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  • 351.
    Truong, Anh
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Winman, Thomas
    University West, School of Business, Economics and IT.
    Ekström-Bergström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Studying intraprofessional and interprofessional learning processes initiated by an educational intervention applying a qualitative design with multimethod approach: a study protocol.2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e058779Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Interprofessional collaboration in education and practice has been highlighted as a premise for providing good care. Both the intraprofessional and interprofessional impacts have bearing on healthcare professionals' performance and learning. Likewise, from the perspective of work-integrated learning, intraprofessional and interprofessional learning play an enduring part in studies about the development of healthcare organisations and professional competence. Educational-intervention research has become significant, which may indicate challenges the healthcare, for example, the area of disabilities is confronting. Earlier studies on intraprofessional and interprofessional learning have often focused on the learning outcome, whereas the learning process remains unexplored. The learning process is complex and is normally influenced by several factors. Therefore, develop knowledge about the intraprofessional and interprofessional learning processes initiated by an educational-intervention and the factors influencing this process may contribute to educational-intervention research, which is also the aim of the forthcoming study.

    METHODS AND ANALYSIS: An inductive qualitative study design with interpretivism as the epistemological stand will be applied. Professionals in healthcare services for people with intellectual disabilities in four residential settings in Sweden are included in the educational-intervention based on web-based training and structured group reflections. Intended data collections are videorecordings of group reflections and individual interviews. An ethnomethodological approach will be applied for studying the details of conversation and interaction in group reflections. The interviews will be analysed using qualitative content analysis to gain participants' viewpoints of the intervention.

    ETHICS AND DISSEMINATION: Approval was obtained from the Swedish Ethical Review Authority, Dnr 35 517. In Addition, a supplemental application to the extended part of the intervention in the forthcoming study has been submitted and approval was received on 21 September 2021. Ethical principles following the Declaration of Helsinki will be strictly followed.

    TRIAL REGISTRATION NUMBER: NCT03390868; Post-results.

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  • 352.
    Van Bulck, Liesbet
    et al.
    KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium (BEL); Research Foundation Flanders (FWO), Brussels, Belgium (BEL).
    Goossens, Eva
    KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, Box 7001, B-3000, Leuven, Belgium (BEL); Research Foundation Flanders (FWO), Brussels, Belgium; University of Antwerp,Division of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, Antwerp, Belgium (BEL).
    Luyckx, Koen
    KU Leuven - University of Leuven, School Psychology and Child and Adolescent Development,Leuven, Belgium (BEL); University of the Free State, UNIBS, Bloemfontein, South Africa (ZAF).
    Apers, Silke
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium (BEL).
    Oechslin, Erwin
    Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada (CAN).
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital - Bern University Hospital, Bern, Switzerland (CHE).
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium (BEL); KU Leuven - University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium (BEL).
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan (JPN).
    Sluman, Maayke A
    Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands (NLD).
    Lu, Chun-Wei
    National Taiwan University Children’s Hospital, Adult Congenital Heart Center, Taiwan (TWN).
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA (USA).
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada (CAN).
    Cook, Stephen C
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA (USA).
    Chidambarathanu, Shanthi
    Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India (IND).
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina (ARG).
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway (NOR).
    Dellborg, Mikael
    Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden; University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital, Edmonton, Canada (CAN).
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia (AUS).
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta (MLT).
    Veldtman, Gruschen
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA (USA).
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France (FRA).
    Fernandes, Susan M
    Adult Congenital Heart Program at Stanford, Lucile Packard Children’s Hospital and Stanford Health Care, USA (USA).
    White, Kamila S
    Washington University, Adult Congenital Heart Disease Center ; University of Missouri, Barnes Jewish Heart & Vascular Center, Saint Louis, Missouri USA (USA).
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy (ITA); Università degli Studi di Milano, Department of Biomedical Sciences for Health, Milan, Italy (ITA).
    Kutty, Shelby
    University of Nebraska Medical Center, Adult Congenital Heart Disease Center, Children's Hospital and Medical Center, Omaha, NE, USA (USA).
    Moons, Philip
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium (BEL); Centre for Person-Centred Care (GPCC), Gothenburg, Sweden; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden; University of Cape Town, Department of Paediatrics and Child Health, Cape Town, South Africa (ZAF).
    Healthcare system inputs and patient-reported outcomes: a study in adults with congenital heart defect from 15 countries2020In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 496Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The relationship between healthcare system inputs (e.g., human resources and infrastructure) and mortality has been extensively studied. However, the association between healthcare system inputs and patient-reported outcomes remains unclear. Hence, we explored the predictive value of human resources and infrastructures of the countries' healthcare system on patient-reported outcomes in adults with congenital heart disease.

    METHODS: This cross-sectional study included 3588 patients with congenital heart disease (median age = 31y; IQR = 16.0; 52% women; 26% simple, 49% moderate, and 25% complex defects) from 15 countries. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviors, and quality of life. The assessed inputs of the healthcare system were: (i) human resources (i.e., density of physicians and nurses, both per 1000 people) and (ii) infrastructure (i.e., density of hospital beds per 10,000 people). Univariable, multivariable, and sensitivity analyses using general linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

    RESULTS: Sensitivity analyses showed that higher density of physicians was significantly associated with better self-reported physical and mental health, less psychological distress, and better quality of life. A greater number of nurses was significantly associated with better self-reported physical health, less psychological distress, and less risky health behavior. No associations between a higher density of hospital beds and patient-reported outcomes were observed.

    CONCLUSIONS: This explorative study suggests that density of human resources for health, measured on country level, are associated with patient-reported outcomes in adults with congenital heart disease. More research needs to be conducted before firm conclusions about the relationships observed can be drawn.

    TRIAL REGISTRATION: ClinicalTrials.gov: NCT02150603. Registered 30 May 2014.

  • 353.
    Van Bulck, Lisbet
    et al.
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Luyckx, Koen
    KU Leuven – University of Leuven, School Psychology and Development in Context, Belgium; UNIBS, University of the Free State, South Africa.
    Goossens, Eva
    KU Leuven – University of Leuven, Department of Public Health and Primary Care,Belgium; Research Foundation Flanders (FWO), Belgium; Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium .
    Apers, Silke
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Kovacs, Adrienne. H.
    University of Toronto, Peter Munk Cardiac Centre, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, USA .
    Thomet, Corina
    Center for Congenital Heart Disease, Bern University Hospital, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium ; KU Leuven – University of Leuven, Department of Cardiovascular Sciences,Belgium .
    Sluman, Maayke A.
    Department of Cardiology, Academic Medical Center, The Netherlands; Department of Cardiology, Jeroen Bosch Hospital, The Netherlands; Coronel Institute for Occupational Health, Academic Medical Centre, The Netherlands.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital – Rikshospitalet, Norway.
    Dellborg, Mikael
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden; Adult Congenital Heart Unit, Sahlgrenska University Hospital, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Sweden.
    Caruana, Mayanne
    Department of Cardiology, Mater Dei Hospital, Malta.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, France.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Italy; Università degli Studi di Milano, Department of Biomedical Sciences for Health, Italy .
    Moons, Philip
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Sweden; Department of Paediatrics and Child Health, University of Cape Town, South Africa .
    Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance2019In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 465-473Article in journal (Refereed)
    Abstract [en]

    Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries' healthcare system performance are of importance for patient-reported outcomes.

    Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease.

    Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

    Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes.

    Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

  • 354.
    Wennerberg, Mia M.T.
    et al.
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden..
    Eriksson, Monica
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Lundgren, Solveig M.
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden..
    Danielson, Ella
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden..
    Unravelling Swedish informal caregivers' Generalized Resistance Deficits2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 186-196Article in journal (Refereed)
    Abstract [en]

    In salutogenic theory, individual/contextual, immaterial/material characteristics enabling movements towards health are labelled Specific and Generalised Resistance Resources, SRRs/GRRs, and characteristics counteracting such movements Specific and Generalised Resistance Deficits, SRDs/GRDs. The aim of this paper was to present SRDs and GRDs described by caregivers as stemming from themselves and their care recipient. Guided by salutogenic theory, an explorative design was used to collect data through interviews with 32 Swedish informal caregivers. During the theory-driven analysis, SRDs were unravelled using within-case approaches. To be able to unite them as GRDs across cases, a serviceable GRD definition was developed from the existing theoretical GRR definition. In findings, SRDs are visualised in citations and GRDs described in detail. Caregivers' experiences of SRDs/GRDs are presented as themes: 'Experiencing personal deficiencies', when stemming from themselves; and 'Struggling with an uncooperative co-worker', when stemming from their care recipients. Findings indicate that if these themes dominate a caregiver's view of life, she/he seems to have reached the 'breaking point' when caregiving ends due to lack of usable SRRs/GRRs. To prolong the time until this occurs, support, making otherwise unusable SRRs/GRRs usable, is needed. When designing this type of 'salutogenic' support, it seems essential to involve the target group (e.g. caregivers, care recipients), to ascertain what their SRRs/GRRs and SRDs/GRDs may consist of. Such knowledge regarding SRRs/SRDs could be used to design individualised support, and regarding GRRs/GRDs to design generalised support at group level. This study suggests how such new knowledge regarding resistance resources and deficits could be acquired.

  • 355.
    Winman, Thomas
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Transforming information into practical actions: A study of professional knowledge in the use of electronic patient records2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Today, technologies are being introduced into historically established settings, which change the conditions for work as well as for work-integrated learning. In health care, electronic patient records (EPRs) has been implemented during the last decades to serve as a tool for planning, decision making and evaluation of care work. The overall aim of the research presented in this thesis is to analyse the complex actions and interactions that occur when EPRs are used in health care practice. Analytically, such an interest is pursued employing a socio-cultural perspective on workplace studies, where the use of technology is studied in action. Through three separate studies, practical actions and practical use of EPRs have been examined and the empirical data draws on observations, video-recordings, audio-recordings and documents from a hospital ward in Sweden. The result shows that technologies such as EPRs both offer and presuppose standardization of terminologies and information structures. This, however, does not mean that EPRs completely format and structure information, or that it is driven by its own logic. When staffs comply with a set of standards, transformations of those standards will gradually occur. Those transformations are collective achievements and since each professional involved act in a conscious and active manner, this affects the use of standards as well as the development of collective proficiency. The results also demonstrate that meaning making in(through) the use of EPRs presupposes extensive knowledge of the indexicality of categories, something that originates in the participants‘ shared institutional history. It is in the process of reliving, creating and exposing the meaning of information, that health care professionals actually bring information in EPRs to life. In further development of EPRs that exceeds institutional and even national boundaries it is important to see this development not as solely technical or organizational questions. To develop systems that enhance the possibilities for professionals in different institutions with different professional domains to make sense of standardized information may be a much more  demanding task than it seems to be. Such boundary-crossing systems are nevertheless of great importance for the further development of health care practice.

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  • 356.
    Winman, Thomas
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Rystedt, Hans
    Department of Education, University of Gothenburg.
    Electronic patient records in interprofessional decision making: Standardized categories and local use2012In: Human Technology, E-ISSN 1795-6889, Vol. 8, no 1, p. 46-64Article in journal (Refereed)
    Abstract [en]

    Electronic patient records (EPRs) are a constitutive element of medical practice and are expected to improve interprofessional communication and support decision making. The aim of the current study is to explore the ways in which access to structured information from multiple professions within EPRs enters into the phases involved in arriving at final agreements about patients' future care. The results show that decision making in interprofessional team rounds involves a prestructuring of a pathological reality. Further, the results demonstrate how information in EPRs is deconstructed and recast into patterns that presuppose knowledge about the EPR's structural organization. This means that EPRs are highly flexible technologies and that their design does not determine their usefulness. A major conclusion is that the members' knowledge on how to bridge between standardized categories in EPRs and their local meanings is decisive for understanding the basic conditions necessary for how EPRs could support interprofessional collaboration.

  • 357.
    Winman, Thomas
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Säljö, Roger
    Department of Education, University of Gothenburg.
    Rystedt, Hans
    Department of Education, University of Gothenburg.
    Local knowing and the use of electronic patientrecords: categories and continuity of health care2012In: Health and Technology, ISSN 2190-7188, E-ISSN 2190-7196, Vol. 2, no 3, p. 185-196Article in journal (Refereed)
    Abstract [en]

    The electronic patient record (EPR) is a constitutive element of medical practice and can be conceived of as a multi-purpose tool that is intended to support a range of activities such as planning, decision-making and evaluation. Each of these activities is quite complex in its own right. The aim of the present study is to explore how the standardized format of EPRs intervenes in the work of sustaining continuity in patients ' care. In doing this we analyse ow this standardized format contributes to structure the production and use of information concerning patients' mundane problems in the context of rehabilitation. Data consists of observations, informal interviews and video-recordings from a ward for patients affected by stroke. The results show that there is a tension between the highly uniform structures and standards for documentation in EPRs, on the one hand, and, on the other, how information is designed and put into use by care providers. When staff members use EPRs, they constantly have to contextualize what is written in relation to what they know about patients and/or the current situation. On the local level, the increasing standardization that follows the introduction of EPRs will make it even more necessary for professionals to engage in such interpretative work to close the gap between the standardized categories of the EPR and contextually relevant health care interventions. In spite of requests for increasing standardization there will always be a need to adapt to specific needs for more flexible information structures. Otherwise, there may be the risk that non-standard features the initial standardization was intended to reduce may be re-introduced.

  • 358.
    Zouini, Btissame
    et al.
    Abdelmalek Essaadi University, Department of Biology, Faculty of Sciences, Tetouan, Morocco.
    Sfendla, Anis
    Higher Institute of Nursing Professions and Health Techniques, Errachidia, Morocco.
    Hedman Ahlström, Britt
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Senhaji, Meftaha
    Abdelmalek Essaadi University, Faculty of Sciences, Tetouan, Morocco.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Mental health profile and its relation with parental alcohol use problems and/or the experience of abuse in a sample of Moroccan high school students: An explorative study2019In: Annals of General Psychiatry, E-ISSN 1744-859X, Vol. 18, no 1, article id 27Article in journal (Refereed)
    Abstract [en]

    Background: Studies on mental health are scarce from Arab countries, especially studies focusing on adolescents. In addition to the neurobiological and physiological changes that occur during adolescent development, psychological, societal and cultural influences have strong effects on adolescents’ behavior and on their somatic and mental health. The present study aimed (1) to describe the mental health profile, operationalized as psychological distress, of a sample of Moroccan adolescents, and (2) to investigate how specific psychosocial factors (parental alcohol use problems and the experience of physical and/or psychological abuse) may affect adolescents’ mental health. Methods: The sample included 375 adolescents from conveniently selected classes of four high schools in the city of Tetouan in Morocco. The participants responded to an anonymous survey containing, beside other inventories, the Brief Symptom Inventory (BSI) and identified those reporting parental alcohol use problems and/or the previous experience of abuse. The sample characteristics were defined using descriptive statistics. The effects of the defined psychosocial factors were identified using the Kruskal-Wallis test, followed by the post hoc Fisher’s least significant difference test. Results: The most common problems found in high school students from an urban region of Morocco were memory problems, concentration difficulties, restlessness, fear, nervosity and feelings of inadequacy during interpersonal interactions. The female students reported significantly higher psychological distress levels when compared to the male students (p < 0.001). The adolescents reporting parental alcohol use problems and the experience of physical/psychological abuse showed significantly higher levels of psychological distress (p = 0.02), especially symptoms of somatization (p < 0.001), hostility (p = 0.005) and anxiety (p = 0.01), than those not reporting any of these psychosocial factors. Conclusion: The mental health profile of female adolescents from an urban area of Morocco is worse than that of their male fellow students. Adolescents reporting parental alcohol use problems and/or the experience of physical/psychological abuse need synchronized support from social- A nd healthcare services. © 2019 The Author(s).

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  • 359. Åman, J
    et al.
    Samuelson, Gösta
    Tuvemo, T
    Problemfri overgång till insulin 100 for barn  och ungdom1989In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 38, p. 3161-3162Article in journal (Other academic)
  • 360. Östman, J
    et al.
    Samuelson, Gösta
    Starkare insulin från första april 19871986In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 83, no 43, p. 3615-3616Article in journal (Other academic)
  • 361. Samuelson, Gösta (Editor)
    Barn- och ungdomsdiabetes: vårdprogram1987Report (Other academic)
  • 362. Samuelson, Gösta (Editor)
    Kost, aktivitet och hälsa hos barn och ungdom.1990Book (Other academic)
5678 351 - 362 of 362
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