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  • 201.
    Beckerman, Carina
    Handelshögskolan i Stockholm.
    Historien om en datajournal2005Report (Other academic)
    Abstract [sv]

    “Berätta för mig om datajournalprojektet? ”Med den uppmaningen i huvudet gick jag till mitt första möte med fyra anställda på en medicinsk avdelning på X-sjukhuset som ett år tidigare implementerat en datorbaserad patientjournal. Patientjournaler tillhör ju, liksom exempelvis flygledarjournaler, en viss sorts intellektuella artefakter som tills nyligen skrevs för hand med penna på papper. Den kunskap som ligger bakom produktionen av dessa föremål lärs ofta in på plats från en överordnad genom upprepad handling. När arbetsverktyg som dessa datorbaseras sker det inte smärtfritt. Både arbetsrutiner och arbetsrelationer förändras liksom även innehållet i dokumentet. Eftersom jag dessutom ville skaffa erfarenhet av narrativ metod så beslöt jag att låta fyra anställda och projektledaren på kliniken berätta så fritt som möjligt utan inblandning från min sida; därav ovanstående enkla uppmaning. Varför narrativ metod, undrar möjligen en del. Det är inte en vanlig metod inom forskning om informationssystem. Nej, men personligen tror jag och många andra med mig att historier spelar en ofta bortglömd roll i olika organisationers försök att utveckla, implementera och använda informationsteknologi. Detta, och den amerikanske sociologen Elliot Mishlers kritik om att ett alltför strukturerat sätt att intervjua förvandlar människor till artificiella objekt samtidigt som viktiga aspekter i exempelvis förändringsprocesser går förlorade, gjorde mig intresserad av att pröva narrativ metod. Dessutom är patientjournalen i sig en berättelse om en patients sjukdom. Många människor på olika arbetsplatser genomgår numera också dessa så flitigt förekommande IT-projekt, en del lyckade och andra mindre lyckade. En målgrupp för denna studie är därför personer som på olika sätt deltar i och arbetar med implementering av ny informationsteknologi inom sjukvården. En annan målgrupp är kollegor intresserade av narrativ metod.

  • 202.
    Beckerman, Carina
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Implications of Transforming the Patient Record into a Knowledge Management System: Initiating a Movement of Coordination and Enhancement2008In: The ICFAI University Journal of Knowledge Management, ISSN 0972-9216, Vol. Nov, no 6Article in journal (Refereed)
    Abstract [en]

    Today there is often a need to re-innovate who you are and what you do and re-think the tools that are used and the business models that guide action. The purpose of this paper is to show how transforming a document, such as a patient record, might start a horizontal and vertical movement, a movement of coordination and enhancement in an organizational setting, such as a hospital clinic. The observations presented here and the conclusions drawn were obtained during a three year case study following implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed, interpreted and discussed within a framework combining theories about knowledge management and with cognitive theories about use of interpretative schemes and representations. This paper tries to look beyond the implications of reconstructing a patient record on a micro-level or explore if it is good or bad to computerize it. Instead this paper theorizes about how re-thinking the interpretative scheme for what a patient record is and how it may be used might restructure a health care setting. It proposes that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.

  • 203.
    Beckerman, Carina
    Handelshögskolan i Stockholm.
    Sjukhus eller sjukvård - design av betong och infrastruktur2008In: Detta borde vårddebatten handla om / [ed] Claes-Fredrik Helgesson, Hans Winberg, Stockholm: IFL/EFI , 2008, p. 61-77Chapter in book (Other (popular science, discussion, etc.))
  • 204.
    Beckerman, Carina
    Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work.
    Transforming and Computerizing Professional Artifacts: An Underestimated Opportunity for Learning2010In: International Journal of Healthcare Delivery Reform Initiative, ISSN 1938-0216, Vol. 2, no 3, p. -10Article in journal (Refereed)
    Abstract [en]

    Improving the artifacts a knowledge worker uses and how he or she exercises his or her knowledge is a desire that is part of being professional, especially since modern man are supposed to live in a knowledge society. In the knowledge society there is a continuous structuring and re-structuring, construction and re-construction and learning and re-learning going on due to implementing new information and communication technology. But many of these projects fail in spite of management spending huge amounts of money on them. This paper focuses on and wants to create an awareness of how an artefact such as a new knowledge management system becomes a driving force behind expanding the knowledge of an anesthesist and has implications for continuous learning among a group of employees at the anesthesia and intensive care unit. In addition to this, implementing new technology is an underestimated opportunity for learning. This paper suggests that a significant educational effort is taking place in society channelled through many these IT-projects, even when they fail.

  • 205.
    Bedro, Marlen
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ousi, Zahra
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Arbetsglädje hos medarbetare: enhetschefers erfarenheter av att skapa arbetsglädje bland medarbetare på arbetsplatser inom palliativ vård2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Arbetsglädje har många positiva effekter och är av stor betydelse för de anställdas hälsa och nöjdhet hos patienterna och närstående i verksamheterna inom hälso- och sjukvården. En organisations goda arbetsmiljö kan bidra till att medarbetarna är friska och mår bra, vilket motiverar att anställda stannar kvar på sin arbetsplats samt ger ekonomiska framgångar för organisationen. Upplever medarbetare problem i arbetsmiljön och att de inte trivs på arbetsplatsen, leder det till produktionsbortfall.

    Syftet med denna studie är att undersöka vad enhetschefer har för erfarenheter av att skapa arbetsglädje för medarbetare inom verksamheter som arbetar med palliativ vård. Den metod som valdes var en kvalitativ intervjustudie med induktiv ansats. Datainsamlingen bestod av åtta stycken semistrukturerade intervjuer. Resultatet av denna studie visade att det som har betydelse för hur enhetscheferna skapar arbetsglädje för sina medarbetare är följande fyra kategorier: Socialt kapital, medarbetarskap, ledarskap och kommunikation. Respondenterna definierade begreppet arbetsglädje på liknande sätt och ansåg att det var en subjektiv upplevelse.

  • 206. Beillon, Lena Marie
    Att värdera vårdbehov: ett kliniskt dilemma. En studie av nyttjandet av ambulanssjukvård i olika geografiska områden2010Doctoral thesis, monograph (Other academic)
    Abstract [sv]

    De nordiska ländernas hälso- och sjukvård bygger på att sjukvården finns till hands när den behövs. För att ge företräde för de individer som har störst vårdbehov genomförs inom olika verksamheter vårdbehovsprioriteringar. Behovet av prioriteringar tilltar i takt med att efterfrågan på hälso- och sjukvårdens insatser ökar. Skälet till att göra prioriteringar inom hälso- och sjukvården är att upprätthålla en god vård med god effekt till dem som bäst behöver den. Även om hälso- och sjukvården kvantitativt spelar en begränsad roll för folkhälsan, utgör den en viktig del i samhället genom att skapa trygghet. Särskilt betydelsefullt i detta avseende är akutsjukvård varav ambulanssjukvård är en viktig del.

  • 207.
    Bejerholm, Ulrika
    et al.
    Lunds universitet, Institutionen för hälsovetenskaper.
    Markström, Urban
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Bergmark, Magnus
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Svensson, Bengt
    Lunds universitet, Institutionen för hälsovetenskaper.
    From national incentives of implementing Individual Placement and Support to the impact on the service users' quality of life, and view on support2015In: Closing the gap between research and policy in mental health: ENMESH 2015 : Eleventh International Conference of the European Network For Mental Health Service Research : Book of Abstracts, ENMESH , 2015Conference paper (Refereed)
  • 208.
    Bejerot, Eva
    et al.
    Psykologiska institutionen, Stockholms universitet, Stockholm, Sweden.
    Aronsson, Gunnar
    Psykologiska institutionen, Stockholms universitet, Stockholm, Sweden.
    Hasselbladh, Hans
    Örebro University, Örebro University School of Business.
    Bejerot, Susanne
    Karolinska institutet, Stockholm, Sweden.
    Läkarkåren - en profession med allt mindre stöd och inflytande. Enkätstudie av svenska läkares arbetsmiljö 1992 och 2010: [The medical profession, a profession with less and less support and influence. A questionnaire study the occupational environment of Swedish physicians in 1992 and 2010]2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 50, p. 2652-2656Article in journal (Other academic)
    Abstract [sv]

    Syftet med studien var att undersöka förändringar i läkares arbetsvillkor med särskild inriktning på ledning, styrning och stöd. Jämförelser gjordes av enkätdata från två slumpmässiga urval 1992 (n = 390) och 2010 (n = 1 937). Stora förändringar framkom i flera avseenden. Andelen läkare som upplever sig ha något verksamhetsansvar har minskat med 45 procentandelar, från 76 till 31 procent. Mycket stora försämringar framkom vad gäller stöd i arbetet. Tiden som läggs på fortbildning/inläsning och forskning har minskat. Utnyttjandet av läkarnas högsta kompetens har minskat.

  • 209. Bejerot, Susanne
    ST-handledare - ett omöjligt uppdrag?: [Internship supervisor--an impossible mission?]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 29-31, p. 1785-1786Article in journal (Refereed)
  • 210.
    Bendig, Eileen
    et al.
    Univ Ulm, Germany.
    Bauereiss, Natalie
    Univ Ulm, Germany.
    Ebert, David Daniel
    Friedrich Alexander Univ Erlangen Nuremberg, Germany.
    Snoek, Frank
    Vrije Univ Amsterdam, Netherlands; Acad Med Ctr, Netherlands.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Baumeister, Harald
    Univ Ulm, Germany.
    Internet-Based Interventions in Chronic Somatic Disease2018In: Deutsches Ärzteblatt International, ISSN 1866-0452, E-ISSN 1866-0452, Vol. 115, no 38, p. 659-+Article, review/survey (Refereed)
    Abstract [en]

    Background: Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet-and mobile-based interventions (IMIs). The present article provides an overview on the basics of IMIs, applications and their evidence base for people living with chronic somatic diseases. Methods: We conducted a selective literature search in the PubMed and Cochrane databases. Reviews which included randomized controlled trials investigating psychological IMIs were discussed pertaining to their relevance for the population described. Results: IMIs lead to a change in unfavorable behavior connected to chronic somatic diseases. IMIs can foster protective factors like balanced physical activity or risk factors like smoking or alcohol consumption. However, studies reveal small effect sizes of d=0.25 for physical activity and an averaged effect size of d=0.20 for smoking and alcohol consumption. Additionally, IMIs can be used for the (co-) treatment of chronic somatic diseases, for instance to increase disease-specific self-efficacy in patients with diabetes (d=0.23). Studies included in meta-analyses are often highly heterogenous and are investigated in research contexts with limited health care services relevance. Conclusion: IMIs are potentially effective when aiming at lifestyle changes and supporting medical treatment in people with chronic somatic diseases. However, results are still heterogenous and the evidence base is limited regarding specific settings, compounding the discussion of possible ways of implementing IMIs into our health-care systems.

  • 211. Bengmark, S
    et al.
    Schersten, T
    Sterky, G
    Liljedahl, S O
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Wedel, H
    [Length of stay after gallstone operations]1979In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 76, no 45, p. 3989-94Article in journal (Refereed)
  • 212.
    Bengters Littorin, Lina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kluge, Emma
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Upplevelser och attityder i vård av HIV/AIDS-smittade2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpStudent thesis
    Abstract [sv]

    Cirka 4000 personer levde med HIV i Sverige år 2006. Risken för att bli smittad av HIV är liten i jämförelse med annan blodsmitta. Syftet med litteraturöversikten var att belysa upplevelser och attityder i vård av HIV/AIDS-smittade patienter. Innehållsanalys användes för att analysera nio vetenskapliga artiklar. Analysen resulterade i två kategorier och åtta subkategorier. I resultatet framkom vårdpersonals positiva och negativa upplevelser och attityder. En del personal hade respektfullt bemötande samt kände sig trygga och tillfredsställda i vårdarbetet. Något som bidrog till säkerheten var utbildning och erfarenhet. Det som även framkom var att personalen ofta hade fördomar som gav negativa attityder. Vanmakt och frustration upplevdes också i vården, där känslomässig stress var mer oroande än fysisk stress. Resultatet indikerade att det fanns personal som skulle undvika att vårda drabbade personer. Negativa attityder hos vårdpersonal har troligtvis sitt ursprung i bristande kunskaper. Slutsatser som dragits var att framtida forskning torde leda till åtgärder som minimerar vårdpersonals undvikande beteende vilket möjliggör alla människors lika rätt till god vård oavsett diagnos.

  • 213. Bengtsson, I
    et al.
    Karlson, B
    Herlitz, Johan
    University of Borås, School of Health Science.
    Haglid Evander, M
    Währborg, P
    A 14-year follow-up study of chest pain patients including stress hormones and mental stress at index event2012In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 154, no 3, p. 306-311Article in journal (Refereed)
    Abstract [en]

    Background Knowledge of long-term outcome in chest pain patients is limited. We reinvestigated patients who 14 years earlier had visited the emergency department due to chest pain, and were discharged without hospitalization. Extensive examinations were made at that time on 484 patients including full medical history, exercise test, a battery of stress questions and stress hormone sampling. Methods From a previously conducted chest pain study patients still alive after 14 years were approached. Hospitalization or deaths with a diagnosis of ischemic heart disease or cerebrovascular disease were used as end point. Results During the follow-up period 24 patients had died with a diagnosis of ischemic heart or cerebrovascular disease, and 50 patients had been given such a diagnosis at hospital discharge. Age (OR 1.12, CI 1.06–1.19), previous history of angina pectoris (OR 9.69, CI 2.06–71.61), pathological ECG at emergency department visit (OR 3.27, CI 1.23–8.67), hypertension (OR 5.03, CI 1.90–13.76), smoking (OR 3.04, CI 1.26–7.63) and lipid lowering medication (OR 14.9, CI 1.60–152.77) were all associated with future ischemic heart or cerebrovascular events. Noradrenalin levels were higher in the event group than in the non-event group, mean (SD) 2.44 (1.02) nmol/L versus 1.90 (0.75) nmol/L. When noradrenalin was included in the regression model high maximal exercise capacity was protective of an event (OR 0.986, CI 0.975–0.997). Conclusion In chest pain patients previous history of angina pectoris, hypertension, smoking, pathological ECG at primary examination, and age were the main risk factors associated with future cardiovascular or cerebrovascular events.

  • 214. Bennett, Sara
    et al.
    Mahmood, Shehrin Shaila
    Edward, Anbrasi
    Tetui, Moses
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
    Ekirapa-Kiracho, Elizabeth
    Strengthening scaling up through learning from implementation: comparing experiences from Afghanistan, Bangladesh and Uganda2017In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 15, article id 108Article in journal (Refereed)
    Abstract [en]

    Background: Many effective innovations and interventions are never effectively scaled up. Implementation research (IR) has the promise of supporting scale-up through enabling rapid learning about the intervention and its fit with the context in which it is implemented. We integrate conceptual frameworks addressing different dimensions of scaling up (specifically, the attributes of the service or innovation being scaled, the actors involved, the context, and the scale-up strategy) and questions commonly addressed by IR (concerning acceptability, appropriateness, adoption, feasibility, fidelity to original design, implementation costs, coverage and sustainability) to explore how IR can support scale-up.

    Methods: We draw upon three IR studies conducted by Future Health Systems (FHS) in Afghanistan, Bangladesh and Uganda. We reviewed project documents from the period 2011-2016 to identify information related, to the dimensions of scaling up. Further, for each country, we developed rich descriptions of how the research teams approached scaling up, and how IR contributed to scale-up. The rich descriptions were checked by FHS research teams. We identified common patterns and. differences across the three cases.

    Results: The three cases planned quite different innovations/interventions and had very different types of scale-up strategies. In all three cases, the research teams had extensive prior experience within the study communities, and. little explicit attention was paid, to contextual factors. All three cases involved complex interactions between the research teams and other stakeholders, among stakeholders, and between stakeholders and the intervention. The IR planned by the research teams focussed primarily on feasibility and effectiveness, but in practice, the research teams also had critical insights into other factors such as sustainability, acceptability, cost-effectiveness and appropriateness. Stakeholder analyses and other project management tools further complemented IR.

    Conclusions: IR can provide significant insights into how best to scale-up a particular intervention. To take advantage of insights from IR, scale-up strategies require flexibility and IR must also be sufficiently flexible to respond to new emerging questions. While commonly used conceptual frameworks for scale-up clearly delineate actors, such as implementers, target communities and the support team, in our experience, IR blurred the links between these groups.

  • 215.
    Bennich-Björkman, Li
    Statsvetenskapliga institutionen, Institutionen för folkhälsooch vårdvetenskap, Uppsala universitet.
    Förutsättningar för politiska prioriteringar i offentlig sjukvård: en jämförelse mellan landstingen i Östergötland och Uppsala2004Report (Other academic)
    Abstract [sv]

    Behovet av beslutssystem inom den offentligt finansierade sjukvården där politiker kan ta risken att fatta obehagliga, svåra och till och med impopulära beslut framstår som allt större i takt med att resurserna krymper, den medicinska tekniken förbättras och människor lever allt längre. Utgångspunkten i denna studie är att sådana beslut – beslut om horisontella prioriteringar – emellertid kräver särskilda förutsättningar inom landstingsorganisationen för att kunna förverkligas och bli varaktiga, eftersom det svenska politiska systemet som det konstruerats byggt in starka hinder mot beslutsfattande i avsikt att spara, omfördela eller försämra. De politiska kostnaderna för sådana – ibland tyvärr nödvändiga – beslut är höga. Landstingens kultur och organisation kan skapa förutsättningar för att dessa ”kostnader” kan bli mindre.

    Utvecklade förtroenderelationer, vad som här kallas ett högt ”inomorganisatoriskt” förtroende, inom och mellan sjukvårdens nyckelgrupper den medicinska professionen, de förtroendevalda, sjukvårdsadministratörerna och patientgrupper, är en avgörande sådan förutsättning. Först när politiker kan lita på att svåra beslut inte kommer att utnyttjas av andra politiker, av läkare, tjänstemän eller genom allianser mellan någon av dessa grupper och patientföreningar, finns förutsättningar för att fatta politiska beslut om horisontella prioriteringar och stå fast vid dem. Att bygga förtroende är emellertid ingen lätt uppgift. Många studier har till exempel pekat på att spänningen mellan politiker och den medicinska professionen har varit stor i det svenska sjukvårdssystemet.

    I denna studie görs en jämförelse mellan två landsting, Östergötlands och Uppsalas, för att undersöka hur relationerna inom landstingsorganisationerna gestaltar sig och vad detta kan bero på. Studien genomfördes 2002-2003 och grundmaterialet är intervjuer med ledande politiska företrädare, företrädare för den medicinska professionen samt chefstjänstemän i de båda landstingen. Huvudresultaten av jämförelsen visar att relationerna - landstingskulturen - skiljer sig starkt åt. Den i Östergötland kännetecknas av en hög grad av förtroende mellan politiker, läkare och sjukvårdsadministratörer, medan distans och på sina håll en misstro är vanligt förekommande i Uppsala. En förståelse för varandras skilda roller i systemet, respekt samt tydliga roller som medger ett definierat utrymme för varje grupp är beskrivningar som återkommer i de intervjuer som gjorts med ledande politiker, centrumchefer och chefstjänstemän i Östergötland, liksom ömsesidig lojalitet mellan profession och politiker. Landstinget i Östergötland har lyckats mejsla fram en känsla av landstinget som en gemensam organisation, vilket är ovanligt. I studien söks förklaringen till skillnaden i landstingskultur framförallt i att det sätt på vilket den konsekvent genomförda decentraliserade organisationen i Östergötland ”tvingat fram” en hög grad av personliga möten och personlig interaktion som saknas i Uppsala. Det i sin tur har bidragit till att bygga upp förtroendefulla relationer mellan de olika grupperna som annars, vilket är fallet i Uppsala, tenderar att leva långt från varandras verklighet.

  • 216. Berfenstam, R
    Medelvårdtiden vid svenska sjukhus1968In: Landstingens tidskrift, Vol. 55, no 2, p. 29-30Article in journal (Refereed)
  • 217. Berfenstam, R
    et al.
    Berg, B
    Boström, H
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Waern, U
    [Levels of outpatient care: A study within the framework of the Tierp project]1976In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 73, no 3, p. 127-30Article in journal (Refereed)
  • 218. Berfenstam, R
    et al.
    Berg, B
    Boström, H
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Waern, U
    Vårdnivåer i öppen vård: Kort-rapport nr 3 från Tierpsprojektet1978Report (Other academic)
  • 219. Berfenstam, R
    et al.
    Berg, B
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Sjukvårdskonsumtion i Tierpsområdet april-maj 1973: En personbaserad studie av olika slag av sjukvårdskontakter i en definierad befolkning1976Report (Other academic)
  • 220. Berfenstam, R
    et al.
    Hammarström, A
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Åberg, H
    [Sources of error in medical care statistics: Cerebrovascular lesions and hypertension]1980In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 77, no 46, p. 4255-57Article in journal (Refereed)
  • 221. Berfenstam, R
    et al.
    Jonsson, E
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Sterky, G
    Thurburn, T
    Wennström, G
    Hälsoekonomi: Ett samlat synsätt på fördelning av resurser för hälsa1979Report (Other academic)
  • 222. Berfenstam, R
    et al.
    Lagerberg, D
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Victim characteristics in fatal home accidents: Alcohol, mental disorder, and suicidal intent in officially registered accidents in the home1969In: Acta socio-medica Scandinavica, ISSN 0044-6041, Vol. 1, no 3, p. 145-64Article in journal (Refereed)
  • 223. Berfenstam, R
    et al.
    Petersson, O
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Evaluation research and measurement of benefits of health services (eds)1978In: Scandinavian journal of social medicine. Supplementum, ISSN 0301-7311, Vol. Suppl 13Article in journal (Refereed)
  • 224. Berfenstam, R
    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.
    [Health care research examines use and quality]1977In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 74, no 40, p. 3432-34Article in journal (Refereed)
  • 225. Berfenstam, R
    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.
    Initiativrapport: Omvårdnadsforskning1979In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 76, p. 103-05Article in journal (Refereed)
  • 226. Berfenstam, R
    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.
    [International comparison gives useful perspectives in hospital care]1969In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 66, no 20, p. 2111-19Article in journal (Refereed)
  • 227. Berfenstam, R
    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.
    Kort-rapport nr 2 från Tierpsprojektet1977Report (Other academic)
  • 228. Berfenstam, R
    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.
    Samverkan mellan medicinsk och social vård: Några erfarenheter från försöksverksamheten i Tierp1976In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 53, p. 365-72Article in journal (Refereed)
  • 229. Berfenstam, R
    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.
    Sjukvårdskonsumtionen i Tierpsområdet 1971: En personbaserad studie av olika slag av sjukvårdskontakter i en definierad befolkning1974Report (Other academic)
  • 230. Berfenstam, R
    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.
    Tierpsprojektet1978In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 55, p. 417-20Article in journal (Refereed)
  • 231. Berfenstam, R
    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.
    Utveckling av insamlingsrutiner för uppgifter om läkarbesök i öppen vård: Tierpsprojektet (stencil)1975Report (Other academic)
  • 232. Berfenstam, R
    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.
    Vad är hälso- och sjukvårdsforskning?1975In: Landstingens tidskrift, Vol. 62, no 12, p. 31-33Article in journal (Other academic)
  • 233. Berfenstam, Ragnar
    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.
    Om sjuklighet och sjukvårdskonsumtion1963In: Medlemsblad för SSF:s Rikssektion för distriktssköterskor, Vol. 1, p. 23-26Article in journal (Other (popular science, discussion, etc.))
  • 234. Berfenstam, Ragnar
    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.
    Sjuklighet och vårdkonsumtion: Redogörelse för en pågående undersökning1963In: Tidskrift för Allmän Försäkring, Vol. 2, p. 73-76Article in journal (Refereed)
  • 235. Berg, B
    et al.
    Bredberg, G
    Korpela, M
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    [The effect of an otologist at the health care centre]1980In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 77, no 18, p. 1752-54Article in journal (Refereed)
  • 236. Berg, B
    et al.
    Bredberg, G
    Korpela, M
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Vad betyder en öronspecialist vid vårdcentral?: En vårdnivåstudie inom ramen för Tierpsprojektet1980Report (Other academic)
  • 237.
    Berg, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hedengran, Kristina
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Enhetschefers och distriktssköterskors upplevelser av beredskap inför en stor olycka eller katastrof - en intervjustudie i primärvården 2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.

  • 238. Berg, Katarina
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköpings universitet, Ersta Sköndal University College .
    Kjellgren, Karin
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study.2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, p. 1630-1638Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patients' own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home. OBJECTIVE: To explore day surgery patients' different perceptions of postoperative recovery. DESIGN: A qualitative design with a phenomenographic approach was used. METHODS AND SETTINGS: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face to face at the patients' homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital. RESULTS: The patients perceived postoperative recovery as comprising internal and external prerequisites and implying changes in ordinary life with varying levels of support. The effective production at the day surgery unit was perceived as having an impact on patients' prerequisites for recovery. The results are elucidated in three descriptive categories: 'Conditions for recovery at home', 'The rollback to ordinary life' and 'Being a cog in a flow of care'. CONCLUSIONS: The postoperative phase seems to be a weak link in day surgery care. From the patients' perspective, postoperative recovery following day surgery implies extensive responsibility at home. Patients need knowledge and understanding concerning what constitutes the normal range in recovery and how to manage self-care following their specific surgical procedure.

  • 239.
    Berg, Marie
    et al.
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Linden, Karolina
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health Sciences.
    Sparud Lundin, Carina
    Centre for Person-Centred Care (GPCC), Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ranerup, Agneta
    Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden.
    Web-Based Intervention for Women With Type 1 Diabetes in Pregnancy and Early Motherhood: Critical Analysis of Adherence to Technological Elements and Study Design2018In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, no 5, article id el60Article in journal (Refereed)
    Abstract [en]

    Background: Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important.

    Objective: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial.

    Method: The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used.

    Results: The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The randomization element in a randomized controlled trial design can become a barrier to achieving a critical mass of user interactions in Web-based interventions, especially when social support is included. For extended study periods, the technology used may need to be adapted in line with newly available technical options to avoid the risk of becoming outdated in the user realm, which in turn might jeopardize study validity in terms of randomized controlled trial designs. Conclusions: On the basis of lessons learned in this randomized controlled trial, we give recommendations to consider when designing and evaluating Web-based health interventions.

  • 240.
    Berg, Noora
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Al-Janabi, Thair
    National Institute for Health and Welfare.
    Santalahti, Päivi
    National Institute for Health and Welfare.
    Kuinka tukea terveydenhuollon ammattilaisia, jotka ovat turvapaikanhakijoina tai pakolaisina Suomessa?2017In: Journal of Social Medicine, ISSN 0355-5097, Vol. 54, no 3, p. 244-246Article in journal (Other (popular science, discussion, etc.))
  • 241.
    Bergdahl, Elisabeth
    et al.
    Erstaköndal Högskola.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Univ Coll, Dept Palliat Care Res, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal Högskola.
    Elmberger, Eva
    Ersta Sköndal Högskola.
    Andershed, Birgitta
    Ersta Sköndal Högskola.
    Co-creating possibilities for patients in palliative care to reach vital goals: a multiple case study of home-care nursing encounters2013In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 20, no 4, p. 341-351Article in journal (Refereed)
    Abstract [en]

    Co-creating possibilities for patients in palliative care to reach vital goals – a multiple case study of home-care nursing encountersThe patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophyand how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patient’srelatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been areliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliativecare. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation buildingphase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for thepatient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However,in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals werenot reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presentedin this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.

  • 242.
    Bergerum, Carolina
    Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Quality Improvement in a Maternity Ward and Neonatal Intensive Care Unit. What are staff and patients' experiences of Experience-based Co-design?: Part 1: A qualitative study2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts.

    Purpose:This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden.

    Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design.

    Results:The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far.

    Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future.

    Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals.

  • 243.
    Berglund, Alexandra
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Olin, Hedvig
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    FYSS och FaR i Stockholms innerstad: Erfarenheter, inställning och önskemål inför arbete med FaR2005Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpStudent thesis
    Abstract [en]

    Aim:

    The aim of this study was to look at the experience, attitude and needs in the primary care in the city of Stockholm in order to work with FaR (physical activity by prescription) and the book FYSS (Physical activity in health prevention and medical treatment). Another purpose was to make a suggestion for a model of how the primary care may work with FaR, for example with a co-ordinator function.

    Method:

    A questionnaire was handed out to 13 healthcare centres at Kungsholmen, Norrmalm, Vasastaden, City, Östermalm, Hjorthagen and Gärdet. 119 questionnaires were answered and handed in. The people participating in the study were doctors and nurses. One person at BKV, SLL, (BKV decides what the healthcare in Stockholm should focus on and not) was interviewed, to find out how they look upon obstacles, possibilities and if and how FaR and FYSS is an alternative in SLL.

    Results:

    The study showed that the big majority were in favour of working with FaR an FYSS both in health prevention and health care. Many of those who participated in the study wanted more information and education. About half of the respondents knew what FYSS respectively FaR were. 104 answered that they gave an oral recommendation to their patients. Only 14 prescribed written recommendations. A majority were in favour of working with written recommendations, motivating conversations, working with a co-ordinator and applying some kind of health test. Another result from the study was that there are a lot of questionmarks when it comes to helping the patient to start with a suitable activity, motivation and evaluation. Interestingly 82 of the respondents did not see any obstacles working with FaR. The most frequent obstacles suggested were insecurity of where to send the patient, insecurity of how to work with the process of prescription and the lack of time.

    Conclusion:

    In this study it was concluded that there is a big interest in working with FaR. Today there is a lack of effective working methods and activities to send the patients to. Earlier studies have shown that for FaR to work successfully it requires education in FaR and FYSS for the health care staff, motivating conversations with the patients, a co-ordinator with contacts with the prophylaxis and a follow up

  • 244.
    Berglund, Anna
    et al.
    Uppsala University, National Centre for Knowledge on Men.
    Lindmark, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Preconception health and care (PHC)a strategy for improved maternal and child health2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 4, p. 216-221Article, review/survey (Refereed)
    Abstract [en]

    Maternal health status before pregnancy is a decisive factor for pregnancy outcomes and for risk for maternal and infant complications. Still, maternity care does not start until the pregnancy is established and in most low-income settings not until more than half of the pregnancy has passed, which often is too late to impact outcomes. In Western societies preconception care (PCC) is widely recognized as a way to optimize women's health through biomedical and behavioural changes prior to conception with the aim of improving pregnancy outcomes. But the content of PCC is inconsistent and limited to single interventions or preconception counselling to women with chronic illnesses. It has been suggested that PCC should be extended to preconception health and care (PHC), including interventions prior to pregnancy in order to optimize women's health in general, and thereby subsequent pregnancy outcomes, the well-being of the family, and the health of the future child. With this definition, almost every activity that can improve the health of girls and women can be included in the concept. In the World Health Report of 2005 a longitudinal approach to women's wellness and reproductive health was highlighted, and the World Health Organization has proposed a more comprehensive maternal and child health care, also including psychosocial issues and intimate partner violence. The present article gives an overview of the recent literature and discusses contents and delivery of PCC/PHC in Western as well as low-income countries. The article puts special emphasis on why violence against women is an issue for PHC.

  • 245.
    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.

  • 246.
    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.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment2018In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 18, article id 106Article in journal (Refereed)
    Abstract [en]

    Background Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the patient's perspective and different magnitudes do not seem to clearly discriminate between levels of effect presented to people. Methods In this randomised cross-sectional survey experiment, performed in a Swedish population-based sample (n=1041, response rate 58.6%), the respondents, aged between 40 and 75years were given information on a hypothetical preventive cardiovascular treatment. Respondents were randomised into groups in which the treatment was described as having the effect of delaying a heart attack for different periods of time (Delay of Event,DoE): 1month, 6months or 18months. Respondents were thereafter asked about their willingness to initiate such therapy, as well as questions about how they valued the proposed therapy. ResultsLonger DoE:s were associated with comparatively greater willingness to initiate treatment. The proportions accepting treatment were 81, 71 and 46% when postponement was 18months, 6months and 1month respectively. In adjusted binary logistic regression models the odds ratio for being willing to take therapy was 4.45 (95% CI 2.72-7.30) for a DoE of 6months, and 6.08 (95% CI 3.61-10.23) for a DoE of 18months compared with a DoE of 1month. Greater belief in the necessity of medical treatment increased the odds of being willing to initiate therapy. ConclusionsLay people's willingness to initiate preventive therapy was sensitive to the magnitude of the effect presented as DoE. The results indicate that DoE is a comprehensible effect measure, of potential value in shared clinical decision-making.

  • 247.
    Berglund Kristiansson, Elisabeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vårdrelaterade infektioner - ett folkhälsoproblemGes patienten möjlighet att påverka?2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 248. Bergman, Caroline
    et al.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Skagert, Katrin
    Exploring communication processes in workplace meetings: A mixed methods study in a Swedish healthcare organization2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 3, p. 533-541Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An efficient team and a good organizational climate not only improve employee health but also the health and safety of the patients. Building up trust, a good organizational climate and a healthy workplace requires effective communication processes. In Sweden, workplace meetings as settings for communication processes are regulated by a collective labor agreement. However, little is known about how these meetings are organized in which communication processes can be strengthened. OBJECTIVE: The aim of this study was to explore communication processes during workplace meetings in a Swedish healthcare organization. METHODS: A qualitatively driven, mixed methods design was used with data collected by observations, interviews, focus group interviews and mirroring feedback seminars. Data were analyzed using descriptive statistics and conventional content analysis. RESULTS: The communication flow and the organization of the observed meetings varied in terms of physical setting, frequency, time allocated and duration. The topics for the workplace meetings were mainly functional with a focus on clinical processes. Overall, the meetings were viewed not only as an opportunity to communicate information top down but also a means by which employees could influence decision-making and development at the workplace. CONCLUSIONS: Workplace meetings have very distinct health-promoting value. It emerged that information and the opportunity to influence decisions related to workplace development are important to the workers. These aspects also affect the outcome of the care provided.

  • 249.
    Bergman, Mats A.
    et al.
    Sodertorn Univ, Stockholm, Sweden..
    Johansson, Per
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Lundberg, Sofia
    Umea Univ, Umea Sch Business & Econ, Dept Econ, S-90187 Umea, Sweden..
    Spagnolo, Giancarlo
    Univ Roma Tor Vergata, Ctr Econ Policy Res, EIEF, Stockholm Sch Econ SITE, Rome, Italy..
    Privatization and quality: Evidence from elderly care in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 49, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates - an important and not easily contractible quality dimension - using a difference-in-difference in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates.

  • 250.
    Bergman, Mats A.
    et al.
    Södertörns Högskola.
    Johansson, Per
    Uppsala University.
    Lundberg, Sofia
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics.
    Spagnolo, Giancarlo
    Stockholm School of Economics.
    Privatization and quality: evidence from elderly care in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 49, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates – an important and not easily contractible quality dimension – using a difference-in-difference-in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates. 

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