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  • 1. Abdon, Nils Johan
    et al.
    Bergfeldt, Lennart
    Herlitz, Johan
    University of Borås, School of Health Science.
    Hjärtstopp utlöst av läkemedel kanske vanligare än vi tror2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 8, 521-525 p.Article in journal (Refereed)
  • 2. Abrahamsson, Birgitta
    et al.
    Berg, Marie-Louise U.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jonsson, Annikki
    To recommend the local primary health-care centre or not: What importance do patients attach to initial contact quality, staff continuity and responsive staff encounters?2015In: International Journal for Quality in Health Care, ISSN 1353-4505, 1353-4505, Vol. 27, no 3, 196-200 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This study aims to examine the circumstances associated with patients’ tendencies to recommend a primary care centre, based on four hypotheses, the initial contact’s quality, care relationship continuity, treatment encounter responsiveness and whether the significance of encounter responsiveness differs depending on whether the patient has been seeing a nurse or physician. Design: The study is based on the patient’ self-reported responses, retrieved from the Swedish National Patient Survey. The design is cross-sectional, and data were analysed using a binary logistic regression. Setting: Data were collected from three primary healthcare centres in the region of Västra Götaland, Sweden. Participants: A total of 362 patients (62% females) having visited any of three publicly run healthcare centres in September 2010 constitute the analytical sample. Participants were fairly evenly distributed across all age groups. Main Outcome Measures: Recommendation was captured by patients’ binary responses to the question: Would you recommend the visited primary healthcare centre? Results: The hypotheses involving initial contact quality, care relationship continuity and treatment encounter responsiveness were supported by the analyses. The latter was strongly associated with patient tendency to recommend the primary healthcare centre. However, the profession (nurse or physician) involved in the treatment encounter made no difference for the predictive significance of encounter responsiveness for a patient’s tendency to recommend the healthcare centre. Conclusions: Striving for stable and responsive patient/staff relationships and an open approach towards patients are potentially successful strategies for primary healthcare centres seeking to attract new patients and maintain current ones. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(journal abstract)

  • 3.
    Achit, Hamza
    et al.
    Université Paris-Est, IFSTTAR.
    Carnis, Laurent
    Université Paris-Est, IFSTTAR.
    Physical Impairment and Medical Care Spending by Road Accident Victims2013In: Proceedings of the 16th International Conference Road Safety on Four Continents: Beijing, China. 15-17 May 2013, Linköping: Statens väg- och transportforskningsinstitut, 2013Conference paper (Other academic)
    Abstract [en]

    In addition to the immediate physical injuries they suffer, road accident victims may also be subject to ongoing deterioration of their state of health in terms of permanent physical and mental problems, disabilities, etc. These various health shocks entail recourse to care and treatment, the upshot being increases in health expenses. In France little is known about the financial impact of accidents on victims. This paper uses data from a sample of 777 individuals suffering from road accident-induced physical impairment. Information about these individuals includes details of their personal and socioprofessional characteristics, together with data provided by their health insurance offices regarding their use of treatment and their medical expenses. The analysis of these data reveals that the costs incurred by road accident victims are significantly associated with such factors as age, seriousness of impairment, and marital status. Interaction effects are also noted between these explanatory factors: for example, the effect of the seriousness of impairment on the costs involved differs according to the age of the victim.

  • 4.
    Adamiak, Grazyna Teresa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Påverkan av organisatoriska och miljömässiga faktorer på tillgänglighet till akutsjukvården2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The settings investigated were departments of internal medicine (IM), orthopaedics and surgery in acute care hospitals in Sweden. The objective was to identify exogenous and endogenous determinants of accessibility of health care. Both qualitative and quantitative analysis of utilisation was performed on national and regional level of data aggregation. The study proposes that accessibility to acute health services is influenced by exogenous factors, partly outside the control of health care professionals, such as season, physical proximity and overall supply. Organisational properties such as availability of inpatient beds, hospital and physician specialisation and the degree of system integration between provides of emergency care have effects on the quality of care. The novel finding is the strong association between acute readmissions and remaining inpatient utilisation indicating effects of bed supply on global use within IM. These conclusions follow:

    § structural changes on system level work as a method of prioritisation between patient groups by changes in criteria of accessibility;

    § the natural and organisational environments determine waiting times in EDs in hospitals by fluctuations of demand;

    § geographical accessibility coincides with the supply in terms of over- or underutilisation mirrored in the outcome of medical care;

    § effective access is determined by the divide of resources between inpatient and outpatient care and the total supply of inpatient care;

    § increasing demands on inpatient care in IM may be derived from deficiencies in the care of chronically ill, elderly patients;

    § transition of information and communication among care givers and patients varies in efficiency depending on vehicles for coordination and system integration;

    § the level of training of the admitting physician has effects on effective accessibility to inpatient care.

    There are conflicts between accessibility, efficiency and appropriateness of settings calling for attention to capacity to benefit in addition to needs as priority criteria.

  • 5. Adriansson, C
    et al.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Bergbom, I
    The use of topical anaesthesia at children's minor lacerations: an experimental study2004In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 12, no 2, 74-84 p.Article in journal (Refereed)
    Abstract [en]

    Background: In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. Aim: The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews. Result: The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety. Conclusion: Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children’s pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children’s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.

  • 6.
    Agevall, Lena
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Social Sciences. Statsvetenskap.
    Jonnergård, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Management and Economics. Ekonomistyrning.
    Management by documents - a risk of de-professionalizing?2007In: In tension between Organization and Profession: Professionals in Nordic Public Service, Nordic Academic Presss, Lund , 2007, 33-56 p.Chapter in book (Other (popular science, discussion, etc.))
    Abstract [en]

    If we have to document our professional action, will we then only perform the actions that we are supposed to document? This question reflects the content of this chapter. The chapter includes a frame of reference for studying control of professionals in organizations and illustration on different types of professional controls.

  • 7.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Hjälte, L
    Johansson, C
    Wireklint-Sundström, Birgitta
    University of Borås, School of Health Science.
    Jonsson, Anders
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Culture and care in the Swedish ambulance services2005In: Emergency Nurse, ISSN 1354-5752, E-ISSN 2047-8984, Vol. 13, no 8, 30-36 p.Article in journal (Refereed)
  • 8.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Jansson, L
    Making up one’s mind: Patients Experiences of Calling an Ambulance2006In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 14, 11-19 p.Article in journal (Refereed)
    Abstract [en]

    The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals’ and caregivers’ perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients’ existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients’ experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals’ point of view but also take account of the patients’ reactions when they experience a threat to their life and health.

  • 9.
    Ahl, Johannes
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Karlsmo, Martin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    SJUKSKÖTERSKANS STRESS RELATERAD TILL ARBETSBELASTNING: En enkätsstudie2017Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Negativ arbetsrelaterad stress är ett ständigt problem i flera samhällssektorer, även så i stor utsträckning inom vårdsektorn. Forskning visar att arbetsrelaterad stress inom vården kan utlösas av flera olika faktorer, bland annat en för hög arbetsbelastning. Långvarig negativ stress kan orsaka utmattningssymtom och utbrändhet.

    Syfte: Syftet med studien var att undersöka stress relaterad till arbetsbelastningen hos allmänsjuksköterskor som arbetar på sjukhusavdelningar.

    Metod: En kvantitativ enkätstudie utfördes på fyra sjukhusavdelningar på ett sjukhus i Södra Sverige. Instrumentet Maslach Burnout Inventory- HSS användes för att mäta respondenternas stress. Resultatet redovisades och analyserades med deskriptiv statistik, regressionsanalys och Spearmans rangkorrelationskoefficient.

    Resultat: Resultatet visar att det hos allmänsjuksköterskor finns ett samband mellan arbetsbelastning och stress. Samband uppmättes mellan antal övertidstimmar och utbrändhetsfaktorn ”Otillräcklighet” (p < 0,05), samt mellan känslan av att vara överarbetad och utbrändhetsfaktorn ”Emotionell utmattning” (p < 0,01).  Resultatet visar också att bakgrundsfaktorer som kan kopplas  till privatlivet spelar en mindre roll för sjuksköterskornas upplevda arbetsstress och att det huvudsakligen är arbetsrelaterade faktorer som påverkar upplevelsen av stress.

    Slutsats: Den undersökta populationen lider av stressfaktorer kopplade till arbetsbelastning och låg arbetstillfredsställelse och majoriteten av den undersökta populationen löper en risk att drabbas av utbrändhet. För att bibehålla god vårdkvalité, eller förbättra den ytterligare, bör åtgärder för att sänka arbetsbelastningen och öka arbetstillfredställelsen ses över.

  • 10.
    Ahlgren, Asa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Mid Sweden University, Östersund, Sweden.
    Broman, Lisbet
    Karolinska Institutet, Stockholm, Sweden.
    Bergroth, Alf
    Mid Sweden University, Östersund, Sweden.
    Ekholm, Jan
    Mid Sweden University, Östersund, Sweden.
    Disability pension despite vocational rehabilitation?: A study from six social insurance offices of a county2005In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 28, no 1, 33-42 p.Article in journal (Refereed)
    Abstract [en]

    Many long-term sick-listed individuals move from vocational rehabilitation to pension, rather than reaching the goal of return to work. There is thus reason to consider whether rehabilitation resources are being used optimally. Individuals receiving disability pensions are consuming financial and personnel resources at the insurance offices and also consume a large amount of health care. The general objective of the study was to evaluate the proportion of individuals granted vocational rehabilitation but then obtaining temporary or permanent disability pensions. All persons receiving any kind of rehabilitation and attending one of six local national insurance offices in a county in Sweden in 1998 and 1999 were studied. A 2-year follow-up was carried out to assess changes in status among those who had received temporary disability pensions. Of all individuals receiving rehabilitation, 46.2% ended up with a disability pension allowance. In addition, a large portion of the temporary disability pensions was transformed to permanent disability pensions within 2 years. For clients with a temporary disability pension, the rate of resuming work was close to nil. Among rehabilitation measures, investigation showed the lowest figures of work resumption while job training showed the best outcome in this respect. The study concluded that a large portion of the financial and personnel resources allocated by the national insurance offices to rehabilitation resulted in disability pensions.

  • 11. Ahlstrom, Linda
    et al.
    Hagberg, Mats
    Dellve, Lotta
    University of Borås, School of Health Science.
    Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study2013In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 23, no 2, 248-260 p.Article in journal (Refereed)
    Abstract [en]

    Purpose To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Methods Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. Results The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. Conclusion The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

  • 12.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science.
    Integrating improvement learning into health professional educational curricula2008In: International Forum on Quality Improvement in Healthcare, France, April 24 2008: International Forum on QI , 2008, 1- p.Conference paper (Refereed)
    Abstract [en]

    We all need to start where we are and also wanting to go further all the time. This is the essence in quality improvement. The leader and the teachers must own this attitude themselves in order to have the ability to be trustworthy for the students. There is evidence in the literature about the impact of education on the professional attitude and role. This means that it is important to work with better professional development for better outcomes in the faculty.

    One starting point for us in the planning of our different programs are that improvement knowledge will be a streak through the whole education in order to establish a professional attitude of daily inspiration to produce the best practise. We have applied all curricula to Boologna declaration and in this system progression in learning is a key point. We have four levels in the basic education (3-years education which lead to Bachelor degree) where we start to introduce 1) Concepts and models in health improvement. Then let our students make a 2) Personal improvement in their everyday life. Later in the education we teach about 3) Evidence practise and systematic literature reviews. Finally the students are 4) Making health improvements in collaboration with the staff during one clinical education.

    All educational programmes on basic level since 2007 include aim descriptions about quality improvement. The aim of the learning is to have the competence to initiate and participate in work about health care improvements.

    Finally, besides the mentions aspects in improvement education there are some other factors that needs for better system performance.

  • 13.
    Aidemark, Jan
    et al.
    Linnaeus University.
    Askenäs, Linda
    Linnaeus University.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Strömberg, Anna
    Linköping University.
    User involvement in the co-design of self-care support systems for heart failure patients2015In: Procedia Computer Science, ISSN 1877-0509, E-ISSN 1877-0509, Vol. 64, 118-124 p.Article in journal (Refereed)
    Abstract [en]

    In this paper the nature of user involvement in a co-design process will be explored. The outlines of a research project aiming at developing support systems for self-care inpatients suffering from chronic heart failure will be presented. The project is planned to perform a co-design effort where users (patients and healthcare professionals) will be given the opportunity to influence the development of support systems. We will discuss a number of possibilities and challenges that lie in the design of this kind of project and also some findings from its early stages. This report presents the experiences of users’ input, which are discussed in the context of previous research on benefits of user contributions in systems development.

  • 14.
    Akay, Altug
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Systems Safety and Management.
    Dragomir, Andrei
    Erlandsson, Björn-Erik
    KTH, School of Technology and Health (STH), Health Systems Engineering, Systems Safety and Management.
    A Novel-Data Mining Platform to Monitor the Outcomes of Erlontinib (Tarceva) using Social Media2014In: XIII Mediterranean Conference on Medical and Biological Engineering and Computing 2013, Springer, 2014, 1394-1397 p.Conference paper (Refereed)
    Abstract [en]

    A novel data-mining method was developed to gauge the experiences of the oncology drug Tarceva. Self-organizing maps were used to analyze forum posts numerically to infer user opinion of drug Tarceva. The result is a word list compilation correlating positive and negative word cluster groups and a web of influential users on Tarceva. The implica-tions could open new research avenues into rapid data collec-tion, feedback, and analysis that would enable improved solu-tions for public health.

  • 15. Akerborg, Örjan
    et al.
    Lang, Andrea
    Wimo, Anders
    Sköldunger, Anders
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Gaudig, Maren
    Rosenlund, Mats
    Cost of Dementia and Its Correlation With Dependence2016In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 28, no 8, 1448-1464 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was Euro43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

  • 16.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Temaledare: Vård på lika villkor – Vad kan vi lära av Lärandeprojektet?2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 2, 103-106 p.Article in journal (Other academic)
  • 17.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Blev det ett genombrott?: Utvärdering av det nationella lärandeprojektet – Vård på lika villkor2014Report (Other academic)
    Abstract [sv]

    Sjukvården i Sverige är i dag inte jämlik, har brister i tillgänglighet och erbjuds inte på likvärdiga villkor trots Hälso- och sjukvårdslagens mål om en god hälsa och en vård på lika villkor för hela befolkningen.

    För att bryta den pågående trenden och öka jämlikheten gjordes en överenskommelse mellan regeringen och SKL om lärandeprojektet Vård på lika villkor (under åren 2011–2014). Syftet med projektets har varit att inom socioekonomiskt resurssvaga bostadsområden öka jämlikheten i första linjens vård. Detta genom att testa, utveckla och identifiera effektiva arbetssätt och metoder vid sju primärvårdsverksamheter från fem landsting i Sverige.

    Mälardalens högskola, Akademin för hälsa, vård och välfärd, fick av SKL i uppdrag att svara för forskarstöd och att genomföra en utvärdering av de metoder och arbetssätt som utvecklades och testades i lärandeprojektet.

    Resultatet från den genomförda utvärderingen som belyser den genomförda processen, mål- och resultat samt hälsoekonomiska aspekter beskrivs närmare i denna rapport.

  • 18.
    Akner, Gunnar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Andersson, Christer
    Umeå University.
    Ekerstad, Niklas
    NU-sjukvården.
    Eliasson, Mats
    Umeå University.
    Gustafson, Yngve
    Umeå University.
    Järhult, Bengt
    Region Östergötland.
    Petersson, Christer
    Region Kronoberg.
    Tjärnström, Johan
    NU-sjukvården.
    von Zur-Mühlen, Bengt
    Uppsala University Hospital.
    Wingstrand, Hans
    Lund University.
    Styrningen har blivit ett hot2016In: Svenska Dagbladet, ISSN 1101-2412, Vol. 25 jul, 1 p.Article in journal (Other (popular science, discussion, etc.))
  • 19.
    Akner, Gunnar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Järhult, Bengt
    Region Östergötland.
    Värdebaserad vård införs snabbt: värdig efterträdare till NPM?2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 20, 1-3 p., DXUTArticle in journal (Refereed)
  • 20.
    Akner, Gunnar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Järhult, Bengt
    Region Östergötland.
    Ekonomiska incitament ska inte kopplas till den enskilde patienten: Replik till Magnus Lind om värdebaserad vård2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, D4TPArticle in journal (Other academic)
  • 21.
    Akner, Gunnar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Järhult, Bengt
    Vårdcentralen Ryd.
    Värdebaserad vård utan underlag: Apropå!2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 21, DZFHArticle in journal (Other academic)
  • 22.
    Akner, Gunnar
    et al.
    Linnéuniversitetet, Kalmar, Sweden.
    Järhult, Bengt
    Ekonomiska incitament ska inte kopplas till den enskilde patienten2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, D4TPArticle in journal (Refereed)
  • 23.
    Albinsson, Gunilla
    et al.
    Blekinge Institute of Technology.
    Arnesson, Kerstin
    Blekinge Institute of Technology.
    Sustainable gender equality within the Swedish healthcare2013In: FALF-konferens - Arbetslivets föränderlighet, 2013, 3- p.Conference paper (Refereed)
    Abstract [en]

    The aim of the presentation is to discuss whether or not a methodological approach can promote a process of making visible gender equality within the health and medical care.

    Although Sweden has come a long way in making sure that women and men are treated equally in the workplace there are few countries with so obvious gender based occupational segregation. Within Swedish health- and medical care for example 81 per cent of the employees are women. The majority of these work in a hierarchical structure where the lower and intermediate levels primarily are comprised of women. With this point of departure we have studied the construction of gender equality in every day meetings between women and men working in health- and medical care.

    Aim

    The overarching purpose of the study was to describe and problematize the perspective of gender equality within the health- and medical care. Two main questions were posed:

    • How is the aspect of gender equality expressed in work related meetings between women and men working in health care?
    • Which opportunities and hindrances exist for creating sustainable gender equality within the health- and medical care?

    Method

    The empirical material comprised 23 women and men studying health care or public health at Blekinge Institute of Technology. The informants were also working as professional nurses. The study was carried through in two steps. Firstly four introductory lectures were conducted. Two of them were about qualitative methods with a particular emphasis on focus groups as an interview technique. The other two focused on current gender equality research. The informants also deepened their knowledge by reading articles about gender equality. In the second step qualitative interviews in focus groups were conducted. Before these occasions the interviewees had prepared themselves by reading a research report which made it possible to relate the text to personal experiences from working life.

    Result

    The empirical material showed that the knowledge about gender equality differed within the studied group. Most informants considered the problem area of vital importance and stressed the necessity of continual discussions in the workplace. However some of the interviewed had never thought of the issue as they regarded gender equality being a question without any interest. All our informants were aware of the plan of action for equality which is required at the workplace but only few of them had read it or worked actively with the implementation. When the interviewees reflected upon the hierarchical structure in their workplaces a common view was that an obvious difference between women’s and men’s opportunities to influence and exercise domination could be seen.

  • 24.
    Alexanderson, Kristina
    et al.
    Karolinska Institutet, Försäkringsmedicin.
    von Knorring, Mia
    Karolinska Institutet, Försäkringsmedicin.
    Keller, Christina
    Jönköping University, Jönköping International Business School, JIBS, Informatics.
    Impact of a nationwide government program in Sweden on how healthcare managers, in their organisations, manage the work with sickness certification of patients2014In: The European journal of public health, Vol. 24, Supplement 2, 2014, 90- p.Conference paper (Refereed)
  • 25.
    Ali, DK
    et al.
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm.
    Dalal, Koustuv
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm.
    Yousefzade-Chabok, S
    Trauma Research Center, Guilan University of Medical Science, Iran.
    Jansson, B
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm.
    Mohammadi, R
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm.
    Costs related to drowning and near drowning in northern Iran (Guilan province)2011In: Ocean and Coastal Management, ISSN 0964-5691, Vol. 54, no 3, 250-255 p.Article in journal (Refereed)
    Abstract [en]

    In Iran and many other low- and middle-income countries, few  studies have been carried out in order to assess which cost analysis methods should be  undertaken at the household and community level in relation to incidences of drowning. In this study, we have attempted to develop a model for  estimating the impact of the economic burden that drowning and near drowning events incur for victims’ families in the Guilan province in the north of  Iran by  using an  incidence approach. During the financial year of March 2007 to 2008,  the following cost-related aspects of  drowning episodes were evaluated: (note: main cost elements were income adjusted by family and years) medical costs, productivity loss  costs and death costs. A total of 137 drowning fatalities and 104 near drowning incidents were recorded. Males in the age  span of  10e29  years constitute a  majority of  the epidemiology and economy data. When the number of variables included in cost analysis was expanded, the estimated burden of economic duress increased dramatically; however, drowning cost for  one drowned victim was equivalent to 17  times the country’s  gross domestic product(GDP) per capital. Identification of  injured person-based costs in  this study will  enable development of  more effective prevention programs and provide indicators of  other costs related to drowning episodes such as  property damage and the impact of  these accidents on community services and the public health care system.

  • 26. Al-Janabi, Hareth
    et al.
    Coast, Joanna
    Flynn, Terry N
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up.2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 67, no 1, 111-21 p.Article in journal (Refereed)
    Abstract [en]

    Government policies to shift care into the community and demographic changes mean that unpaid (informal) carers will increasingly be relied on to deliver care, particularly to older people. As a result, careful consideration needs to be given to informal care in economic evaluations. Current methods for economic evaluations may neglect important aspects of informal care. This paper reports the development of a simple measure of the caring experience for use in economic evaluations. A meta-ethnography was used to reduce qualitative research to six conceptual attributes of caring. Sixteen semi-structured interviews were then conducted with carers of older people, to check the attributes and develop them into the measure. Six attributes of the caring experience comprise the final measure: getting on, organisational assistance, social support, activities, control, and fulfilment. The final measure (the Carer Experience Scale) focuses on the process of providing care, rather than health outcomes from caring. Arguably this provides a more direct assessment of carers' welfare. Following work to test and scale the measure, it may offer a promising way of incorporating the impact on carers in economic evaluations.

  • 27. Allander, E
    et al.
    Bjurulf, P
    Isacsson, SO
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Svanström, L
    Westrin, CG
    Skilj mellan besluts- och forskningsregister!1985In: Läkartidningen, ISSN 0023-7205, Vol. 82, 4383-84 p.Article in journal (Refereed)
  • 28. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Of vigilance and invisibility: being a patient in technologically intense environments2007In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 12, no 3, 151-158 p.Article in journal (Refereed)
    Abstract [en]

    Equipment and procedures developed during the past several decades have made the modern intensive care unit (ICU) the hospital’s most technologically advanced environment. In terms of patient care, are these advances unmitigated gains? This study aimed to develop a knowledge base of what it means to be critically ill or injured and cared for in technologically intense environments. A lifeworld perspective guided the investigation. Nine unstructured interviews with intensive care patients comprise its data. The qualitative picture uncovered by a phenomenological analysis shows that contradiction and ambivalence characterized the entire care episode. The threat of death overshadows everything and perforates the patient’s existence. Four inter-related constituents further elucidated the patients’ experiences: the confrontation with death, the encounter with forced dependency, an incomprehensible environment and the ambiguity of being an object of clinical vigilance but invisible at the personal level. Neglect of these issues lead to alienating ‘moments’ that compromised care. Fixed at the end of a one-eyed clinical gaze, patients described feeling marginalized, subjected to rituals of power, a stranger cared for by a stranger. The roar of technology silences the shifting needs of ill people, muffles the whispers of death and compromises the competence of the caregivers. This study challenges today’s caregiving system to develop double vision that would balance clinical competence with a holistic, integrated and comprehensive approach to care. Under such vision, subjectivity and objectivity would be equally honoured, and the broken bonds re-forged between techne, ‘the act of nursing’, and poesis, ‘the art of nursing’.

  • 29. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Caught in an Artificial Split: A Phenomenological Study of Being a Caregiver in the Technologically Intense Environment2007In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 2, 130-136 p.Article in journal (Refereed)
    Abstract [en]

    A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle ‘moments’ of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs.

  • 30. Almerud, S
    et al.
    Alapack, R.J.
    Fridlund, Bengt
    Växjö University.
    Ekebergh, Margaretha
    Växjö University.
    Beleuguered by technology: Care in technologically intense environments2008In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 9, no 1, 55-61 p.Article in journal (Refereed)
    Abstract [en]

    Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients’ lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.

  • 31. Almkvist, Henrik
    et al.
    Bergman, Ulf
    Karolinska Universitetssjukhuset Huddinge.
    Edlert, Maria
    Juhasz-Haverinen, Maria
    Pehrsson, Åke
    Thörnwall Bergendahl, Gunilla
    Vég, Anikó
    Läkemedelscentrum, Centrum för vårdutveckling, Stockholms läns landsting.
    Wettermark, Björn
    Kvalitetsbokslut minskade läkemedelskostnaderna i primärvården: Stockholms läns landstings modell för decentraliserat kostnadsansvar2008In: Läkartidningen, ISSN 0023-7205, Vol. 105, no 42, 2930-2934 p.Article in journal (Refereed)
    Abstract [en]

    Increasing drug expenditures have resulted in various models to increase cost consciousness among prescribing doctors. In the County of Stockholm, Sweden, a model for quality assessment of prescribing was introduced in 2006. In all, 139 of 154 primary healthcare centres (PHCs) signed a contract linking extra payment to the adherence to the Drug and Therapeutics Committee guidelines if they analysed their prescribing behaviour in an annual quality report. During the first year, the adherence to guidelines increased from 80 to 83%, substantially higher than the 0-2% annual increase that had been observed previous years. The increase was similar for those PHCs not participating in the program. Qualitative analyses of all written quality reports indicate that the incentive scheme has resulted in an increased interest in quality assessment of drug prescribing. In total, 20 million SEK was spent on incentives, with estimated savings of 100 million SEK on drug expenditures.

  • 32.
    Alverbratt, Catrin
    et al.
    University West, Department of Nursing, Health and Culture.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Åström, Sture
    University West, Department of Nursing, Health and Culture. Umeå universitet.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic2014In: Journal of Hospital Administration, ISSN 1927-6990, ISSN 1927-6990, Vol. 3, no 6, 174-189 p.Article in journal (Refereed)
    Abstract [en]

    The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.

  • 33.
    Alwin, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Lundqvist, Martina
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Lundqvist, Martina
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Husberg, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Levin, Lars-Åke
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Utvärdering av försöksverksamhet med service- och signalhundar2014Report (Other academic)
    Abstract [sv]

    Denna rapport redovisar utvärderingen av en försöksverksamhet med ser-vice- och signalhundar som bedrevs mellan år 2009 och 2014. Utvärderingen inkluderar servicehundar, signalhundar samt alarmerande servicehundar (epilepsihundar och diabeteshundar). Totalt 56 ekipage (förare samt hund) ingick i utvärderingsstudien. Data i studien samlades in före samt efter genomgången service- och signalhundsutbildning. Syftet med utvärderingen är att studera hur certifierade service- och signalhundar påverkar förarnas behov av offentliga stödinsatser och de totala samhällskostnaderna. Dessutom studerades hur service- och signalhundar påverkar förarna med avseende på hälsorelaterad livskvalitet, välbefinnande, självförtroende och fysisk aktivitet samt om användningen av service- och signalhundar är kostnadseffektiv ur ett samhällsperspektiv.

      Resultat och slutsatser

    • Service- och signalhundar minskar i genomsnitt förarnas behov av offentliga stödinsatser med 197 000 kronor (6 procent) under en tioårsperiod.
    • Livskvaliteten för personer med behov av service- och signalhundar är låg jämfört med den allmänna populationen i Sverige. Studien visar på en förbättring i livskvaliteten och välbefinnandet för förare med en certifierad hund.
    • Förarnas grad av fysisk aktivitet ökade med en certifierad hund och majoriteten av dem angav att de ökat sin tid utanför hemmet samt att de även ökat sin tid för att delta i sociala aktiviteter tack vare hunden.
    • Förarnas negativa emotionella upplevelser minskar med en certifierad hund.
    • Förarna beskriver själva den certifierade hunden som ett viktigt verktyg för ökad självständighet och trygghet.
    • Den hälsoekonomiska modellen som analyserar kostnadseffektiviteten visar att ett innehav av en certifierad hund är ett dominant alternativ jämfört med att inte ha en certifierad hund. Detta innebär att kostnaderna ur ett samhällsperspektiv under en tioårsperiod är lägre (-103 000 kronor) samtidigt som effekterna i form av vunna QALY (kvalitetsjusterade levnadsår) är högre (+0,15).
    • Finansieringsanalysen visar att förare som har certifierade hundar sparar resurser åt alla aktörer (stat, kommun och landsting) men får själva ökade utgifter på grund av hunden.
    • Studien baseras på ett lågt antal observationer (56 ekipage). Det i kombination med att det är en stor spridning i resursförbrukningen mellan ekipagen medför att det finns en statistisk osäkerhet i resultaten. Slutsatserna bedöms dock som rimliga eftersom de är samstämmiga.
  • 34.
    Alwén, Erzsébet
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wessman, Carin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Kommunernas rekryteringsprocess: HR i praktiken2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Rekryteringsprocessens utformning och utövande är helt avgörande för att verksamheten ska kunna fortsätta att utvecklas samt nå uppsatta mål och visioner. Hur arbetsgivare rekryterar på ett professionellt och tillförlitligt sätt kräver kompetens. Organisationer idag har i regel en egen personalavdelning som inriktar sig på att rekrytera nya medarbetare. Många organisationer som anställer personer i betydande positioner använder sig av externa rekryteringsföretag. Rekrytering är en omfattande och kostnadskrävande process, men att göra rekryteringsprocessen rätt från början kan bli förhållandevis billigare än en felrekrytering. Rätt person på rätt plats kräver planering och framförhållning för att den tilltänkta ska kunna matcha in perfekt förtjänsten.

    Syftet är att beskriva rekryteringsprocessen inom kommunalt verksamhetsområde och i vilken utsträckning befintliga HRM processer upplevs som ett stöd i arbetet för enhetschefer inom rekrytering. Åtta intervjuer med informanter i ledande befattning inom den kommunala organisationens sociala sektor har genomförts. Studiens resultat visar på svårigheter i många delar under hela rekryteringsprocessen. Detta orsakas delvis av lagföreskrifter och delvis utav huruvida den rekryterande chefen anser sig behöva följa den utav strategisk Human Resource personal utarbetade rekryteringsprocessen.

    I vilken utsträckning cheferna tog hjälp av Human Resource avdelningen eller bemanningsenheten vid rekrytering varierade i omfattning bland deltagarna. Gemensamt för kommunerna var att det i samband med en chefsrekrytering lades ner mer resurser i form av tid och pengar på att det skulle bli rätt. Författarna fick en känsla av att rekryterande enhetschefer i större utsträckning kontaktade ansvarig Human Resource personal i samband med arbetsrättsliga processer och inte i lika stor utsträckning i samband med själva rekryteringsprocessen.

  • 35.
    Amin, Mahgol
    et al.
    Mälardalen University, School of Business, Society and Engineering.
    Kubo, Tomomi
    Mälardalen University, School of Business, Society and Engineering.
    KANBAN Implementation from a Change Management Perspective: A Case Study of Volvo IT2014Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this thesis is to investigate and analyze the implementation process of KANBAN, a lean technique, into a section of Volvo IT (i.e. BEAT). The KANBAN implementation into BEAT when ‘resistance for change’ and ‘forces for change’ arise is also analyzed. This implementation of KANBAN is equivalent to change taking place in the Volvo IT’s operational process. The thesis follows theories and literature on change management and lean principles in order to support the research investigation.

    How has KANBAN, with respect to change management, been implemented into an IT organization for its service production? How has KANBAN changed the operational process of the organization?

     The research conducted in the thesis is based on qualitative case study. Focused and in-depth interviews, combined with observations, are carried out to obtain the primary data for the case study. The collected primary and secondary data stems from the literature reviewed, which covers the lean principles, KANBAN, and change management. Moreover, the thesis adopts an abductive approach that goes back-and-forth between the theory and the empirical findings in order to develop a model.

    Due to various factors already existing in the BEAT, minimal resistance to change implementation was found to be present in Volvo IT. This finding indicates that change initiatives found a way to implementation because the predominance of the ‘forces for change’, as compared to, the ‘resistance to change’ is higher in BEAT. The KANBAN implementation into the IT service production is identified to be aligned with Volvo IT’s change implementation objectives. The visualization of the ‘intangible service’ workflow on the Kanban board contributes to identify the source of bottlenecks, which has been removed through effective communication in the BEAT team and better linkages between tasks. The KANBAN effectively deals with change implementation by modifying the way team members work.

  • 36.
    Amundstuen Reppe, Linda
    et al.
    Nordic University, Norway; Norwegian University of Science and Technology, Norway; St Olays Hospital, Norway.
    Lydersen, Stian
    Norwegian University of Science and Technology, Norway.
    Schjott, Jan
    Haukeland Hospital, Norway; University of Bergen, Norway; Haukeland Hospital, Norway.
    Damkier, Per
    Odense University Hospital, Denmark.
    Rolighed Christensen, Hanne
    Bispebjerg and Frederiksberg University Hospital, Denmark.
    Peter Kampmann, Jens
    Bispebjerg and Frederiksberg University Hospital, Denmark.
    Böttiger, Ylva
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Spigset, Olav
    Norwegian University of Science and Technology, Norway; St Olays Hospital, Norway.
    Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia2016In: Clinical Therapeutics, ISSN 0149-2918, E-ISSN 1879-114X, Vol. 38, no 7, 1738-1749 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: The aims of this study were to assess the quality of responses produced by drug information centers (DICs) in Scandinavia, and to study the association between time consumption processing queries and the quality of the responses. Methods: We posed six identical drug-related queries to seven DICs in Scandinavia, and the time consumption required for processing them was estimated. Clinical pharmacologists (internal experts) and general practitioners (external experts) reviewed responses individually. We used mixed model linear regression analyses to study the associations between time consumption on one hand and the summarized quality scores and the overall impression of the responses on the other hand. Findings: Both expert groups generally assessed the quality of the responses as "satisfactory" to "good." A few responses were criticized for being poorly synthesized and less relevant, of which none were quality-assured using co-signatures. For external experts, an increase in time consumption was statistically significantly associated with a decrease in common quality score (change in score, -0.20 per hour of work; 95% CI, -0.33 to -0.06; P = 0.004), and overall impression (change in score, -0.05 per hour of work; 95% CI, -0.08 to -0.01; P = 0.005). No such associations were found for the internal experts assessment. Implications: To our knowledge, this is the first study of the association between time consumption and quality of responses to drug-related queries in DICs. The quality of responses were in general good, but time consumption and quality were only weakly associated in this setting. (C) 2016 The Authors. Published by Elsevier HS Journals, Inc.

  • 37. Andersen, R
    et al.
    Anderson, OW
    Smedby, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Perception of the response to symptoms of illness in Sweden and the United States1968In: Medical Care, Vol. 6, 18-30 p.Article in journal (Refereed)
  • 38. Andersen, 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.
    Changes in response to symptoms of illness in the United States and Sweden1979In: Health Handbook / [ed] George K Chacko, 1979, 942-55 p.Chapter in book (Other academic)
  • 39. Andersen, 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.
    Comparative health systems - Part IV - Specific studies in several countries: Changes in response to symptoms of illness in the United States and Sweden1975In: Inquiry, ISSN 0046-9580, Vol. 12, no 2 SUPPL, 116-27 p.Article in journal (Refereed)
  • 40. Andersen, 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.
    Anderson, OW
    Medical care use in Sweden and the United States: A comparative analysis of systems and behavior1970In: Center for Health Administation Studies, University of Chicago, Research Series, Vol. 27Article, review/survey (Refereed)
  • 41. Andersen, 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.
    Eklund, G
    Uses of the Automatic Interaction Detector (AID) program for analyzing health survey data1971In: Health Services Research, ISSN 0017-9124, E-ISSN 1475-6773, Vol. 6, no 2, 165-83 p.Article in journal (Refereed)
  • 42.
    Andersson, Agneta
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Health economic studies on advanced home care2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to examine the cost-effectiveness of specific advanced home care and home rehabilitation interventions and to improve economic evaluation methods when applied to advanced home care. This included a comparison of two alternative ways of administering oxygen at home to patients with chronic hypoxaemia, as well as a review of scientific evidence on costs and effects of home rehabilitation after stroke. Also included were studies on prominent methodological issues in advanced home care - the redistribution of care efforts among caregivers and costing of informal care efforts.

    For patients with chronic hypoxaemia, a randomised, controlled trial showed that mobile liquid oxygen was considerably more costly compared to concentrator treatment. However, the treatment effects showed that liquid oxygen had a better impact on patient quality of life. The literature review revealed that the outcomes and costs of home rehabilitation after stroke are equal to those of alternative treatment strategies. Similar results were obtained in a study comparing hospital-based and home-based stroke rehabilitation, which also showed that there is a considerable redistribution of costs between health care providers and social welfare providers. Studies of patients in advanced home care in the county of Östergötland, Sweden, showed that the cost of informal care constitutes a considerable part of the care effort in all costing approaches used. Also, informal care costs were higher among patients who were men, who were younger, who had their own housing and had a cancer diagnosis.

    This thesis reveals that advanced home care interventions can differ regarding costs as well as effects, and thus comparisons between alternative home care interventions must also be performed. Further, redistribution effects are important to consider in evaluations. The cost of informal care is substantial in advanced home care. These costs must be included in evaluations with a societal perspective or else the comparisons will be biased.

  • 43.
    Andersson, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Levin, Lars-Åke
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Emtinger, Bengt Göran
    The National Board of Health and Welfare.
    Costs of informal care for patients in advanced home care: a population based study2003In: International Journal of Technology Assessment in Health Care, ISSN 0266-4623, E-ISSN 1471-6348, Vol. 19, no 4, 656-663 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: Several studies have sought to analyze the cost-effectiveness of advanced home care andhome rehabilitation. However, the costs of informal care are rarely included in economic appraisals ofhome care. This study estimates the cost of informal care for patients treated in advanced home careand analyses some patient characteristics that influence informal care costs.Methods: During one week in October 1995, data were collected on all 451 patients in advanced homecare in the Swedish county of O¨ stergo¨ tland. Costs were calculated by using two models: one includingleisure time, and one excluding leisure time. Multiple regression analysis was used to analyze factorsassociated with costs of informal care.Results: Seventy percent of the patients in the study had informal care around the clock during theweek investigated. The patients had, on average, five formal care visits per week, each of which lastedfor almost half an hour. Thus, the cost of informal care constituted a considerable part of the costof advanced home care. When the cost of leisure time was included, the cost of informal care wasestimated at SEK 5,880 per week per patient, or twice as high as total formal caregiver costs. Whenleisure time was excluded, the cost of informal care was estimated at SEK 3,410 per week per patient,which is still 1.2 times higher than formal caregiver costs (estimated at SEK 2,810 per week per patient).Informal care costs were higher among patients who were men, who were younger, who had their ownhousing, and who were diagnosed with cancer.Conclusions: Studies of advanced home care that exclude the cost of informal care substantiallyunderestimate the costs to society, regardless of whether or not the leisure time of the caregiver isincluded in the calculations.

  • 44.
    Andersson, Anders-Petter
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Cappelen, Birgitta
    The Oslo School of Architecture and Design.
    Vocal and tangible technology for music and health2013In: Book of abstracts: setting the tone: cultures of relating and reflecting in music therapy / [ed] Gro Trondalen, Oslo: The Norwegian Academy of Music , 2013, 24-24 p.Conference paper (Refereed)
    Abstract [en]

    Our voice and body are important parts of our self-expression and self-experience. They are also essential for our way to communicate and build relations cross borders like abilities, ages, locations, backgrounds and cultures. Voice and tangibility gradually become more important when developing new music technology for the Music Therapy and the Music and Health fields, due to new technology possibilities that have recently arisen. For example smartphones, computer games and networked, social media services like Skype. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project. The goal is to improve health for families, adults and children with severe disabilities through use of collaborative, musical, tangible sensorial media. We build on use of voice in Music Therapy and studies by Lisa Sokolov, Diane Austin, Kenneth Bruscia and Joanne Loewy. Further we build on knowledge from Multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible, sensorially stimulating interactive media, that through use reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross- media techniques, to create rhythms, melodies and harmonic chords to stimulate body- voice connections, positive emotions and structures for actions. The reflections in this paper build on action research methods, video observations and research-by-design methods. We reflect on observations of families and close others with children with severe disabilities, interacting in three vocal and tangible installations.

  • 45.
    Andersson, Anders-Petter
    et al.
    The Oslo School of Architecture and Design.
    Cappelen, Birgitta
    The Oslo School of Architecture and Design.
    Designing empowering vocal and tangible interaction: 2013In: The International conference on new interfaces for musical expression / [ed] Kyogu Lee, Kaejeon, Korea: Seoul National University , 2013, 406-412 p.Conference paper (Refereed)
    Abstract [en]

    Our voice and body are important parts of our self-experience, and our communication and relational possibilities. They gradually become more important for Interaction Design due to increased development of tangible interaction and mobile communication. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project RHYME. The goal is to improve health for families, adults and children with disabilities through use of collaborative, musical, tangible media. We build on the use of voice in Music Therapy and on a humanistic health approach. Our challenge is to design vocal and tangible interactive media that through use reduce isolation and passivity and increase empowerment for the users. We use sound recognition, generative sound synthesis, vibrations and cross-media techniques to create rhythms, melodies and harmonic chords to stimulate voice-body connections, positive emotions and structures for actions.

  • 46. Andersson, Anna
    et al.
    Garpenby, Peter
    Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
    Medical management in search for systematic and open priorities in Sweden2004Conference paper (Other academic)
  • 47.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Ainalem, Ingrid
    Centre for Innovation and Improvement (CII), Region Skåne, Malmö, Sweden.
    Berg, Agneta
    School of Health and Society, Kristianstad University, Sweden.
    Janlov, Ann-Christin
    School of Health and Society, Kristianstad University, Sweden.
    Challenges to improve inter-professional care and service collaboration for people living with psychiatric disabilities in ordinary housing2016In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, no 1, 44-52 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking backevaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

  • 48.
    Andersson, Ann-Christine
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Melke, Anna
    Erfarenheter från lärandeseminarier: Barn som anhöriga: Reflektioner från följeforskning2016Report (Other academic)
    Abstract [sv]

    Under 2015 genomfördes nationella lärandeseminarier för att stärka implementeringen av den lag som ger barn rätt till information, råd och stöd när en förälder plötsligt avlider, är svårt sjuk eller skadad (HSL 2g §). Satsningen var ett förbättringsarbete som omfattade sex landsting som med hjälp av en projektledning träffades vid fyra tillfällen från januari till september. Två av träffarna skedde i Stockholm och två var digitala. Under våren 2015 knöts följeforskning till arbetet med frågeställningar om vilka resultat förbättringsarbetet gav och hur deltagarna upplevde arbetssättet. Syftet var att lyfta fram vad satsningen gav samt att lära inför framtida satsningar – är lärandeseminarier ett användbart arbetssätt för nationella implementeringssatsningar?

    Rapporten visar att lärandeseminarier tycks vara en användbar form. Teamen kan redovisa att de uppnått många av de mål som de föresatte sig under projekttiden. Det handlade om kartläggning av kunskapsläge och strukturer, kompetensutveckling samt utveckling av rutiner och material. Teamen uppskattade också att få delta i ett nationellt sammanhang som gav inspiration. Samtidigt framkom det önskemål om fortsatt och ännu mer handfast stöd i fortsatt implementering i klinisk verksamhet.

  • 49.
    Andersson, Ann-Christine
    et al.
    Division of Quality Technology and Management, Linköping University, Linköping.
    Elg, Mattias
    Division of Quality Technology and Management and HELIX Vinn Excellence Centre, Linköping University, Linköping.
    Perseius, Kent-Inge
    Nyckeln competence centre for pedagogy in health care, Kalmar County Council, Kalmar.
    Idwall, Ewa
    Faculty of Health and Society, Malmö University, Malmö.
    Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare2013In: BMC Health Services Research, ISSN 1472-6963, Vol. 13, 48- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare.

    METHODS:

    A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted.

    RESULTS:

    The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach's alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach's alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work.

    CONCLUSIONS:

    The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

  • 50.
    Andersson, Ann-Christine
    et al.
    The Jönköping Academy for Improvements of Health and Welfare, School of Health Sciences, Jönköping University, Sweden .
    Idvall, Ewa
    Department of Care Science, Faculty of Health and Society, Malmö University and Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, Malmö, Sweden.
    Perseius, Kent-Inge
    Red Cross University College of Nursing. Nyckeln Competence Centre for Pedagogy in Health Care, Kalmar County Council.
    Elg, Mattias
    Division of Quality Technology and Management and HELIX Vinn Excellence Centre, Linköping University, Sweden.
    Two Different Strategies to Facilitate Involvement in Healthcare Improvements: A Swedish County Council Initiative2014In: Global Advances in Health and Medicine, ISSN 2164-957X, E-ISSN 2164-9561, Vol. 3, no 5, 22-28 p.Article in journal (Refereed)
    Abstract [en]

    Background: From a management point of view, there are many different approaches from which to choose to engage staff members in initiatives to improve performance.

    Objective: The present study evaluated how two different types of improvement strategies facilitate and encourage involvement of different professional groups in health-care organizations.

    Methods/Design: Empirical data of two different types of strategies were collected within an improvement project in a County Council in Sweden. The data analysis was carried out through classifying the participants' profession, position, gender, and the organizational administration of which they were a part, in relation to their participation.

    Setting: An improvement project in a County Council in Sweden.

    Participants: Designed Improvement Processes consisted of n=105 teams and Intrapreneurship Projects of n=202 projects.

    Intervention: Two different types of improvement strategies, Designed Improvement Processes and Intrapreneurship Projects.

    Main Outcome Measures: How two different types of improvement strategies facilitate and encourage involvement of different professional groups in healthcare organizations.

    Results: Nurses were the largest group participating in both improvement initiatives. Physicians were also well represented, although they seemed to prefer the less structured Intrapreneurship Projects approach. Assistant nurses, being the second largest staff group, were poorly represented in both initiatives. This indicates that the benefits and support for one group may push another group aside.

    Conclusions: Managers need to give prerequisites and incentives for staff who do not participate in improvements to do so. Comparisons of different types of improvement initiatives are an underused research strategy that yields interesting and thoughtful results.

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