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  • 1.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hälsokommunikation i relation till samhällsorientering och etablering av nyanlända flyktingar i Sverige: Förstudie MILSA2015Report (Other academic)
    Abstract [sv]

    I etableringsprocessen för nyanlända flyktingar, där ansvaret delas av flera aktörer, ses hälsofrämjande åtgärder idag som en allt viktigare del. Som ett led i detta har länsstyrelserna prioriterat frågan om hälsokommunikation och hur den kan sprid as och utvecklas inom ramen för etableringen. Många kommuner och andra aktörer har också valt att utöka antalet timmar som ägnas åt hälsokommunikation och andra hälsoinsatser. Fördelarna räknas inte bara på den individuella nivån. Information, hälsopromotion och prevention är samhällsekonomiskt en god affär; preventiva åtgärder förhindrar onödig användning av primär- och akutvård och minskar belastningen på hälso- och sjukvården överlag.

    Förstudien har tagits fram inom ramen för projektet forskningsbaserad stödplattform för migration och hälsa (MILSA) och dess delprojekt MILSA 4 som har som mål att samla den kunskap och de erfarenheter som finns kring hälsokommunikation och att lyfta frågan om behovet av hälsokommunikation för nyanlända flyktingar i etableringen.(1)

    Syftet med förstudien är att kartlägga vilka modeller för hälsokommunikation som prövats i Sverige, framförallt inom etableringen, och erfarenheterna av dessa. I detta ingår en beskrivning av kommunikatörers bakgrunder, vilka ut bildningar som ges till gruppen idag samt vilka material och metoder som används. En sammanfattning av resultat från några utvärderingar som gjorts på hälsokommunikationsverksamhet bland annat i Stockholm, Östergötland och Skåne, presenteras också.

    Förstudien bygger på intervjuer med ett antal utvalda aktörer inom etablering, samhällsorientering och hälsokommunikation inom olika län med geografisk spridning samt på dokumentstudier.

    ---------

    (1) Parallellt tar projektet fram rekommendationer för hur rollen som hälsokommunikatör kan utvecklas och professionaliseras. Förstudien och annan dokumentation från MILSA 4 kommer att ligga till grund för en eventuell ansökan om finansiering för fortsatt utvecklingsarbete.

  • 2.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Utvärdering av pilotfasen i “Välkommen till Skåne”: Delprojekt 4, MILSA 2.02017Report (Other academic)
  • 3.
    Anderberg, Ulla Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Fibromyalgi: på grund av stress?2007Book (Other academic)
  • 4.
    Anderzén, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Demmelmaier, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Hansson, Ann-Sophie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Johansson, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics. Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Lindahl, Erica
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics. Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Samverkan i Resursteam: effekter på organisation, hälsa och sjukskrivning2008Report (Other academic)
    Abstract [sv]

    Vi utvärderar samverkansformen Resursteam, som bedrivits som ett försök för att minska långa sjukskrivningar. Resursteam innebär att ett team med hand-läggare från Försäkringskassan, husläkare, sjukgymnast och beteendevetare, vid regelbundna möten bedömer sjukskrivna personers rehabiliteringsbehov och ger förslag på åtgärder. Det övergripande syftet är att skatta effekten av Resursteam på den försäkrades sjukskrivningslängd och självskattade hälsa. Vi har genomfört (i) en kartläggning av verksamheten, (ii) en enkätstudie till sjuk-skrivna som deltagit i Resursteam och till jämförelsepersoner samt (ii) skattat effekten av Resursteam på självskattad hälsa och sjukskrivning. Resultaten är entydiga och visar på inga eller negativa effekter för de personer som ingått i Resursteam. Som exempel kan nämnas att tiden i sjukskrivning förlängs med cirka 20 procent i genomsnitt.

  • 5.
    Anderzén, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hansson, Ann-Sophie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Liljestam Hurtigh, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Slutrapport – NySatsa Haninge: Projekt med syfte att främja individens möjligheter till återgång i arbete genom individuell utveckling och vägledning2010Report (Other academic)
  • 6.
    Angner, E
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindahl, G
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Rosenqvist, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Besparingar och förändringar inom vården - förutsättningar, aktörer och mål1997Other (Other academic)
  • 7.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Ekman, RolfUppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Stress in Health and Disease2006Collection (editor) (Other academic)
    Abstract [en]

    This first book to address the most urgent issues combines a solid research approach with applied individual and stress issues. It focuses on our latest knowledge of various causes of stress and its neuro-cognitive and biological implications. World-renowned authors cover all perspectives: societal, individual, organ and molecular level.

  • 8.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Frenzel, L.
    Åkerstedt, T.
    Lisspers, Jan
    The brief fatigue syndrome scale: validation and utilization in fatigue recovery studies2008In: Fatigue Science for Human Health / [ed] Y. Watanabe, B. Evengård, B.H. Natelson, L. A. Jason and H. Kuratsune, Tokyo: Springer , 2008, p. 55-66Chapter in book (Other academic)
  • 9.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hamdan, Thamer A.
    Grzybowski, Mary
    Severson, Rick
    Shukri, Sawsan W.
    Jamil, Hikmet
    War-related mental health disorders among Iraqis 10 years after the 1991 Gulf War: A comparative study of soldiers and civilians living under sustained socio-environmental stress2009In: The New Iraqi Journal of Medicine, ISSN 1817-5562, Vol. 5, no 1, p. 9-21Article in journal (Refereed)
    Abstract [en]

    Background: Prior studies of mental health consequences of the Gulf War (GW) have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress.

    Methods: A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder (PTSD), were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure.

    Results: Iraqi soldiers reported significantly more depression (Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1) and anxiety (OR 3.9; 95% CI, 1.2-13.3) compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter (OR 104.6; 95% CI, 28.0-390.8) and anxiety (OR 4.1; 95% CI, 1.5-11.1). The highest self-reported trauma exposure occurred in the southwest of Iraq.

    Conclusion: Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations.

  • 10.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lucas, Todd
    Arnetz, Judith E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Organizational Climate, Occupational Stress, and Employee Mental Health: Mediating Effects of Organizational Efficiency2011In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 53, no 1, p. 34-42Article in journal (Refereed)
    Abstract [en]

    Objective: To determine whether the relationship between organizational climate and employee mental health is consistent (ie, invariant) or differs across four large hospitals, and whether organizational efficiency mediates this relationship. Methods: Participants (total N = 5316) completed validated measures of organizational climate variables (social climate, participatory management, goal clarity, and performance feedback), organizational efficiency, occupational stress, and mental health. Results: Path analysis best supported a model in which organizational efficiency partially mediated relationships between organizational climate, occupational stress, and mental health. Conclusions: Focusing on improving both the psychosocial work environment and organizational efficiency might contribute to decreased employee stress, improved mental well-being, and organizational performance.

  • 11.
    Arnetz, Bengt B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Nevedal, Dana C
    Lumley, Mark A
    Backman, Lena
    Lublin, Åke
    Trauma resiliency training for police: psychophysiological and performance effects2009In: Journal of Police and Criminal Psychology, ISSN 0882-0783, Vol. 24, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The objective of this study is to test the effects of police trauma resilience training on stress and performance during a critical incident police work simulation. Rookie police officers (N = 18) participated in a randomized trial of a 10-week imagery and skills training program versus training as usual. Twelve months later, psychophysiological stress and police work performance were assessed during a live critical incident simulation. Training resulted in significantly less negative mood, less heart rate reactivity, a larger increase in antithrombin, and better police performance compared to controls. Trends for cortisol and self-reported stress also suggested benefits of training. This novel training program is a promising paradigm for improving police well-being, stress resiliency, and optimizing job performance.

  • 12.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Wiholm, Clairy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Wang, Shinan
    Slatcher, Rich
    Lumley, Mark
    Hytter, Anders
    Sandmark, Helen
    Shi, Weisong
    Real-Time Ecologically-Valid Assessment of Cognitive and Cardiovascular Load in Real-Life in Mid-Career Female Managers2013In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 75, no 3, p. A100-A100Article in journal (Other academic)
  • 13.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Åkerstedt, Torbjörn
    Hillert, Lena
    Lowden, Arne
    Kuster, Niels
    Wiholm, Clairy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    The Effects of 884 MHz GSM Wireless Communication Signals on Self-reported Symptoms and Sleep: An Experimental Provocation Study2007In: PIERS online, ISSN 1931-7360, Vol. 3, no 7, p. 1148-1150Article in journal (Refereed)
    Abstract [en]

    In the current study we assessed possible effects of prolonged (3 hours) exposure to 884 MHz GSM wireless communication signals on self-reported symptoms, cognitive function, and electroencephalographically (EEG) recorded sleep. The study group consisted of 36 women and 35 men. Twenty-two women and sixteen men reported symptoms they specifically related to mobile phone use (SG). The rest of the participants reported no mobile phone-related symptoms (NG). Potential participants volunteering for the study were evaluated by physicians, including some biochemical assessments, to rule out medical conditions that could interfere with study variables of interest. Once selected, participants spent three different sessions in the laboratory. The habituation session was followed by two subsequent sessions. In these subsequent sessions, subjects were either exposed to sham exposure (sham) or 884 MHz GSM wireless communication signals for 3 hours (an average of 1.4 W/kg including periods of DTX and Non-DTX. Exposure directed to the left hemisphere). Data was collected before, during and following the exposure/sham sessions. Data collected included self-reported symptoms, including headache, cognitive function, mood, and electroencephalographic recordings. During actual exposure, as compared to sham exposure, sleep initiated one hour after exposure was affected. There was a prolonged latency to reach the first cycle of deep sleep (stage 3). The amount of stage 4 sleep was also decreased in exposed subjects. NG subjects reported more headaches during exposures vs. sham exposure. Neither group (SG and NG) was able to detect the true exposure status more frequently than by chance alone. The study indicates that during laboratory exposure to 884 MHz wireless signals, components of sleep, believed to be important for recovery from daily wear and tear, are adversely affected. Moreover, participants that otherwise have no self-reported symptoms related to mobile phone use, appear to have more headaches during actual radiofrequency exposure as compared to sham exposure. However, subjects were not able to detect the true exposure status more often than would have been expected by statistical chance alone. Additional self-reported findings, biochemical, performance and electrophysiological data are currently being analyzed. Possible health implications from the findings will also be further explored.

  • 14.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Aranyos, Deanna
    Ager, Joel
    Upfal, Mark J.
    Development and Application of a Population-Based System for Workplace Violence Surveillance in Hospitals2011In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 54, no 12, p. 925-934Article in journal (Refereed)
    Abstract [en]

    Background A unique and comprehensive reporting and population-based violence surveillance system in a multi-site hospital system is presented. Methods Incidence rates and rate ratios (RR) were calculated by year, hospital, violence type, and job category in six hospitals, 2003-2008. Results Incidence rates per hospital for the 6-year period ranged from a low of 1.52 to a high of 10.89 incidents/100 full-time equivalents (FTEs), with the highest risk at a hospital with an outpatient mental health facility (RR = 7.16, 95% CI = 5.17-10.26). Rates for worker-on-worker violence exceeded rates for patient-to-worker violence from 2004 to 2008. Mental health technicians (RR = 13.82, 95% CI = 11.13-17.29) and security personnel (RR = 2.25, CI = 1.68-3.00) were at greatest risk for violence. Conclusions This surveillance system provides ongoing information on professional groups and hospital departments at risk and trends in violence reporting over time. It can be used to determine where appropriate violence prevention efforts are most needed, and to evaluate violence interventions.

  • 15.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Aranyos, Deanna
    Ager, Joel
    Upfal, Mark J.
    Worker-on-worker Violence among Hospital Employees2011In: International journal of occupational and environmental health, ISSN 1077-3525, E-ISSN 2049-3967, Vol. 17, no 4, p. 328-335Article in journal (Refereed)
    Abstract [en]

    Violence toward hospital workers is an internationally recognized occupational hazard. While patients are frequently perpetrators of physical violence, other employees are often responsible for acts of nonphysical violence. However, few hospitals have systems for documenting and monitoring worker-on-worker violence. This study encompassed all incidents of worker-on-worker violence recorded by employees in a hospital system database over a six-year period. Incidence rates per 100 full-time equivalents (FTEs) and rate ratios (RR) were calculated by year, hospital, and job category. The majority (87%) of worker-on-worker incidents involved nonphysical conflict. The overall incidence rate was 1.65/100 FTEs, ranging among the six hospitals from 0.54 to 3.42/100 FTEs. Based on multivariate analysis, no single professional group was at increased risk for worker-on-worker violence. Co-worker violence threatens the well-being of hospital employees and should be regularly tracked with other forms of work-place violence so that suitable intervention programs can be implemented and assessed.

  • 16.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Gender differences in patient perceptions of involvement in myocardial infarction care2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 3, p. 174-181Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gender differences in the clinical presentation, treatment and outcomes of myocardial infarction (MI) have been demonstrated. However, few studies have examined gender differences in patients' perceptions of involvement in MI care, and whether differing levels of involvement might be associated with gender differences in treatment and outcome. AIM: To examine possible gender differences in MI patients' perceptions of their involvement during hospitalization. METHODS: Questionnaire study conducted in 2005-2006 among MI patients under the age of 75 at eleven hospitals. Patient ratings of their involvement during hospitalization were analyzed for age-stratified gender differences. RESULTS: Younger (<70 years of age) female MI patients placed significantly more value on shared decision-making than younger (<70) men. More than one third of patients would have liked to be more involved in their care during hospitalization and discharge planning, with women significantly more dissatisfied than men. Significantly fewer younger female patients discussed secondary preventive lifestyle changes with cardiology staff prior to hospital discharge. CONCLUSION: Significant age-specific gender differences exist in MI patient ratings of, and satisfaction with, involvement during hospitalization. Further study is needed regarding the possible role of involvement in the recognized gender differences in the treatment and outcomes of MI.

  • 17.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Winblad, Ulrika
    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 Public Health and Caring Sciences.
    Development and evaluation of a questionnaire for measuring patient views of involvement in myocardial infarction care2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 3, p. 229-238Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Patients' involvement in their healthcare has been associated with improved treatment outcomes in chronic illness. Less is known about the affects of patient involvement on the outcomes of acute illness, such as myocardial infarction. A better understanding of patients' views and behaviour during hospitalization might improve clinical practice and enhance patient involvement.

    AIM

    The aim of this study was to develop and evaluate a questionnaire for measuring patients' perceptions of their involvement during hospitalization for myocardial infarction care.

    METHODS

    Focus groups with myocardial infarction patients provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among myocardial infarction patients at eleven Swedish hospitals.

    RESULTS

    The questionnaire demonstrated good validity and reliability, with six factors measuring patient views and behaviour regarding involvement.

    CONCLUSION

    The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of patients regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of patient-staff interaction that need improvement. Pinpointing such areas may lead to improved patient involvement, satisfaction with care, and treatment outcomes.

  • 18.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Staff views and behaviour regarding patient involvement in myocardial infarction care: development and evaluation of a questionnaire2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Healthcare legislation in several nations now dictates the responsibility of health care professionals to involve patients in decisions concerning care and treatment. However, few studies have examined the impact of patient involvement on the work of health care professionals. A better understanding of staff views and behaviour might enhance patient involvement.

    AIM

    The aim of this study was to develop and validate a questionnaire for measuring views and behaviour regarding patient involvement among physicians and nursing staff caring for patients with myocardial infarction.

    METHODS

    Focus groups among cardiology staff provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among cardiology staff at twelve Swedish hospitals.

    RESULTS

    The questionnaire demonstrated good validity and reliability, with two factors measuring staff views and four measuring behaviour.

    CONCLUSION

    The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of physicians and nursing staff regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of staff-patient interaction that need improvement, as well as implications of patient involvement for the work of each professional group on cardiology wards.

  • 19.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Spångberg, Kalle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Wang, Yun
    Ager, Joel
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome?: an exploratory study2010In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 13, no 3, p. 298-311Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6–10 weeks after hospital discharge.

    Background Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI.

    Design Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients.

    Setting and participants Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals.

    Main outcome measures Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals.

    Results More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6–10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance.

    Conclusion This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6–10 weeks after hospital discharge to the extent hypothesized.

  • 20.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Zhdanova, Ludmila S.
    Elsouhag, Dalia
    Lichtenberg, Peter
    Luborsky, Mark R.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Organizational Climate Determinants of Resident Safety Culture in Nursing Homes2011In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 51, no 6, p. 739-749Article in journal (Refereed)
    Abstract [en]

    Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Design and Methods: Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures. Results: The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Implications: Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.

  • 21. Barkho, Evone
    et al.
    Fakhouri, Monty
    Arnetz, Judith E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Intimate Partner Violence Among Iraqi Immigrant Women in Metro Detroit: A Pilot Study2011In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 13, no 4, p. 725-731Article in journal (Refereed)
    Abstract [en]

    Violence against women is an important public health problem. The objective of this study was to examine the prevalence of intimate partner violence (IPV) among immigrant Iraqi women, and to explore the association between IPV and self-rated health. A pilot study using a previously published, self-report questionnaire was carried out among a convenience sampling of 55 Iraqi women in greater Detroit. The overall prevalence of controlling behavior, threatening behavior, and physical violence was 93, 76, and 80%, respectively. Approximately 40% of the women reported having poor or fair health, and 90% reported experiencing one or more types of psychosomatic symptoms. Self-rated health was inversely related to exposure to threatening behavior and physical violence, and positively related to knowledge of one's legal rights. The prevalence of IPV in this sample was high. Results indicated a significant association between exposure to IPV and women's physical health and psychosomatic symptoms.

  • 22.
    Berg, Peter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Sundelin, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    The connection between socioeconomic and psycho-social factors and bicycle helmet use among school children and teenagers2010Article in journal (Other academic)
  • 23.
    Berg, Peter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    A decrease in both mild and severe bicycle-related head injuries in helmet wearing ages--trend analyses in Sweden2007In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 22, no 3, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Several international studies point at the efficacy of bicycle helmets in reducing head injuries. In Sweden, observational studies show that from 1988 to 1996 helmet use increased in all categories of cyclists. The objectives of this study were to analyse the trends of bicycle-related head injuries based on their main diagnosis and external cause of injury by different age groups. Our study area was the whole population of Sweden from 1987 to 1996. Outcome evaluation was based on data from the Swedish National Hospital Discharge Register concerning all bicycle-related injuries from 1987 to 1996, which presented 49 758 reported in-patient care. The trends in incidence rates (IRs) were studied with regression analyses. The results show that children under 15 years had the highest IRs. For these children, the IR decreased by 46%. The head injuries in children decreased both in collisions with motor vehicles and in other accidents. Similarly, the IR of concussion and skull fracture decreased. For non-head injuries, there were no significant changes for children. On the other hand, the incidence of both head and other injuries for adults aged 16-50 years increased. Ages above that showed no significant changes. Our conclusions are that the decrease in IR for bicycle-related head injuries refers to children in ages for whom bicycle helmet use during the period increased. This could not be explained by any general decrease in bicycle-related accidents or by any changes in the distribution of injuries after collision with motor vehicles. The increasing helmet use among younger schoolchildren probably contributed to the decrease in head injuries.

  • 24.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Active Traveling and Its Associations with Self-Rated Health, BMI and Physical Activity: A Comparative Study in the Adult Swedish Population2016In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 13, no 5, article id 455Article in journal (Refereed)
    Abstract [en]

    Active traveling to a daily occupation means that an individual uses an active way of traveling between two destinations. Active travel to work or other daily occupations offers a convenient way to increase physical activity levels which is known to have positive effects on several health outcomes. Frequently used concepts in city planning and regional planning today are to create environments for active commuting and active living. Even then, little research has focused on traveling modes and subjective health outcomes such as self-rated health (SRH). This study aimed to explore and investigate associations between travel mode and health-related outcomes, such as self-rated health (SRH), body mass index (BMI) and overall physical activity, in an adult population in Sweden. A cross-sectional study was conducted in a randomly selected population-based sample (n = 1786, age 45-75 years); the respondents completed a questionnaire about their regular travel mode, demographics, lifestyle, BMI and SRH. Chi-square tests and logistic regressions found that inactive traveling was associated with poor SRH, a greater risk of obesity or being overweight and overall physical inactivity. In addition, lifestyle factors, such as choice of food and smoking habits, were associated with SRH, BMI and overall physical activity.

  • 25.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Adherence to and beliefs in lipid-lowering medical treatments: A structural equation modeling approach including the necessity-concern framework2013In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 91, no 1, p. 105-112Article in journal (Refereed)
    Abstract [en]

    Objective

    This study attempts to identify a structure among patient-related factors that could predict treatment adherence in statin patients, especially with regards to the necessity-concern framework.

    Methods

    414 Swedish patients using statins completed a questionnaire about their health, treatment, locus of control, perception of necessity-concern and adherence. The data were handled using a structural equation modeling approach.

    Results

    Patients that reported high perceptions of necessity to treatment seemed to adhere well, and side effects appear to affect adherence negatively. Disease burden, cardiovascular disease experience and high locus of control seem to have mediating effects on adherence.

    Conclusion

    This study provides support for the hypothesis that health- and treatment-related factors, as well as locus of control factors, are indirectly associated with treatment adherence via their association with mediating factor necessity.

    Practice implications:

    This study highlights the importance of considering patients' beliefsabout medications, disease burden, experience of cardiovascular events and locus of control as these factors are associated with adherence behavior to statin treatment. This study also emphasizes more generally the importance of an approach targeting necessity and concern when communicating with and treating patients with lipid-lowering medication. (

  • 26.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health and wellbeing in informal caregivers and non-caregivers: a comparative cross-sectional study of the Swedish a general population2015In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 13, article id 109Article in journal (Refereed)
    Abstract [en]

    Background: Informal caregiving by relatives is a great resource for individuals as well as for society, but the caregiving role is associated with health problems for the caregiver. This study aimed to compare caregivers' self-rated health, number of recent days with poor health and psychological wellbeing with that of non-caregivers in a general Swedish population. Methods: From 2004 to 2013, 90,845 Swedish people completed a postal questionnaire about their health, number of recent days with poor health during last month, psychological wellbeing and if they were performing caregiving or not. Descriptive statistics, chi-square analysis, ANOVA, logistic regressions and negative binomial regression models were used to investigate associations between being a caregiver or not and health and wellbeing. Negative binomial regression was used to assess the relation between caregiver status and recent days with poor health or functioning. Results: Eleven percent reported having a caregiving role. Caregivers reported poorer self-rated health compered to non-caregivers, also in adjusted models; odds ratio (OR): 1.07 with a 95 % confidence interval (CI): 1.01-1.13. Caregivers also reported lower psychological wellbeing compared to non-caregivers; OR: 1.22, CI: 1.15-1.30. Caregiving status was associated with more recent days with poor physical health and more recent days with poor mental health. Conclusions: This study suggests that caregivers have worse perceptions in self-rated health and psychological wellbeing compared with non-caregivers, indicating that the role of caregiver is adversely associated with health. This association also appears in terms of reporting days of poor health in the last month. The underlying mechanism of these associations, including the potential detrimental health effects of being a caregiver, needs to be investigated in longitudinal studies.

  • 27.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    The influence of locus of control on self-rated health in context of chronic disease: a structural equation modeling approach in a cross sectional study2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, p. 492-Article in journal (Refereed)
    Abstract [en]

    Background: Self-rated health is a robust predictor of several health outcomes, such as functional ability, health care utilization, morbidity and mortality. The purpose of this study is to investigate and explore how health locus of control and disease burden relate to self-rated health among patients at risk for cardiovascular disease. Methods: In 2009, 414 Swedish patients who were using statins completed a questionnaire about their health, diseases and their views on the three-dimensional health locus of control scale. The scale determines which category of health locus of control - internal, chance or powerful others - a patient most identifies with. The data was analyzed using logistic regression and a structural equation modeling approach. Results: The analyses showed positive associations between internal health locus of control and self-rated health, and a negative association between health locus of control in chance and powerful others and self-rated health. High internal health locus of control was negatively associated with the cumulative burden of diseases, while health locus of control in chance and powerful others were positively associated with burden of diseases. In addition, age and education level had indirect associations with self-rated health through health locus of control. Conclusions: This study suggests that self-rated health is positively correlated with internal locus of control and negatively associated with high locus of control in chance and powerful others in patients at high risk for cardiovascular disease. Furthermore, disease burden seems to be negatively associated with self-rated health.

  • 28.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Social and health-related factors associated with refraining from seeking dental care: A cross-sectional population study2017In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 45, no 3, p. 258-265Article in journal (Refereed)
    Abstract [en]

    Background: Social inequities are considered to affect healthcare utilization, whereas less is known about the factors associated with refraining from seeking dental care. This study aimed to investigate whether people with no social support, long-term illness, caregiver burden and low socioeconomic status (SES) refrained from seeking dental care in higher proportion than the general Swedish population.

    Methods: This study used cross-sectional questionnaire data from repeated nationwide health surveys during 2004-2013 of a total of 90 845 people. The questionnaire included questions on demographic characteristics, social support, long-term illness, caregiving burden, SES and dental care-seeking behaviour. Descriptive statistics, chi-square tests, correlation analyses and logistic regressions were used to investigate associations between independent variables and dental care-seeking behaviour.

    Results: In the total sample, 15.1% of respondents reported refraining from seeking dental care. Having no emotional social support or having no instrumental social support was separately associated with reporting refraining from seeking dental care in adjusted multivariate models (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.18-1.34 and OR: 1.89, 95% CI: 1.67-2.13, respectively). Having a long-term illness was associated with refraining from seeking dental care in adjusted models (adjusted OR: 1.43, 95% CI: 1.35-1.51). Furthermore, being an informal caregiver was associated with refraining from seeking dental care (adjusted OR: 1.15, 95% CI: 1.07-1.23). Low SES was associated with higher refraining from seeking dental care; the strongest association was with having financial problems (adjusted OR: 3.57, 95% CI: 3.19-4.00). Interaction effects were found between education level and SES, and between social support and long-term illness, and the outcome.

    Conclusions: The findings in this study imply that having no social support, having long-term illness, being informal caregiver or having financial problems are factors associated with reporting refraining from seeking dental care, on a population basis.

  • 29.
    Berglund, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Sundstrom, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Treatment effect expressed as the novel Delay of Event measure is associated with high willingness to initiate preventive treatment - A randomized survey experiment comparing effect measures2016In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, no 12, p. 2005-2011Article in journal (Refereed)
    Abstract [en]

    Objectives: This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time. Methods: In this cross-sectional, randomized survey experiment in the general Swedish population, 1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment. Results: Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP. Conclusions: Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment. Practice implications: An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making.

  • 30. Bergman, David
    et al.
    Arnetz, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Wahlström, Rolf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Sandahl, Christer
    Effects of dialogue groups on physicians' work environment2007In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 21, no 1, p. 27-38Article in journal (Refereed)
    Abstract [en]

    Abstract: Purpose – The purpose of this study is to evaluate whether dialogue groups for physicians can improve their psychosocial work environment. Design/methodology/approach – The study assessed the impact of eight dialogue groups, which involved 60 physicians at a children's clinic in one of the main hospitals in Stockholm. Psychosocial work environment measures were collected through a validated instrument sent to all physicians (n=68) in 1999, 2001 and 2003. Follow-up data were collected after the termination of the groups. Findings – The overall score of organizational and staff wellbeing, as assessed by the physicians at the clinic, deteriorated from 1999 until 2003 and then improved 2004. This shift in the trend coincided with the intervention. No other factors which might explain this shift could be identified. Research limitations/implications – In a naturalistic study of this kind it is not possible to prove any causal relationships. A controlled survey of management programmes concerning the work environment among physicians would be of interest for further research. Practical implications – The results suggest that dialogue groups may be one way to improve the psychosocial work environment for physicians. Originality/value – There is a lack of intervention studies regarding the efficacy of management programmes directed toward physicians, concerning the effects on professional and personal wellbeing. This is the first time dialogue groups have been studied within a health care setting.

  • 31.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Dansa dig till normalstress2005In: Sjukgymnasten, ISSN 0037-6019, Vol. 5, p. 40-42Article in journal (Other academic)
  • 32.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Evaluating DMT in fibromyalgia patients2006In: Advances in dance/movement therapy: theoretical perspectives and empirical findings / [ed] Sabine C. Koch & Iris Bräuninger, Berlin: Logos Verlag Berlin, 2006, p. 73-87Chapter in book (Other academic)
  • 33.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    I dansens rörelser försvinner den kroniska smärtan2004In: Populär psykologi och medicin, Vol. 1, p. 56-59Article in journal (Other (popular science, discussion, etc.))
  • 34.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Konstnärliga terapiformers betydelse: hälsa och stress2003In: PG Magazine, Vol. 1, p. 24-25Article in journal (Other academic)
  • 35.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kultur för hälsans skull2011Book (Other academic)
  • 36.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Musik har terapeutisk effekt2006In: Fysioterapi, ISSN 0037-6019, Vol. 8, p. 28-31Article in journal (Other academic)
  • 37.
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Videotolkning: en ny metod som hjälper dig att verbalisera ditt kroppspråk2002In: PQ Magazine, Vol. 4, p. 20-23Article in journal (Other (popular science, discussion, etc.))
  • 38.
    Bojner Horwitz, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Bojner, Gunilla
    Må bättre med musik2005Book (Other (popular science, discussion, etc.))
  • 39.
    Bojner Horwitz, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kowalski, Jan
    Anderberg, Ulla Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Theater for, by and with fibromyalgia patients: evaluation of emotional expression using video interpretation2010In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 37, no 1, p. 13-19Article in journal (Refereed)
    Abstract [en]

    The healing function of theatre is reflected in all human cultures. Today, therapists and scientists work with psychodrama and drama therapy, often describing theatre as the art form closest to life itself.

    In a unique cooperation between professional actors and a dance movement therapist/pain researcher, patients with fibromyalgia have first been trained in body- and voice expression and thereafter acted out a drama onstage together with professional actors. A video interpretation technique was used to help patients interpret their own emotional expressions towards other actors and evaluate their perceived pain and self-rated health.

    The results of this experimental study show that the variation of emotional expression from video interpretation is dependent upon whether or not the patient acts with an actor. The intensity of emotional expression increases significantly when acting together with a professional actor. The results also show an increase in self-rated health and a decrease in pain after three months of using this theatre-based technique. A correlation between strong emotional expression and decreased pain was also observed. However, when patients did not actively participate in a theatre play, their self-estimated pain was not significantly decreased.

    In this study, the cross-fertilization of culture/expressive arts and health care is presented as a new resource for pain treatment. In particular there may be a link between intense emotional expressions when acting with professional actors and decreased perceptions of pain. The paper also discusses the potential therapeutic value of working with professional actors in the treatment of other pain patients. Hopefully, this “healing theatre” can contribute to developing collaboration between actors and creative art therapists and stimulate controlled studies of evidence-based science.

  • 40.
    Bojner Horwitz, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kowalski, Jan
    Theorell, Töres
    Anderberg, Ulla Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Psychiatry, University hospital.
    Dance/movement therapy in fibromyalgia patients: Changes in self-figure drawings and their relation to verbal self-rating scales2006In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 33, no 1, p. 11-25Article in journal (Refereed)
    Abstract [en]

    This study evaluates if verbally oriented scales are as effective as the visual instruments of self-figure drawing and video interpretation in detecting treatment responses after 6 months of dance/movement therapy in fibromyalgia patients.

    The self-figure drawing and video interpretation technique captured treatment effects that were not seen on verbal scales. In the self-figure drawings, significant differences were seen in the variables “amount of body details” and “amount of paper use in percent” between the treatment group and controls after dance/movement therapy. The treatment group showed a significant increase in the “amount of body details” and “amount of paper use in percent” compared to controls. Specific parts of the verbally oriented ratings in CPRS, “bodily discomfort” and “compulsive act,” were positively correlated to “number of different colours.” The variable “pain and ache” in the CPRS indicated a negative correlation to the “amount of paper use in percent,” i.e. the more pain, the less paper used.

    The use of different assessment techniques may affect the treatment outcome and verbal instrumentation may not be the most appropriate in this patient group. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors that are discussed.

  • 41.
    Branth, Stefan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ronquist, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Stridsberg, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Hambraeus, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Kindgren, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Olsson, Roger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carlander, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Arnetz, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Development of abdominal fat and incipient metabolic syndrome in young healthy men exposed to long-term stress2007In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 17, no 6, p. 427-435Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIM: The sympathetic nervous system may be involved in the pathophysiology of insulin resistance and metabolic cardiovascular syndrome in young men. The aim was to study the effects of long-term stress on different features of the metabolic syndrome (MES) in formerly non-obese healthy young males during 5 months of defined conditions. METHODS AND RESULTS: Sixteen healthy male sailors (mean age 36.5 (SD)+/-7 years) participating in a sailing race around the world were recruited for the study. Investigations were done before the start and at stop overs after finishing laps 1, 2 and 4 (1, 2(1/2) and 5 months, respectively). Anthropometric and blood pressure data as well as biochemical data associated with MES were substantiated. Food intake and exercise were chartered and largely controlled. A mean weight loss of 4.5+/-2 kg (P<0.005), comprising both fat and lean body mass, was recorded during the first lap. Subsequently after 5 months, a weight gain, mainly consisting of 1.2+/-1.1 kg body fat (P<0.05), took place, concomitantly with a protein mass drop of 0.6+/-1.1 kg (P<0.05). The body fat gain accumulated on the abdominal region. Elevated blood levels of HbA1c, insulin and the triglycerides/high-density lipoprotein ratio were also observed during the race. Likewise heart rate and systolic blood pressure increased slightly but to a statistically significant extent. CONCLUSIONS: Non-obese healthy young men exposed to long-term stress developed abdominal obesity and signs of a metabolic syndrome in embryo, also emphasized by biochemical and blood pressure alterations. It is suggested that long-term and sustained stress activation might be an additional risk factor for the development of MES, even after control of dietary and exercise habits.

  • 42.
    Brattberg, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Connective tissue massage in the treatment of fibromyalgia1999In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 3, no 3, p. 235-244Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the effect of connective tissue massage in the treatment of individuals with fibromyalgia. The results of this random study of 48 individuals diagnosed with fibromyalgia (23 in the treatment group and 25 in the reference group) show that a series of 15 treatments with connective tissue massage conveys a pain relieving effect of 37%, reduces depression and the use of analgesics, and positively effects quality of life. The treatment effects appeared gradually during the 10-week treatment period. Three months after the treatment period about 30% of the pain relieving effect was gone, and 6 months after the treatment period pain was back to about 90% of the basic value. As long as there is a lack of effective medical treatment for individuals with fibromyalgia, they ought to be offered treatments with connective tissue massage. However, further studies are needed in the mechanisms behind the treatment effects.

  • 43. Brown, C.
    et al.
    Hasson, H.
    Thyselius, Vanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Almborg, A. -H
    Post-stroke depression and functional independence: a conundrum2012In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 126, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Objectives People who suffer a stroke are at risk of developing post-stroke depression (PSD). Not only does this lower their quality of life but it also increases their risk of another stroke or death. This study aimed to investigate the factors associated with PSD in order to better direct rehabilitation efforts aimed at cutting the incidence of PSD.

    Material and methods This study was based on all patients admitted to the stroke unit of a hospital in southern Sweden from 1 October 2003 to 30 November 2005. The total number of patients involved was 181. Measures were collected at 2 +/- 1 weeks after discharge from hospital, 3 +/- 0.5 months after the occurrence of the stroke and 12 +/- 1 months after the occurrence of the stroke. Information collected was results from the Center of Epidemiologic Studies Depression Scale and the Barthel Index together with demographic data including age, sex, time since stroke and relationship status.

    Results Those patients involved in the study were mainly men (5859%) and generally those either married or cohabiting (5357%). The age of respondents ranged from 32 to 92 years with a mean age of 74.0 (95%CI 72.3775.63) at 2 +/- 1 weeks after discharge. The Barthel Index scores ranged from 15 to 100 with means of between 88.7 and 91.7. Between 15% and 19% of the group were clinically depressed during the time frame of the study. The Barthel Index, measuring functional independence in terms of need for assistance with personal activities of daily living (P-ADL), was consistently associated with PSD.

    Conclusions The differences found in levels of depression between those with lower functional independence after a stroke compared to those more independent in P-ADL, raise the possibility that attention should be paid to therapeutic rehabilitation for stroke patients to help them recover as much functional independence as possible in order to improve their quality of life and lower their chances of developing PSD.

  • 44.
    Carlsson, Lars
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Anderzén, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Wallman, Thorne
    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).
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Motivation for return to work and actual return to work among people on long-term sick leave due to pain syndrome or mental health conditionsManuscript (preprint) (Other academic)
  • 45.
    Claesson, Cecilia B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Burman, K
    Nilsson, JLG
    Vinge, E
    Prescription errors detected by Swedish pharmacists1995In: International Journal of Pharmacy Practice, ISSN 0961-7671, E-ISSN 2042-7174, Vol. 3, p. 151-6Article in journal (Refereed)
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    et al.
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    Lin, John K.
    Bixby, Honor
    Magliano, Dianna
    Bovet, Pascal
    Miranda, J. Jaime
    Khang, Young-Ho
    Stevens, Gretchen A.
    Riley, Leanne M.
    Ali, Mohammed K.
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    Al Nsour, Mohannad
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    Aris, Tahir
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    Assah, Felix K.
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    Batieha, Anwar M.
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    Ben Romdhane, Habiba
    Bernabe-Ortiz, Antonio
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    Bi, Yufang
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    Bo, Simona
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    Boissonnet, Carlos P.
    Brajkovich, Imperia
    Breckenkamp, Juergen
    Brewster, Lizzy M.
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    Bruno, Graziella
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    de Leon, Antonio Cabrera
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    Caserta, Carmelo A.
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    Chen, Shuohua
    Cheng, Ching-Yu
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    Cifkova, Renata
    Claessens, Frank
    Concin, Hans
    Cooper, Cyrus
    Cooper, Rachel
    Costanzo, Simona
    Cottel, Dominique
    Cowell, Chris
    Crujeiras, Ana B.
    D'Arrigo, Graziella
    Dallongeville, Jean
    Dankner, Rachel
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    de Gaetano, Giovanni
    De Henauw, Stefaan
    Deepa, Mohan
    Dehghan, Abbas
    Dhana, Klodian
    Di Castelnuovo, Augusto F.
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    Drygas, Wojciech
    Du, Yong
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    El Ati, Jalila
    Elosua, Roberto
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    la Penaa, Jorge Escobedo-De
    Fall, Caroline H.
    Farzadfar, Farshad
    Felix-Redondo, Francisco J.
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    Fernandez-Berges, Daniel
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    Foo, Leng Huat
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    Franco, Maria do Carmo
    Franco, Oscar H.
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    Iwasaki, Masanori
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    Koskinen, Seppo
    Kratzer, Wolfgang
    Kromhout, Daan
    Kula, Krzysztof
    Kurjata, Pawel
    Kyobutungi, Catherine
    Lachat, Carl
    Laid, Youcef
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    Landrove, Orlando
    Lanska, Vera
    Lappas, Georg
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    Lee, Jeonghee
    Lehtimaki, Terho
    Lekhraj, Rampal
    Leon-Munoz, Luz M.
    Li, Yanping
    Lim, Wei-Yen
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    Lin, Hsien-Ho
    Lin, Xu
    Lissner, Lauren
    Lorbeer, Roberto
    Lozano, Jose Eugenio
    Lundqvist, Annamari
    Lytsy, Per
    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, Social Medicine.
    Ma, Guansheng
    Machado-Coelho, George L. L.
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    Marques-Vidal, Pedro
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    Meshram, Indrapal I.
    Mi, Jie
    Miquel, Juan Francisco
    Mohamed, Mostafa K.
    Mohammad, Kazem
    Mohan, Viswanathan
    Yusoff, Muhammad Fadhli Mohd
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    Scazufca, Marcia
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    Scheidt-Nave, Christa
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    Shin, Youchan
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    Simon, Mary
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    Solfrizzi, Vincenzo
    Sonestedt, Emily
    Soumare, Aicha
    Staessen, Jan A.
    Steene-Johannessen, Jostein
    Stehle, Peter
    Stein, Aryeh D.
    Stessman, Jochanan
    Stockl, Doris
    Stokwiszewski, Jakub
    Strufaldi, Maria Wany
    Sun, Chien-An
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Suriyawongpaisal, Paibul
    Sy, Rody G.
    Tai, E. Shyong
    Tarawneh, Mohammed
    Tarqui-Mamani, Carolina B.
    Thijs, Lutgarde
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