire consisting of three different patient cases with periodontal disease was sent to 804 private practitioners, 809 dentists in Dental Public Service, 802 dental hygienists and 40 dental students on their final semester at the Dental School in Malmo.The questionnaire was completed by 1,103 respondents (47%). A majority of all practitioner groups (94%) found that a relatively healthy patient had disease, the risk for developing further disease was deemed none too low by 97%, but 91% wanted to give preventive care. A vast majority suggested more dental care to healthy patients as compared to patients with severe periodontal disease. In Conclusion the two groups, i.e. dentists and dental hygienists, did not to a sufficiently high degree share views on diagnosis and treatment, in order to optimize the resources in dentistry. The delivery of dental care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons.To change this pattern, the incentives in and structure of the national assurance system could be adapted. Furthermore, the knowledge basis for periodontal diagnosis and treatment needs, with special reference to the National Guidelines, should to a higher degree be shared by all caregivers.

Place, publisher, year, edition, pages
Swedish Dental Journal, 2015
Keywords
Periodontal treatment, undergraduate students, professional performers, evidence based treatment, National Guidelines
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6273 (URN)000377057900004 ()26529834 (PubMedID)27376 (Local ID)27376 (Archive number)27376 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-07-27Bibliographically approved
Ayala-Luis, J., Johansson, V., Sampogna, F., Axtelius, B. & Söderfeldt, B. (2014). A multivariable analysis of patient dental satisfaction and oral health-related quality-of-life: A cross-sectional study based on DVSS and OHIP-14 (ed.). Acta Odontologica Scandinavica, 72(3), 187-193
Open this publication in new window or tab >>A multivariable analysis of patient dental satisfaction and oral health-related quality-of-life: A cross-sectional study based on DVSS and OHIP-14
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2014 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 3, p. 187-193Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this paper was to study the association between dental satisfaction and oral health-related quality-of-life (OHRQoL) when controlling for individual, clinical and psychological factors. Materials. Secondary analysis was conducted using data from a large study carried out in the Swedish region of Varmland in 2004. The questionnaire included demographic variables, clinical assessment and the following instruments: the Dental Visit Satisfaction Scale (DVSS), the short version of Oral Health Impact Profile (OHIP-14) and a modified version of the revised helping alliance questionnaire. Internal consistency analysis was undertaken on the instruments to assess reliability; bivariate comparisons were assessed to compare DVSS scores with individual factors (age, gender and education). In addition, a three step hierarchical multiple regression analysis was performed with DVSS as a dependent variable. Results. Data were completed for 485 randomly selected patients. The mean age of participants was 43.5 years, 54.6% were women, and 41.2% had high education. The median DVSS score was 48 (range 10-50) and the median OHIP was 3.0 (range 0-56). All the instruments showed good reliability. Bivariate analysis showed that females were more satisfied than males (p <= 0.01) and patients of 50 years or older were more satisfied than the younger ones (p <= 0.05). Finally, the following variables explained 31% of the variance of being very satisfied with dental visit: a good OHRQoL and patients' positive perceptions of the relationship with their care provider. Conclusion. This study showed positive associations between dental satisfaction and OHRQoL when controlling for related factors. The result suggests that care providers should take into account the various dimensions of OHRQoL rather than use only clinical measurements when they evaluate patient satisfaction.

Place, publisher, year, edition, pages
Taylor & Francis, 2014
Keywords
dentist-patient relations, patient satisfaction, public health dentistry, quality-of-life, regression analysis
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6071 (URN)10.3109/00016357.2012.762987 (DOI)000333047400004 ()24460031 (PubMedID)2-s2.0-84899024481 (Scopus ID)27447 (Local ID)27447 (Archive number)27447 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Jansson, H., Wahlin, Å., Johansson, V., Åkerman, S., Lundegren, N., Isberg, P.-E. & Norderyd, O. (2014). Impact of Periodontal Disease Experience on Oral Health-related Quality of Life (ed.). Journal of Periodontology, 85(3), 438-445
Open this publication in new window or tab >>Impact of Periodontal Disease Experience on Oral Health-related Quality of Life
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2014 (English)In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 3, p. 438-445Article in journal (Refereed)
Abstract [en]

BACKGROUND: Periodontal research has traditionally focused on the site level, regarding etiology, pathogenesis, and treatment outcome. Recently, some studies have indicated that the presence of periodontal disease is associated with reduced quality of life. The aim of this study is to investigate the impact of periodontal disease experience on the quality of life. METHODS: This cross-sectional study includes 443 individuals. Clinical and radiographic examinations were performed; in conjunction, the oral health-related quality of life of all participants was assessed using the Swedish short-form version of the Oral Health Impact Profile (OHIP-14). Based on marginal bone loss, measured on radiographs, three different groups were identified: participants with loss of supporting bone tissue of less than one third of the root length (BL-), loss of supporting bone tissue of one third or more of the root length in <30% of teeth (BL), or loss of supporting bone tissue of one third or more of the root length in ≥ 30% of teeth (BL+). RESULTS: The effect of periodontal disease experience on quality of life was considerable. For the BL- group, the mean OHIP-14 score was 3.91 (SD: 5.39). The corresponding mean values were 3.81 (SD: 5.29) for the BL group and 8.47 (SD: 10.38) for the BL+ group. The difference among all groups was statistically significant (P ≤ 0.001). A comparison among the mean OHIP-14 scores in the different groups (BL-, BL, and BL+) revealed significant differences in six of seven conceptual domains. CONCLUSIONS: The BL+ individuals experienced reduced quality of life, expressed as the OHIP-14 score, compared with the BL and BL- participants.

Place, publisher, year, edition, pages
American Academy of Periodontology, 2014
Keywords
Alveolar bone loss, health impact assessment, oral health, periodontal disease, periodontitis, quality of life
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15930 (URN)10.1902/jop.2013.130188 (DOI)000332532500015 ()23895254 (PubMedID)2-s2.0-84896510986 (Scopus ID)17532 (Local ID)17532 (Archive number)17532 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Johansson, V. (2012). Dental hygienist students and communication with patients about health behaviours (ed.). Paper presented at European Association of Dental Public Health, London (2012). Paper presented at European Association of Dental Public Health, London (2012).
Open this publication in new window or tab >>Dental hygienist students and communication with patients about health behaviours
2012 (English)Conference paper, Poster (with or without abstract) (Other academic)
Keywords
dental hygienist, communication, self-efficacy, motivational interviewing
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-12295 (URN)14744 (Local ID)14744 (Archive number)14744 (OAI)
Conference
European Association of Dental Public Health, London (2012)
Available from: 2020-02-29 Created: 2020-02-29 Last updated: 2022-06-27Bibliographically approved
Johansson, V. (2010). Bättre oral hälsa i kontraktstandvård (ed.). Tandläkartidningen (12), 72-73
Open this publication in new window or tab >>Bättre oral hälsa i kontraktstandvård
2010 (Swedish)In: Tandläkartidningen, ISSN 0039-6982, no 12, p. 72-73Article in journal (Other (popular science, discussion, etc.))
Abstract [sv]

Patienterna i kontraktstandvård har bättre oral hälsorelaterad livskvalitet än patienterna i styckepristandvård, visar Veronica Johansson i sin avhandling.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6851 (URN)11179 (Local ID)11179 (Archive number)11179 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-06-27Bibliographically approved
Johansson, V., Axtelius, B., Söderfeldt, B., Sampogna, F., Paulander, J. & Sondell, K. (2010). Multivariate analyses of patient financial systems and oral health-related quality of life (ed.). Community Dentistry and Oral Epidemiology, 38(5), 436-444
Open this publication in new window or tab >>Multivariate analyses of patient financial systems and oral health-related quality of life
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2010 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 38, no 5, p. 436-444Article in journal (Refereed) Published
Abstract [en]

Objectives: Since 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, has two co-existing patient financial systems, i.e. ways for the patient to pay for dental care services. Alongside the traditional system of fee-for-service payment, i.e. paying afterwards for provided services, a new system of contract care is offered. In this system, dental care is covered by a contractual agreement, for which the patient pays an annual fee and receives care covered by the contract without additional costs. The aim of this article was to study whether patient financial system was associated with oral health-related quality of life (OHRQoL). Methods: A questionnaire was answered by 1324 randomly selected patients, 52% from contract care and 48% from fee-for-service. The questionnaire contained questions about how much one was prepared to pay for dental care, how much one paid for dental care the previous year, OHIP-14 (measured OHRQoL), dental anxiety, humanism of caregiver, SF-36 (measured general health), multidimensional health locus of control, sense of coherence (SOC), self-esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The material was analysed with a hierarchical block method of multiple regression analysis. Results: When controlling for all other variables, patient financial system was one of the strongest associations with OHRQoL: patients in fee-for-service had worse OHRQoL than those in contract care. OHRQoL was also associated with general health, SOC and to some extent also with psychological and economic factors. Of the social variables, only being foreign born was significant: it was associated with worse OHRQoL. Conclusions: Patient financial system was associated with OHRQoL when controlling for confounding factors: patients in contract care had better OHRQoL than those in fee-for-service care.

Keywords
contract care, fee-for-service care, OHRQoL, patient financial system
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6754 (URN)10.1111/j.1600-0528.2010.00546.x (DOI)000281641600006 ()20545720 (PubMedID)2-s2.0-77956355866 (Scopus ID)10536 (Local ID)10536 (Archive number)10536 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Johansson, V., Axtelius, B. & Söderfeldt, B. (2009). A path analysis of contract and fee-for-service care (ed.). Paper presented at Congress of the European Association of Dental Public Health (EADPH), Tromsö, Norway (2009). Paper presented at Congress of the European Association of Dental Public Health (EADPH), Tromsö, Norway (2009).
Open this publication in new window or tab >>A path analysis of contract and fee-for-service care
2009 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Objectives: In Swedish dentistry, the traditional patient financial system is fee-for-service care (FFS). Since 1999, the public dental health service (PDHS) in the county of Värmland offers an alternative system, contract care (CC). Here, the patient pays a set fee for a fixed period of time, and receives oral health care as specified by a contract, without additional costs. Previously, an association between patient financial system and oral health-related quality of life (OHRQoL) was found. The aim was to model direct and indirect effects with path analysis, to study if there were different underlying mechanisms in the patient financial systems. Material and methods: In 2003, a questionnaire was sent to randomly selected patients enrolled in CC (n=1,200) and FFS (n=1,200) in the PDHS in Värmland. The study was approved by the ethical board in the Southern region of Sweden. Response rate was 57%. Data without internal non-response (n=1,044; CC: 57%, FFS: 43%) were analysed with a multiple group path analysis. The interactions of four variables were of central interest: OHRQoL, the respondents’ perceptions of the dental caregiver’s humanistic (patient-, as opposed to disease-centred) qualities, what the respondents were prepared to pay, and what they had paid for dental care the previous year. Results: The underlying mechanisms in the systems were similar. However, there were differences regarding the central variables: the perceived humanism of the caregiver affected OHRQoL only in FFS, while what the respondents were prepared to pay for dental care was affecting the perception of humanism only in CC. Conclusions: The findings indicated that the perception of the caregiver’s humanistic qualities were important for oral health for respondents in FFS, while financial considerations were important for how the caregiver’s qualities were perceived by respondents in CC. Funding: The study was financed by the Swedish Research Council.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-12208 (URN)9098 (Local ID)9098 (Archive number)9098 (OAI)
Conference
Congress of the European Association of Dental Public Health (EADPH), Tromsö, Norway (2009)
Available from: 2020-02-29 Created: 2020-02-29 Last updated: 2022-06-27Bibliographically approved
Johansson, V. (2009). Oral health-related quality of life and patient payment systems: A study of Contract and Fee-for-service care in a county in Sweden (ed.). (Doctoral dissertation). Malmö University
Open this publication in new window or tab >>Oral health-related quality of life and patient payment systems: A study of Contract and Fee-for-service care in a county in Sweden
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Sedan 1999 har Folktandvården i Värmland två alternativa tandvårdssystem: Styckepris- och Kontraktstandvård. I Kontraktstandvård tecknar patienten ett kontrakt med Folktandvården, betalar en fast summa för en specifik tidsperiod, och erhåller sedan vård utan extra kostnader.Det övergripande syftet var att undersöka om de förmodade olika behandlingsfilosofierna i Kontrakts- och Styckepristandvård leder till olika utfall, med bättre oralhälso-relaterad livskvalitet hos patienter i Kontraktstandvård, än hos patienter i Styckepristandvård.Studie I var en litteraturgenomgång av tidigare forskning, med material insamlat genom databassökningar. Studie II, III och IV bestod av material insamlat genom en postenkät under 2003. Enkäten sändes till 1 200 slumpvis utvalda patienter i varje system i Folktandvården Värmland, totalt 2 400 patienter. Studie I. Det fanns indikationer på mer preventiv vård, och i det långa loppet också på minskat behov av restorativa åtgärder i kapitering, jämfört med i fee-for-service. Det fanns för lite material för att kunna dra några slutsatser om produktivitet, tandläkarens tillfredsställelse med sitt arbete och patientens tillfredsställelse med erhållen vård. Studie II. Patienterna i Kontraktstandvård var yngre, hade högre utbildning, var i större utsträckning gifta eller sammanboende, födda i Sverige, och hade bättre allmänhälsa och oralhälso-relaterad livskvalitet än Styckepristandvårdspatienterna. De senare upplevde å andra sidan en högre samhörighet med sitt bostadsområde. Studie III. När andra faktorer kontrollerades i hierarkisk multipel regression fanns ett samband mellan oralhälso-relaterad livskvalitet och tandvårdssystem: Kontraktstandvårdspatienterna hade en signifikant bättre oralhälso-relaterad livskvalitet än Styckepristandvårdspatienterna. Studie IV. I pathanalys med strukturell ekvationsmodellering fanns indikationer på olika underliggande mekanismer i de två systemen. I Styckepristandvård samvarierade patientens uppfattning om vårdgivarens förhållningssätt med den oralhälso-relaterade livskvaliteten: ju mer patientcentrerat förhållningssätt, desto bättre oralhälso-relaterad livskvalitet. Detta samband fanns inte i Kontraktstandvård. Där samvarierade istället hur mycket patienten var beredd att betala för sin tandvård med hur högt hon skattade vårdgivarens förhållningssätt som patient-centrerat: ju mer patienten var beredd att betala, ju högre skattade hon vårdgivaren som patient-centrerad. Detta samband fanns inte i Styckepristandvård. Vad patienten hade betalat för sin tandvård föregående år samvarierade med oralhälso-relaterad livskvalitet i båda tandvårdssystemen: ju mer patienten hade betalat, desto sämre oralhälso-relaterad livskvalitet. Sambandet var dock dubbelt så starkt i Styckepristandvård jämfört med Kontraktstandvård. Sammanfattningsvis fanns det skillnader mellan tandvårdssystemen som hade samband med den oralhälso-relaterade livskvaliteten. Selektionsbias, dvs att olika individer söker sig till olika system, kan inte helt uteslutas, men avsaknaden av multivariata samband mellan exempelvis utbildning, ålder och oralhälso-relaterad livskvalitet indikerar att skillnaderna mellan systemen troligen beror systemfaktorer. Denna konklusion styrktes av att de skillnader som fanns mellan systemen inte var relaterade till bakgrundsvariabler.

Abstract [en]

Since 1999, the Public Dental Health Service in Värmland has two alternative patient payment systems: Fee-for-service and Contract care. In Fee-for-service, the patient pays per provided service, after treatment. In Contract care, the patient enters a contractual agreement with the Public Dental Health Service, pays a fixed fee for a fixed period of time, and then receives all dental care needed and covered by the contract, without additional costs.The overarching aim was to investigate if the assumed different treatment philosophies in Contract and Fee-for-service care would lead to different outcomes, with patients in Contract care having better oral health-related quality of life than patients in Fee-for-service care. Study I was a literature review of previous research, with material gathered through searches in different databases. Studies II, III and IV were conducted on material gathered through a postal questionnaire in 2003, sent to 1,200 randomly selected patients in each patient payment system in the Public Dental Health Service in Värmland, in all 2,400 patients. Study I. There were indications of more preventive services, and in the long run, of decreased need for restorative care in capitation, compared to in fee-for-service. Regarding productivity, dentists’ satisfaction with their work and patients’ satisfaction with provided care, there was too little information to draw conclusions.Study II. The patients in Contract care were younger, better educated, to a larger extent married or living with somebody, born in Sweden, and had better general health and oral health-related quality of life, than the Fee-for-service care patients. On the other hand, the latter felt a higher degree of social affinity with their housing area. Study III. Controlling for possible confounding factors in hierarchical multiple regression analysis, oral health-related quality of life was associated with patient payment systems: patients in Contract care had significantly better oral health-related quality of life than had the patients in Fee-for-service care. Study IV. In path analyses, using structural equating modeling, there were indications of different underlying mechanisms in the patient payment systems. In Fee-for-service care, the patient’s perception of the caregiver’s patient-centred stance was associated with oral health-related quality of life: the more patient-centred stance, the better the oral health-related quality of life. This relationship was not present in Contract care. There patient-centredness was associated with how much the patient was prepared to pay: the more she was prepared to pay, the higher she ranked her caregiver as being patient-centred. This was not found in Fee-for-service care. What the patient had paid for dental care the previous year was associated with a decrease in oral health-related quality of life in both systems. However, the association was twice as strong in Fee-for-service care, compared to Contract care. In conclusion, there were differences between the patient payment systems, influencing oral health-related quality of life. Even though selection bias cannot be excluded, the fact that the bivariate differences regarding e.g. education and age did not remain in the multivariate analyses indicated that the differences found in oral health-related quality of life probably are due to the payment systems themselves. This conclusion was strengthened by the fact that the differences found in underlying mechanisms in the systems were not related to background variables, but to variables associated with the dental care situation.

Place, publisher, year, edition, pages
Malmö University, 2009. p. 76
Series
Malmö University Odontological Dissertations, ISSN 1650-6065
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7717 (URN)9017 (Local ID)91-7104-308-X (ISBN)9017 (Archive number)9017 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper III in dissertation as manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-29Bibliographically approved
Johansson, V., Axtelius, B. & Söderfeldt, B. (2009). Path analyses of patient payment systems and oral health-related quality of life.
Open this publication in new window or tab >>Path analyses of patient payment systems and oral health-related quality of life
2009 (English)Manuscript (preprint) (Other academic)
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-37456 (URN)
Available from: 2020-12-10 Created: 2020-12-10 Last updated: 2021-04-27Bibliographically approved
Sampogna, F., Johansson, V., Axtelius, B., Abeni, D. & Söderfeldt, B. (2009). Quality of life in patients with dental conditions: comparing patients' and providers' evaluation (ed.). Community Dental Health, 26(4), 234-238
Open this publication in new window or tab >>Quality of life in patients with dental conditions: comparing patients' and providers' evaluation
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2009 (English)In: Community Dental Health, ISSN 0265-539X, Vol. 26, no 4, p. 234-238Article in journal (Refereed) Published
Abstract [en]

Objective. To measure the agreement between patients and their caregivers in evaluating patients’ oral quality of life. Basic research design. Cross-sectional study. Clinical setting. Data collected in four Swedish dental clinics in 2004. Participants. Consecutive patients. Data were completed for 444 patients. Fifteen dentists and 12 dental hygienists agreed to participate. Interventions. For each patient, the patient him/herself and his/her caregiver completed the 14-item Oral Health Impact Profile (OHIP-14), a specific instrument used to measure quality of life in oral conditions, with higher scores indicating a worse quality of life. Information on personal and clinical characteristics of patients were also collected. Main outcome measures. Median OHIP-14 scores given by caregivers and patients were calculated and compared in different subgroups of patients. Cohen’s kappa was calculated to measure the agreement between the evaluation of patients and caregivers. Results. OHIP-14 scores median values were 3.0 among patients and 9.0 among caregivers. Caregivers always gave a higher score than patients, especially in older patients and patients with lower education. The concordance between patients’ and caregivers’ evaluation was very low (for different OHIP-14 cutoffs: Cohen’s kappa from 0.10 to 0.15). Conclusions. In this study, great discrepancies were observed between patients and caregivers in the evaluation of patients’ oral quality of life, with caregivers overestimating the burden of dental conditions on patients. It is important to improve patient-caregiver communication, in order to increase patient satisfaction and provide better care. A good patient-caregiver relationship is essential for the patients’ well-being and their adherence to treatment.

Keywords
communication, odontology, quality of life.
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6708 (URN)10.1922/CDH_2304Sampogna05 (DOI)000276266500008 ()20088222 (PubMedID)2-s2.0-56749147297 (Scopus ID)9431 (Local ID)9431 (Archive number)9431 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-05-22Bibliographically approved
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