uu.seUppsala University Publications
Change search
Refine search result
3456789 251 - 300 of 743
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 251.
    Holmström, Inger
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalen university, School of Health, Care and Social Welfare, Västerås.
    Röing, Marta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Veg, Aniko
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Educating Swedish telenurses to improve caller experience: Reflections on a pilot study2014In: Clinical Nursing Studies, ISSN 2324-7959, Vol. 2, no 2, p. 61-73Article in journal (Refereed)
    Abstract [en]

    Telenurses employed at Swedish Healthcare Direct offer triage recommendations and self-care advice to the general public over the telephone on a wide range of health problems. Their understanding of work and ability to communicate are essential for callers’ adherence to recommendations and satisfaction with the service. This paper presents and reflects upon an educational intervention for Swedish telenurses which aimed to improve caller experience. Twelve telenurses participated. Six were randomised to an intervention group, the other six to a reference group. The nurses in the intervention group individually listened to, and reflected on their authentic calls together with one of the researchers on five to six separate occasions. Callers’ experiences were surveyed using a postal questionnaire sent within 48 hours of their call, both before and after the intervention. Descriptive and comparative statistics as well as content analysis were used in the analysis of the questionnaires. The most striking finding was that the educational intervention did not seem to have any effect on outcomes of the telenurses calls. Other findings revealed that a large group of callers, about 20%, did not find the call useful and only 50% to 60% of the callers reported that they had learned something from the call. Callers’ most frequent unfulfilled expectations centred on not being referred to a physician, and a perceived low level of competence among telenurses. The modest impact of the intervention on the services of telenursing may have been due to the participating nurses, the organisation, or the design of the intervention. Lessons have been learned that need to be taken into account in future and more large scale studies.

  • 252.
    Holmström, Inger
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Sanner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Swedish medical students' views of the changing professional role of medical doctors and the organisation of health care2004In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 9, no 1, p. 5-14Article in journal (Refereed)
    Abstract [en]

    Medical students will influence future health care considerably. Their professional orientation while at medical school will be related to their future professional development. Therefore, it is important to study this group's view of the role of medical doctors, especially because Swedish health care is currently undergoing major changes and financial cut backs. Here, the theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work influences their actions. The aim of this study was to describe medical students' views of their future professional role in health care. In total, 57 fourth-year medical students at a Swedish university were asked to write a short essay about how they conceptualised their professional role in future health care. Fifty-three students (93%) replied. The essays were analysed qualitatively in three steps and four themes were subsequently identified: the professional role in change, organisation of health care, working conditions and the possibilities of having a balanced life. Some factors mentioned that would strongly influence the professional role were being team leader, increased specialisation, supporting the patient and computer science and technology. The students expressed ambiguous feelings about power and leadership. The results indicate that the students share a rather dark view of both the medical profession and health care, which seems to be related to stress and financial cutbacks. Mentoring, time for reflection and changes in the curricula might be needed.

  • 253. Hughes, Carmel M
    et al.
    Hawwa, Ahmed F
    Scullin, Claire
    Anderson, Claire
    Bernsten, Cecilia B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Björnsdóttir, Ingunn
    Cordina, Maria A
    Alves da Costa, Filipa
    De Wulf, Isabelle
    Eichenberger, Patrick
    Foulon, Veerle
    Henman, Martin C
    Hersberger, Kurt E
    Schafer, Marion A
    Söndergaard, Birthe
    Tully, Mary P
    Westerlund, Tommy
    McElnay, James C
    Provision of pharmaceutical care by community pharmacists: a comparison across Europe2010In: Pharmacy World & Science, ISSN 0928-1231, E-ISSN 1573-739X, Vol. 32, no 4, p. 472-487Article in journal (Refereed)
    Abstract [en]

    Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10–71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. Conclusion The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

  • 254. Hultgren, G
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Soop, E
    1968 års sjukdomsklassifikation1969In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 66, p. 2391-97Article in journal (Refereed)
  • 255.
    Hvitfeldt Forsberg, Helena
    et al.
    Karolinska Institutet.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    von Thiele Schwarz, Ulrica
    Karolinska institutet.
    Nurses' perceptions of multitasking in the emergency department: Effective, fun and unproblematic (at least for me): a qualitative study2015In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 23, no 2, p. 59-64Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    The aim was to understand how multitasking is experienced by registered nurses and how it relates to their everyday practice in the emergency department.

    METHOD:

    Interviews with open-ended questions were conducted with registered nurses (n = 9) working in one of two included emergency departments in Sweden. Data were analyzed using Schilling's structured model for qualitative content analysis.

    RESULTS:

    Three core concepts related to multitasking emerged from the interviews: 'multitasking - an attractive prerequisite for ED care'; 'multitasking implies efficiency' and 'multitasking is not stressful'. From these core concepts an additional theme emerged: '… and does not cause errors - at least for me', related to patient safety.

    DISCUSSION:

    This study shows how the patient load and the unreflected multitasking that follows relate to nurses' perceived efficiency and job satisfaction. It also shows that the relationship between multitasking and errors is perceived to be mediated by whom the actor is, and his or her level of experience. Findings from this study add value to the discourse on multitasking and the emergency department context, as few studies go beyond examining the quantitative aspect of interruptions and multitasking and how it is experienced by the staff in their everyday practice.

  • 256. Hvitfeldt, H. Forsberg
    et al.
    Athlin, Åsa Muntlin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Schwarz, U. von Thiele
    Multitasking in the emergency department: does it affect the registered nurses' perceptions of their everyday practice?2014In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 22, no 4, p. 258-258, article id O23.2Article in journal (Other academic)
  • 257. Härnqvist, K
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Socialvetenskapliga forskningsrådets programstöd: En utvärdering av en anslagsform1998Report (Other academic)
  • 258.
    Håkansson Eklund, Jakob
    et al.
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Lindqvist, Anna Ollén
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Sundler, Annelle J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden.
    Hochwälder, Jacek
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Marmstål Hammer, Lena
    Dalarna Univ, Sch Educ Hlth Care & Social Studies, Falun, Sweden.
    Empathy levels among nursing students: A comparative cross-sectional study2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 983-989Article in journal (Refereed)
    Abstract [en]

    Aim: Empathy is a crucial component of the nurse-patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes.

    Design: The design was a comparative cross-sectional study.

    Methods: A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy.

    Results: Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least.

  • 259.
    Höglander, Jessica
    et al.
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Eklund, Jakob Håkansson
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Eide, Hilde
    Univ Coll Southeast Norway, Fac Hlth Sci, Drammen, Norway..
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Sundler, Annelie J.
    Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden..
    Registered Nurses' and nurse assistants' responses to older persons' expressions of emotional needs in home care2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2923-2932Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to explore nurse assistants' and Registered Nurses' responses to older persons' expressions of emotional needs during home care visits.

    Background: Communication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons' expressed emotional needs.

    Design: Descriptive, cross-sectional design on nursing staff responses to older persons' negative emotions in home care.

    Methods: Collected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014-November 2015. The nursing staff responses to older persons' negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

    Results: The nursing staff most often give non-explicit responses, providing space for further disclosure of older persons' expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons' expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.

    Conclusion: The nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.

  • 260.
    Höglander, Jessica
    et al.
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västeås, Sweden.
    Sundler, Annelie J.
    Univ Borås, Dept Caring Sci Work Life & Social Welf, Borås, Sweden.
    Spreeuwenberg, Peter
    Netherlands Inst Hlth Serv Res, Utrecht, Netherlands.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden.
    Eide, Hilde
    Univ South Eastern Norway, Sci Ctr Hlth & Technol, Drammen, Norway.
    van Dulmen, Sandra
    Netherlands Inst Hlth Serv Res, Utrecht, Netherlands; Univ South Eastern Norway, Sci Ctr Hlth & Technol, Drammen, Norway; Radboud Inst Hlth Sci, Dept Primary & Community Care, Nijmegen, Netherlands.
    Eklund, Jakob H.
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden.
    Emotional communication with older people: A cross-sectional study of home care2019In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 21, no 3, p. 382-389Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio-recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65-84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.

  • 261.
    Höglund, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Lännerström, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kaminsky, Elenor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    From denial to awareness: a conceptual model for obtaining equity in healthcare2018In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 9Article in journal (Refereed)
  • 262.
    Höglund, Anna T.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Högskolan i Gävle.
    Holmström, Inger K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Mälardalens högskola.
    Kaminsky, Elenor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalens högskola.
    Impact of telephone nursing education program for equity in health2016In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 1, article id 152Article in journal (Refereed)
    Abstract [en]

    Background:The Swedish Healthcare Act prescribes that healthcare should be provided according to needs andwith respect for each person’s human dignity. The goal is equity in health for the whole population. In spite of this,studies have revealed that Swedish healthcare is not always provided equally. This has also been observed intelephone nursing.Therefore, the aim of the present study was to investigate if and how an educational intervention can improveawareness of equity in healthcare among telephone nurses.Methods:The study had a quasi-experimental design, with one intervention group and one control group. Abase-line measurement was performed before an educational intervention and a follow-up measurement wasmade afterwards in both groups, using a study specific questionnaire in which fictive persons of different age,gender and ethnicity were assessed concerning, e.g., power over one’s own life, quality of life and experience ofdiscrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, coveringaspects of inequality in healthcare related to gender, ageand ethnicity, and gender and intersectionality theoriesas explaining models for these conditions.Results:The results showed few significant differences before and after the intervention in the intervention group.Also in the control group few significant differences were found in the second measurement, although no interventionwas performed in that group. The reason might be that the instrument used was not sensitive enough to pick up anexpected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create asort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higherGood life-index than the fictive persons born outside Europe and of higher age in all assessments.Conclusion:The results are an imperative that equity in healthcare still needs to be educated and discussed indifferent healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but couldeasily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.

  • 263.
    Höglund, Anna T
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Ethical issues in telenursing2009In: International Hospital Equipment & Solutions, Vol. 34, no 7, p. 18-9Article in journal (Other academic)
    Abstract [en]

    Telenursing in healthcare brings advantages for both patients and personnel: for example, the improvement of resource- and time allocation and access for patients. However, this technique might also entail ethical difficulties. In this article a range of ethical aspects that are particularly challenging intelenursing are discussed.

  • 264.
    Höglund, Anna T
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    "It's easier to talk to a woman" - aspects of gender in Swedish telenursing2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 22, p. 2979-2986Article in journal (Refereed)
    Abstract [en]

    Aim. To describe and explore gender aspects in telenursing as experienced by Swedish telenurses.

    Background. Telenurses at call centres in Sweden offer triage recommendations and self-care advice to the general public over the telephone, on a wide range of health problems. The demands on telenurses are multifaceted and competence is needed in many fields such as nursing, pharmacology, psychology and communication. Previous studies have shown that telenurses encounter many ethical dilemmas and that some of these are to do with gender related issues. Most telenurses, as well as most callers, are women. It is, therefore, reasonable to believe that gender plays an important role in the work of telenurses.

    Design. Descriptive and explorative qualitative design.

    Methods. A purposive sample of 12 female telenurses in Sweden participated in in-depth interviews twice during 2004–2005. The transcribed interviews were analysed inductively with a stepwise thematic method.

    Results. Five themes emerged from the interviews, namely: female subordination in the family, disrespect in dialogue with female nurses, distrust in fathers' competence, reluctant male callers and woman-to-woman connection.

    Conclusions. Gender construction and cultural gender norms seem to be at work in the encounter between Swedish telenurses and callers. Questions of power relations, the picture of the mother/woman as the primary carer for small children and distrusting men in their parental role were particularly highlighted.

    Relevance to clinical practice. Telenurses should be aware of the risk of stereotyping their dialogues with callers in a way that seems to fit better with female callers' ways of communicating. Clinical supervision based on reflective practice and peer reviews of calls might diminish this risk. Telenurses also need more training in handling overt or covert power messages based on male superiority.

  • 265.
    Höglund, Anna T
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Arnetz, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Arnetz, Judy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Patient participation during hospitalization for myocardial infarction: perceptions among patients and personnel2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 482-489Article in journal (Refereed)
    Abstract [en]

    Patient participation in healthcare decision-making and illness management has been associated with high patient satisfaction ratings and improved treatment outcomes in chronic diseases. Less is known about patient participation in acute illness, such as myocardial infarction (MI).

    Aim:

    To explore and describe patient and personnel perceptions of patient participation in care processes and decision-making during hospitalization for MI.

    Method:

    A descriptive qualitative design was used. Five thematic focus group interviews were carried out (n = 25), two with patients and three with personnel, at three Swedish hospitals in 2005. Two researchers were present during the interviews; one as facilitator and one responsible for documentation. The interviews were recorded, transcribed verbatim and analysed through a thematic stepwise method.

    Results:

    Five themes emerged from the interviews: the meaning of patient participation, positive outcomes, difficult situations, hindrances and facilitating factors. A shared basic assumption in all groups was that patient participation is valuable and desirable in the patient-doctor/nurse encounter in MI care. However, both staff and patients viewed patient participation primarily as information. Active involvement in medical decision-making was less emphasized. Participation was judged as especially difficult to achieve during the initial, emergency phase of MI, although the informants also stressed the need for information in this phase. Positive outcomes of patient participation mentioned were that the patient may feel more secure if involved and that he/she might be more committed to the recovery process. Hindrances were lack of time, staff and, in patients, medical knowledge. Patient characteristics could also influence the level of participation.

    Conclusion:

    If patient participation is to be achieved in all phases of MI care, patients need to be made aware of their right to participate. Health care professionals need to develop appropriate communication skills for each phase of the MI patient's hospitalization.

  • 266. Irnell, L
    et al.
    Pick, K
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Uppföljning av personer med högt blodtryck konstaterat vid en allmän hälsokontroll1978In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 55, p. 435-38Article in journal (Refereed)
  • 267. Isacson, D
    et al.
    Carsjö, K
    Haglund, B
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Psychotropic drug use in a Swedish community: Patterns of individual use during 2 years1988In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 27, no 3, p. 263-67Article in journal (Refereed)
    Abstract [en]

    Psychotropic drug use in a Swedish community with a general population of about 20,000 was studied using data from a research registry on prescriptions. Patterns of individual psychotropic drug use during 2 years, 1980 and 1981, were analyzed. Use during the second year was studied in relation to use during the first year, and individuals with continued and new use were identified. About two thirds of those who obtained psychotropics during the first year continued using such drugs during the following year. Among those with no use during the first year, 6% obtained psychotropic drugs during the second year. Both continued and new use increased with age. Psychotropic drug use was nearly twice as common among women as compared to men among new users, whereas practically no sex difference was observed in continued use among previous users of psychotropics. Despite the finding that male psychotropic drug users were almost as likely as females to continue using these drugs, the overall proportion of continuous users in the population remained considerably higher among women as compared to men. The results from this study suggest that the greater use of psychotropics among women can be explained by a greater extent of occasional use as well as continuous use among women as compared to men.

  • 268. Isacson, D
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Defining heavy use of prescription drugs. A methodological study.1988In: Medical care, ISSN 0025-7079, Vol. 26, no 11, p. 1103-10Article in journal (Refereed)
  • 269. Isacson, D
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Kostnadsfria läkemedel och högkostnadsskyddet1987Report (Other academic)
  • 270. Isacson, D
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Patterns of psychotropic drug use in a Swedish community1988In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 6, no 1, p. 51-58Article in journal (Refereed)
    Abstract [en]

    In this study individual data on prescription drug purchases in the total population of a Swedish municipality have been analyzed in order to study changes in the use of psychotropic drugs (in this study mainly hypnotics, sedatives and minor tranquillizers) over time. The number of psychotropic prescriptions decreased by 27% during the twelve-year period 1972-1983. The proportion of psychotropic drug users in the total population decreased from 16 to 11%. This decrease in psychotropic drug use was not evenly distributed within the population. The proportion of users decreased from 10 to 4% in the age group 15-44 years and from 23 to 15% in the age group 45-64 years, while the higher proportion of users in the oldest age group, 65 years and older, only decreased from 33 to 28%. Psychotropic drug use was almost twice as common among females as compared to males throughout the study period. Psychotropic drug use among heavy users of prescription drugs in general--identified with the use of a sex- and age-specific definition--was also studied. The decrease in psychotropic drug use during the time period studied was much greater among non-heavy users as compared to heavy users.

  • 271. Isacson, Dag
    et al.
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Förskrivning av lugnande medel och sömnmedel till befolkningen i Tierp 1972-19811985Report (Other academic)
  • 272. Isacson, Dag
    et al.
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Kostnadsfria läkemedel och högkostnadsskyddet1985Report (Other academic)
  • 273.
    Isaksson, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Steering health and social care through quasi-markets2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Municipalities and county councils try a multitude of different strategies when they design and steer health and social care markets to ensure that goals such as quality and equity are met. Depending on the strategies used, different problems arise. The aim of this thesis is to examine how local authorities can design quasi-markets in a way that achieves public goals such as equity and high quality. To answer the aim, four empirical studies were carried out.

    The studies show that when designing a market by contracting-out through public procurement, the issues lay primarily at specifying and defining what is meant by quality before a service is privatized. This is especially difficult to do concerning soft areas such as elder- and healthcare. If this is not done properly, it can lead to crucial issues for monitoring quality since the contracting authority cannot hold the provider responsible for delivering an aspect of a service if that aspect is not specified in the contract.

    When a market is designed as in the patient choice systems in primary care, it creates a whole other set of difficulties for the local governments. Here, it is not as important to specify quality beforehand in the contracts since quality monitoring is done retrospectively by both the counties themselves as well as the patients who with their choices can monitor quality by punishing providers with poor quality by registering with another provider. Instead, the crucial problem is how to design reimbursement system that will lead to an equal access to health care. In this respect, the county councils utilize different methods. However, despite these measures, the primary care choice reform have led to inequity, both geographical inequity in regards to where new private primary health care centres are located but also, to a larger degree, socio-economic inequity relating to what kind of socio-economic groups of individuals are registered with private PHCCs. In other words, county councils do not manage to fully counteract risk selection behaviour by the design of their reimbursement system which could imply issues with unequal access to health care.

    List of papers
    1. Privatization of social care delivery: how can contracts be specified?
    Open this publication in new window or tab >>Privatization of social care delivery: how can contracts be specified?
    2018 (English)In: Public Management Review, ISSN 1471-9037, E-ISSN 1471-9045, Vol. 20, no 11, p. 1643-1662Article in journal (Refereed) Published
    Abstract [en]

    When contracting out services to private actors, public authorities must be able to ensure that the quality of services provided is satisfactory. Therefore, it is important to formulate precise quality requirements, thus making them possible to monitor. In the study, 1,005 quality requirements from public procurements of nursing homes were categorized, and their degree of monitorability assessed. The analysis showed that quality requirements related to soft' areas such as social activities typically were non-monitorable. The requirements were written in an imprecise, vague manner, thus making it difficult for the local governments to determine whether or not they were met.

    Keywords
    Contracting, public procurement, elder care, quality, social services
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Identifiers
    urn:nbn:se:uu:diva-354473 (URN)10.1080/14719037.2017.1417465 (DOI)000443910400004 ()
    Funder
    Swedish Research Council, 421-2011-1382
    Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-10-30Bibliographically approved
    2. Free establishment of primary health care providers: effects on geographical equity
    Open this publication in new window or tab >>Free establishment of primary health care providers: effects on geographical equity
    2016 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, article id 28Article in journal (Refereed) Published
    Abstract [en]

    Background

    A reform in 2010 in Swedish primary care made it possible for private primary care providers to establish themselves freely in the country. In the former, publicly planned system, location was strictly regulated by local authorities. The goal of the new reform was to increase access and quality of health care. Critical arguments were raised that the reform could have detrimental effects on equity if the new primary health care providers chose to establish foremost in socioeconomically prosperous areas.

    The aim of this study is to examine how the primary care choice reform has affected geographical equity by analysing patterns of establishment on the part of new private providers.

    Methods

    The basis of the design was to analyse socio-economic data on individuals who reside in the same electoral areas in which the 1411 primary health care centres in Sweden are established. Since the primary health care centres are located within 21 different county councils with different reimbursement schemes, we controlled for possible cluster effects utilizing generalized estimating equations modelling. The empirical material used in the analysis is a cross-sectional data set containing socio-economic data of the geographical areas in which all primary health care centres are established.

    Results

    When controlling for the effects of the county council regulation, primary health care centres established after the primary care choice reform were found to be located in areas with significantly fewer older adults living alone as well as fewer single parents – groups which generally have lower socio-economic status and high health care needs. However, no significant effects were observed for other socio-economic variables such as mean income, percentage of immigrants, education, unemployment, and children <5 years.

    Conclusions

    The primary care choice reform seems to have had some negative effects on geographical equity, even though these seem relatively minor.

    Keywords
    Patient choice; Equity; Marketization; Sweden; Primary health care; Geographic location
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Identifiers
    urn:nbn:se:uu:diva-274995 (URN)10.1186/s12913-016-1259-z (DOI)000368550800001 ()26803298 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2016-01-27 Created: 2016-01-27 Last updated: 2018-06-28Bibliographically approved
    3. Risk selection in primary care: a cross-sectional fixed effect analysis of Swedish individual data
    Open this publication in new window or tab >>Risk selection in primary care: a cross-sectional fixed effect analysis of Swedish individual data
    2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 10, article id e020402Article in journal (Refereed) Published
    Abstract [en]

    Objective To assess socioeconomic differences between patients registered with private and public primary healthcare centres.

    Design Population-based cross-sectional study controlling for municipality and household.

    Setting Swedish population-based socioeconomic data collected from Statistics Sweden linked with individual registration data from all 21 Swedish regions.

    Participants All individuals residing in Sweden on 31 December 2015 (n=9 851 017) were included in the study.

    Primary outcome measures Registration with private versus public primary healthcare centres.

    Results After controlling for municipality and household, individuals with higher socioeconomic status were more likely to be registered with a private primary healthcare provider. Individuals in the highest income quantile were 4.9 percentage points (13.7%) more likely to be registered with a private primary healthcare provider compared with individuals in the lowest income quantile. Individuals with 1–3 years of higher education were 4.7 percentage points more likely to be registered with a private primary healthcare provider compared with those with an incomplete primary education.

    Conclusions The results show that there are notable differences in registration patterns, indicating a skewed distribution of patients and health risks between private and public primary healthcare providers. This suggests that risk selection behaviour occurs in the reformed Swedish primary healthcare system, foremost through location patterns.

    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Identifiers
    urn:nbn:se:uu:diva-354474 (URN)10.1136/bmjopen-2017-020402 (DOI)000454739500024 ()30355789 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-1137
    Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2019-01-18Bibliographically approved
    4. Preserving social equity in privatized primary care: a matter of contract design
    Open this publication in new window or tab >>Preserving social equity in privatized primary care: a matter of contract design
    (English)Manuscript (preprint) (Other academic)
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Identifiers
    urn:nbn:se:uu:diva-354475 (URN)
    Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-20
  • 274.
    Isaksson, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Blomqvist, Paula
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Pingel, Ronnie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Risk selection in primary care: a cross-sectional fixed effect analysis of Swedish individual data2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 10, article id e020402Article in journal (Refereed)
    Abstract [en]

    Objective To assess socioeconomic differences between patients registered with private and public primary healthcare centres.

    Design Population-based cross-sectional study controlling for municipality and household.

    Setting Swedish population-based socioeconomic data collected from Statistics Sweden linked with individual registration data from all 21 Swedish regions.

    Participants All individuals residing in Sweden on 31 December 2015 (n=9 851 017) were included in the study.

    Primary outcome measures Registration with private versus public primary healthcare centres.

    Results After controlling for municipality and household, individuals with higher socioeconomic status were more likely to be registered with a private primary healthcare provider. Individuals in the highest income quantile were 4.9 percentage points (13.7%) more likely to be registered with a private primary healthcare provider compared with individuals in the lowest income quantile. Individuals with 1–3 years of higher education were 4.7 percentage points more likely to be registered with a private primary healthcare provider compared with those with an incomplete primary education.

    Conclusions The results show that there are notable differences in registration patterns, indicating a skewed distribution of patients and health risks between private and public primary healthcare providers. This suggests that risk selection behaviour occurs in the reformed Swedish primary healthcare system, foremost through location patterns.

  • 275.
    Isaksson, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Blomqvist, Paula
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Free establishment of primary health care providers: effects on geographical equity2016In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, article id 28Article in journal (Refereed)
    Abstract [en]

    Background

    A reform in 2010 in Swedish primary care made it possible for private primary care providers to establish themselves freely in the country. In the former, publicly planned system, location was strictly regulated by local authorities. The goal of the new reform was to increase access and quality of health care. Critical arguments were raised that the reform could have detrimental effects on equity if the new primary health care providers chose to establish foremost in socioeconomically prosperous areas.

    The aim of this study is to examine how the primary care choice reform has affected geographical equity by analysing patterns of establishment on the part of new private providers.

    Methods

    The basis of the design was to analyse socio-economic data on individuals who reside in the same electoral areas in which the 1411 primary health care centres in Sweden are established. Since the primary health care centres are located within 21 different county councils with different reimbursement schemes, we controlled for possible cluster effects utilizing generalized estimating equations modelling. The empirical material used in the analysis is a cross-sectional data set containing socio-economic data of the geographical areas in which all primary health care centres are established.

    Results

    When controlling for the effects of the county council regulation, primary health care centres established after the primary care choice reform were found to be located in areas with significantly fewer older adults living alone as well as fewer single parents – groups which generally have lower socio-economic status and high health care needs. However, no significant effects were observed for other socio-economic variables such as mean income, percentage of immigrants, education, unemployment, and children <5 years.

    Conclusions

    The primary care choice reform seems to have had some negative effects on geographical equity, even though these seem relatively minor.

  • 276.
    Isaksson, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Blomqvist, Paula
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Privatization of social care delivery: how can contracts be specified?2018In: Public Management Review, ISSN 1471-9037, E-ISSN 1471-9045, Vol. 20, no 11, p. 1643-1662Article in journal (Refereed)
    Abstract [en]

    When contracting out services to private actors, public authorities must be able to ensure that the quality of services provided is satisfactory. Therefore, it is important to formulate precise quality requirements, thus making them possible to monitor. In the study, 1,005 quality requirements from public procurements of nursing homes were categorized, and their degree of monitorability assessed. The analysis showed that quality requirements related to soft' areas such as social activities typically were non-monitorable. The requirements were written in an imprecise, vague manner, thus making it difficult for the local governments to determine whether or not they were met.

  • 277.
    Isaksson, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Blomqvist, Paula
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Äldreomsorgens utveckling 1993-2009. Arbetsrapport 2010:12010Other (Other (popular science, discussion, etc.))
  • 278.
    Jangland, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing.
    Carlsson, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Larsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Patients' complaints about negative interactions with health professionals in a surgical setting2011In: International Journal of Person Centered Medicine, ISSN 2043 7749, Vol. 1, no 4, p. 756-765Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the experiences of patients who complain about negative interactions with health professionals in a surgical setting. The study was based on interviews with patients (n = 15) who had contacted their local Patients’ Advisory Committee to report their negative interaction with health professionals in a large university hospital in Sweden. Exploring the experiences of patients who report negative interactions may be a starting point for learning about the patients’ views of the health care organisation, and this information may contribute to quality improvement. The interviews were analysed using qualitative content analysis. Patients’ experiences of negative interactions are described under three main themes: ‘having lost confidence’, ‘feeling like a nuisance’ and ‘feeling abandoned and lonely’. Negative interactions with health professionals caused long-term consequences for patients, including suffering, insecurity, and worry. It also reduced their confidence in upcoming consultations. From the patients’ perspective a caring relationship with health professionals and reliable, appropriate, and timely information are vital to high quality care. Patient access to information and positive interactions with health professionals should be routine quality indicators in the surgical care unit. In the process of quality improvement, all health professionals need to be involved in setting goals, making small tests of changes, and evaluating outcomes. Patients’ stories of negative interactions could provide the impetus for professional reflection sessions in the surgical care unit and for education for all health professionals to develop new competence in patient relations

  • 279.
    Jangland, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing.
    Kitson, Alison
    Univ Adelaide, Sch Nursing, Adelaide, SA 5005, Australia;Australia Green Templeton Coll, Cent Adelaide Local Hlth Network, Adelaide, SA, Australia;Univ Oxford, Oxford OX1 2JD, England.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. School of Nursing, University of Adelaide, South Australia, Australia.
    Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode: a multi-stage qualitative case study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 4, p. 791-801Article in journal (Refereed)
    Abstract [en]

    AIM: To explore how patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode.

    BACKGROUND: Acute abdominal pain is one of the most common conditions to present in the acute care setting. Little is known about how patients' fundamental care needs are managed from presentation to post discharge.

    DESIGN: A multi-stage qualitative case study using the Fundamentals of Care framework as the overarching theoretical and explanatory mechanism.

    METHODS: Repeated reflective interviews were conducted with five adult patients over a 6-month period in 2013 at a university hospital in Sweden. The interviews (n = 14) were analysed using directed content analysis.

    RESULTS: Patients' experiences across the acute care episode are presented as five patient narratives and synthesized into five descriptions of the entire hospital journey. The patients talked about the fundamentals of care and had vivid accounts of what they meant to them. The experiences of each of the patients were influenced by the extent to which they felt engaged with the health professionals. The ability to engage or build a rapport was identified as a central component across the fundamental care elements, but it varied in visibility.

    CONCLUSION: Consistent pain management, comfort, timely and accurate information, choice and dignity and relationships were identified as essential fundamental care needs of patients experiencing acute abdominal pain regardless of setting, diagnosis, or demographic variables. These were variously achieved and the patients' narratives raised areas for improvement in several areas.

  • 280.
    Jangland, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing.
    Larsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Surgical nurses' different understandings of their interactions with patients: a phenomenographic study2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 533-541Article in journal (Refereed)
    Abstract [en]

    Surgical nurses' different understandings of their interactions with patients: a phenomenographic study The aim of this study was to identify and describe different ways surgical nurses understand their roles and interactions with patients and their families in a surgical care setting. The surgical nurse has an important role in supporting and encouraging the patient during the hospital stay. It can be a challenge for the nurse to quickly establish a trustful relationship with the patient. The assumption is that nurses' interactions with patients are affected by their understanding and expectations of the roles in the nurse-patient relationship. A qualitative interview approach was used and the interviews were analysed using the phenomenographic method. A strategic sample of 17 registered nurses in two hospitals in Sweden was interviewed. In the analysis four ways of understanding the nurse's role in interactions with the patient were identified: (A) Focusing on medical treatment, following prescribed instructions, and maintaining routines; (B) Providing information, giving service, and coordinating care and treatment; (C) Seeing patients as vulnerable people and helping and supporting them as individuals; and (D) Inviting patients to participate in the caring process and encouraging them to take responsibility in their own care. Seeing each patient as a person with individual needs and personal resources. The first way of understanding, A, focuses on the work task; the other three understandings focus on the patients, but differ in how the nurses see them as people. Understanding A represents a restricted and task-oriented approach, whereas the others are more patient-focused, but also more complex. To realise patient-centred care, nurses should pay attention to all aspects of the interaction. Nurses need to have time at ward meetings or in supervision to discuss and become aware of different ways of understanding their interactions and relationships with patients. In this way new areas of professional development may be opened up.

  • 281.
    Jangland, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing.
    Teodorsson, Therese
    Hoglandssjukhuset Eksjo, Dept Surg, Eksjo, Sweden.
    Molander, Karin
    Sundsvall Hosp, Dept Surg, Sundsvall, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology. Univ Adelaide, Adelaide Nursing Sch, Adelaide, SA, Australia.
    Inadequate environment, resources, and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the Fundamentals of Care framework2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2311-2321Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The purpose was to explore the delivery of care from the perspective of patients with acute abdominal pain focusing on the contextual factors at system level using the Fundamentals of Care framework.

    BACKGROUND: The Fundamentals of Care framework describes several contextual and systemic factors that can impact the delivery of care. To deliver high- quality, person-centred care it is important to understand how these factors affect patients' experiences and care needs.

    DESIGN: A focused ethnographic approach.

    METHOD: A total of 20 observations were performed on two surgical wards at a Swedish university hospital. Data were collected using participant observation and informal interviews and analysed using deductive content analysis.

    RESULTS: The findings, presented in four categories, reflect the value patients place on the caring relationship and a friendly atmosphere on the ward. Patients had concerns about the environment, particularly the high-tempo culture on the ward and its impact on their integrity, rest and sleep, access to information and planning, and need for support in addressing their existential thoughts. The observers also noted that missed nursing care had serious consequences for patient safety.

    CONCLUSION: Patients with acute abdominal pain were cared for in the high-tempo culture of a surgical ward with limited resources, unclear leadership, and challenges to patients' safety. The findings highlight the crucial importance of prioritizing and valuing the patients' fundamental care needs for recovery.

    RELEVANCE TO CLINICAL PRACTICE: Nursing leaders and nurses need to take the lead to re-conceptualize the value of fundamental care in the acute care setting. To improve clinical practice the value of fundamentals of care must be addressed regardless of patient's clinical condition. Providing a caring relationship is paramount to ensure a positive impact on patient's well-being and recovery.

  • 282.
    Jedenius, Erik
    et al.
    Karolinska Institutet, NVS.
    Wimo, A
    Karolinska Institutet, NVS.
    Strömqvist, J
    Kalmars läns landsting.
    Winblad, Bengt
    Karolinska Institutet, NVS.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Andreasen, N
    Karolinska Institutet, NVS.
    Comparing estimated cost per patient for dementia care: Two municipalities and Swedish national population data2015In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 3, no 2, p. 67-74Article in journal (Refereed)
  • 283.
    Jeffs, Lianne
    et al.
    Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide, Australia.
    Needleman, Jack
    UCLA Fielding School of Public Health / Department of Health Policy and Management, USA.
    Jackson, Debra
    Oxford Brookes University/Department of Nursing,Faculty of Health and Life Sciences, UK.
    Kitson, Alison
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Building the Foundation to Generate a Fundamental Care Standardized Data Set2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2481-2488Article in journal (Refereed)
    Abstract [en]

    Considerable transformation is occurring in healthcare globally with organizations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, health care organizations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardized data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education, and psychosocial support. Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the health care continuum and lifespan should include generating a routinely collected data set of relevant measures. This paper provides an overview of the current state of performance measurement, key trends, and a methodological approach to leverage in efforts to generate a standardized data set for fundamental care.

  • 284.
    Jiang, Jingxiong
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Huishan, Wang
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Yi, Ma
    Toschke, André Michael
    Risk factors for overweight in 2- to 6-year-old children in Beijing, China2006In: International Journal of Pediatric Obesity, ISSN 1747-7166, Vol. 1, no 2, p. 103-108Article in journal (Refereed)
    Abstract [en]

    Objective. To assess the prevalence of overweight among Chinese preschool children and to explore risk factors of childhood obesity focusing on parental characteristics, feeding practice and lifestyle. Methods. Data on 930 families with 2- to 6-year-old children in five kindergartens were obtained in a cross sectional study. Families were randomly selected from two of all six urban districts in Beijing, China. Information on parental characteristics, dietary habits, lifestyle habits, and feeding practice was collected by parental self-report questionnaires. The children's stature and weight were measured in light clothing and without shoes. Overweight and obesity were defined according to international cut-off values, as proposed by the International Obesity Task Force. Multivariate regression analysis was used to explore risk factors of child overweight. Results. The overall prevalence of overweight and obesity was 10.7% and 4.2%, respectively, and increased with age. The prevalence of child overweight was 14.1% and 7.5% in obese and non-obese families, respectively. Significant associations were observed between child and parent characteristics for overweight, frequency of eating in restaurant, television hours, and hours of physical activity. Child overweight was associated with parental overweight (Odds Ratio [OR] 2.43, 95% CI 0.78, 6.59), low maternal education level (OR 2.22, 95% CI 1.39, 3.55), food restriction (OR 2.68, 95% CI 1.64, 4.29), and television watching>2h/d (OR 1.56, 95% CI 1.17, 2.09), after adjusting for sex, age, family income and kindergarten (for cluster study design). Conclusions. Overweight prevalence among Chinese preschool children in Beijing is comparable to some European countries. Prevention strategies should include identified lifestyle risk factors.

  • 285.
    Jiang, Jingxiong
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Wang, Huishan
    Koletzko, Bert
    Lian, Guangli
    Huang, Jing
    Greiner, Ted
    Relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China2009In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 12, no 7, p. 973-978Article in journal (Refereed)
    Abstract [en]

    Background Childhood obesity has become a major public health problem in many countries. To explore the risk factors of overweight in infants and young children might be helpful in developing an early overweight intervention strategy. Objective To assess the prevalence of overweight and the relationship of parental characteristics and feeding practices to overweight in infants and young children in Beijing, China. Design Data on weight and length/height were collected on 4654 children aged 1–35 months in twelve communities in Beijing from a cross-sectional study. Overweight was defined as weight-for-length/height ≥2sd above the median of the WHO reference. Two hundred and fifteen families with overweight children and 215 families with normal-weight children were interviewed using a questionnaire to obtain feeding practices. Results The overall prevalence of overweight was 4·7 %. Both parental overweight and low parental education were significantly higher among overweight than normal-weight children. The total energy intake was significantly higher in overweight than in normal-weight children at 12–35 months of age. Compared with normal-weight children, significantly fewer overweight children were breast-fed for at least 4 months. Overweight children were also more likely to have been introduced to infant formula and semi-solid foods during the first 4 months. Conclusion Early prevention strategies should include feeding practices identified as putting children at risk of obesity. These include early cessation of breast-feeding and premature introduction of other foods.

  • 286.
    Jiang, Jingxiong
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Xia, Xiulan
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Wu, G.
    Lian, Guangli
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    The effects of a 3-year obesity intervention in schoolchildren in Beijing2007In: Child: Care, Health and Development, ISSN 0305-1862, Vol. 33, no 5, p. 641-646Article in journal (Refereed)
    Abstract [en]

    Background: Childhood obesity has become a health problem in urban areas in China. Intervention to reduce childhood obesity should be of high priority. School-based intervention programmes are needed to deal with the growing prevalence of childhood obesity in China.

    Methods: Five primary schools were selected randomly for this study in the Beijing urban area in China; two were allocated to the intervention group and three to the control group. A total of 2425 children (1029 children in intervention schools and 1396 children in control schools) took part in the study for 3 years. In the intervention group, children and their parents were involved in a programme of nutrition education and physical activity. Control school students followed their usual health and physical education curriculum with no extra intervention.

    Results: After the 3-year intervention, the prevalence of overweight and obesity were significantly lower in the intervention schools than in the control schools (overweight: 9.8% vs. 14.4%, P < 0.01; obesity: 7.9% vs. 13.3%, P < 0.01). The prevalence of overweight and obesity decreased by 26.3% and 32.5% in intervention schools respectively after intervention. The prevalence of overweight and obesity increased in control schools. There was also significant difference in body mass index between intervention and control schools (18.2 ± 2.6 vs. 20.3 ± 3.4, P < 0.01) after intervention. More non-obese children became obese in the control schools (7.0%) than in the intervention schools (2.4%) at end line (P < 0.01). Among the children who were obese at baseline, 49.2% remained obese at end line in intervention schools while 61.9% remained obese in control schools (P < 0.01).

    Conclusions: Our study showed that an intervention programme could be feasible in schools in Beijing, China. The prevalence of overweight and obesity was reduced in schoolchildren in Beijing through an intervention focused on nutrition education and physical activity. Overweight and obesity children as well as normal weight children and their parents should be involved in such an intervention programme.

  • 287.
    Jing Xiong, Jiang
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Xiulan, Xia
    Greiner, Ted
    Guangli, Lian
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    A two-year family-based behaviour treatment for obese children2005In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 90, no 12, p. 1235-8Article in journal (Refereed)
    Abstract [en]

    Background: Childhood obesity has become a nutritional problem in China since the 1990s.

    Aims: A family based behavioural treatment was developed and tested, to see if its use was feasible in China and to evaluate its impact on obese schoolchildren.

    Methods: In a single school in Beijing, 33 obese children were randomly assigned to a treatment group and 35 to a control group. The treatment group participated in a family based behavioural treatment programme for two years. Height and weight were measured every six months for all participants. Blood pressure, cholesterol, and triglyceride levels were measured at baseline and after two years of programme implementation.

    Results: Body mass index (BMI, kg/m2) was significantly reduced in the treatment group (from 26.6 (1.7) to 24.0 (0.9), 95% CI 2.06 to 3.18) but not in the control group (from 26.1 (1.5) to 26.0 (1.6)). Total cholesterol decreased 5.5% and triglycerides 9.7% in the treatment group. There was a significant correlation between change in BMI and change in triglycerides. There were no significant changes in plasma lipids in the controls. Blood pressure values also decreased significantly in the treatment, but not the control group.

    Conclusions: A family based behavioural intervention was feasible to use in treating obesity in schoolchildren in Beijing, China. After two years of implementation, it successfully decreased the degree of obesity, reduced levels of blood pressure, and decreased serum lipids in treatment; there were no significant changes among control children.

  • 288.
    Jingxiong, Jiang
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Huishan, Wang
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Guangli, Lian
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Influence of grandparents on eating behaviors of young children in Chinese three-generation families2007In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 48, no 3, p. 377-83Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate how grandparents influence their young grandchildren's eating behaviors in Chinese three-generation families. Methods: This qualitative study used semi-structured in-depth interviews with 12 parents (3 male and 9 female) and 11 grandparents (4 male and 7 female) in Beijing, China. Results: Three domains emerged in this study: (1) grandparents were the primary caretakers of children in the three-generation families. They played an important role in planning and cooking family meals; (2) grandparents' attitudes influenced young children's nutrition and eating habits. They held the belief that children being heavy at a young age would assure that they had a good nutrition status and would become tall in the future. They showed a tendency towards urging the children to eat more meals and larger portions at served meals; (3) grandparents used food as an educational and emotional tool. They shaped the behavior of their grandchildren and expressed love and caring through food. Conclusions: Grandparents were dominant in shaping children's eating behavior in some three-generation families in Chinese urban areas. Nutrition education involving grandparents is a potential framework for developing a healthy dietary behavior in young children.

  • 289. Johansson, L
    et al.
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Utskrivningar från sluten kroppssjukvård under 19771977Report (Other academic)
  • 290. Johansson, Lennarth
    et al.
    Thorslund, Mats
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Formal and informal support among elderly in a rural setting in Sweden1993In: Journal of gerontological social work, ISSN 0163-4372, E-ISSN 1540-4048, Vol. 20, no 1-2, p. 79-94Article in journal (Refereed)
  • 291. Jonsson, PM
    et al.
    Nystrom, L
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Sterky, G
    Wall, S
    Ostman, J
    Diabetes mellitus and health service utilization: a case-control study of outpatient visits 8 years after diagnosis1996In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 13, p. 1056-1063Article in journal (Refereed)
    Abstract [en]

    All incident cases of diabetes mellitus in the age group 15 to 34 years have been prospectively registered in Sweden since January 1983. To analyse the utilization of outpatient services 8 years after disease onset, we selected the cases registered in 1983 and two controls per case from the general population, matched by age, gender, and county of residence. In 1991, retrospective data about utilization patterns during a 3-month period were collected via a mailed questionnaire, returned by 317 (72%) patients with diabetes and 586 (68%) controls. Seventy-four percent of the cases and 19% of the controls reported at least one visit to a hospital outpatient clinic, including accident and emergency departments. The odds ratio for one visit was 14 (95% CI 9.6-20), for two visits 11 (95% CI 7.0-18), and for three or more visits 8.9 (95% CI 5.6-14). Even when specialized diabetes clinics were excluded from the analysis, the cases had higher odds for visits to internal medicine clinics, to ophthalmology clinics, and to gynaecology clinics, but not for visits to surgical clinics or to accident and emergency departments. Of non-hospital outpatient services, only visits to nurse practitioners were reported by a higher percentage of diabetic responders. Twenty-seven percent of patients with diabetes, as compared to 9% of the controls, had visited both hospital and non-hospital outpatient offices. Females were overrepresented among diabetic high-consumers. The results indicate that most young to middle-aged Swedish persons with diabetes are monitored at hospital outpatient offices, but considerable overlap exists between hospital and non-hospital outpatient services. Further research is needed into the determinants of utilization patterns in diabetes, such as gender.

  • 292.
    Julin, Bettina
    et al.
    Ivbar Inst, Stockholm, Sweden.
    Willers, Carl
    Ivbar Inst, Stockholm, Sweden; Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden.
    Leksell, Janeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical diabetology and metabolism. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Lindgren, Peter
    Karolinska Inst, Med Management Ctr, Stockholm, Sweden; Swedish Inst Hlth Econ, Lund, Sweden.
    Muth, Karin Looström
    Alingsås Hosp, Dept Internal Med, Alingsås, Sweden.
    Svensson, Ann-Marie
    Ctr Registers, Natl Diabet Register, Gothenburg, Sweden.
    Lilja, Mikael
    Umeå Univ, Dept Publ Hlth & Clin Med, Unit Res Educ & Dev Östersund, Umeå, Sweden.
    Dahlström, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Association between sociodemographic determinants and health outcomes in individuals with type 2 diabetes in Sweden2018In: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560, Vol. 34, no 4, article id e2984Article in journal (Refereed)
    Abstract [en]

    Background: Concurrent multifactorial treatment is needed to reduce consequent risks of diabetes, yet most studies investigating the relationship between sociodemographic factors and health outcomes have focused on only one risk factor at a time. Swedish health care is mainly tax‐funded, thus providing an environment that should facilitate equal health outcomes in patients, independent of background, socioeconomic status, or health profile. This study aimed at investigating the association between several sociodemographic factors and diabetes‐related health outcomes represented by HbA1c, systolic blood pressure, low‐density lipoprotein cholesterol, predicted 5‐year risk of cardiovascular disease, and statin use.

    Methods: This large retrospective registry study was based on patient‐level data from individuals diagnosed with type 2 diabetes during 2010 to 2011 (n = 416,228) in any of 7 Swedish regions (~65% of the Swedish population). Health equity in diabetes care analysed through multivariate regression analyses on intermediary outcomes (HbA1c, systolic blood pressure, and low‐density lipoprotein), predicted 5‐year risk of cardiovascular disease and process (i.e., statin use) after 1‐year follow‐up, adjusting for several sociodemographic factors.

    Results: We observed differences in intermediary risk measures, predicted 5‐year risk of cardiovascular disease, and process dependent on place of birth, sex, age, education, and social setting, despite Sweden's articulated vision of equal health care.

    Conclusions: Diabetes patients' health was associated with sociodemographic prerequisites. Furthermore, in addition to demographics (age and sex) and disease history, educational level, marital status, and region of birth are important factors to consider when benchmarking health outcomes, e.g., average HbA1c level, and evaluating the level of health equity between organizational units or between different administrative regions.

  • 293. Kaisdotter Andersson, Annika
    et al.
    Kron, Josefin
    Karolinska institutet.
    Castren, Maaret
    Karolinska institutet.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    Hök, Bertil
    Wiklund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Assessment of the breath alcohol concentration in emergency care patients with different level of consciousness2015In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 23, no 1, article id 11Article in journal (Refereed)
    Abstract [en]