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Foldevi, Mats
Publications (10 of 26) Show all publications
Agvall, B., Paulsson, T., Foldevi, M., Dahlström, U. & Alehagen, U. (2014). Resource use and cost implications of implementing a heart failure program for patients with systolic heart failure in Swedish primary health care. International Journal of Cardiology, 176, 731-738
Open this publication in new window or tab >>Resource use and cost implications of implementing a heart failure program for patients with systolic heart failure in Swedish primary health care
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2014 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 176, p. 731-738Article in journal (Refereed) Published
Abstract [en]

Aim: Heart failure (HF) is a common but serious condition which involves a significant economic burden on the health care economy. The purpose of this study was to evaluate cost and quality of life (QoL) implications of implementing a HF management program (HFMP) in primary health care (PHC).

Methods and results: This was a prospective randomized open-label study including 160 patientswith a diagnosis of HF from five PHC centers in south-eastern Sweden. Patients randomized to the intervention group received information about HF from HF nurses and from a validated computer-based awareness program. HF nurses and physicians followed the patients intensely in order to optimize HF treatment according to current guidelines. The patients in the control group were followed by their regular general practitioner (GP) and received standard treatment according to local management routines. No significant changes were observed in NYHA class and quality-adjusted life years (QALY), implying that functional class and QoL were preserved. However, costs for hospital care (HC) and PHC were reduced by EUR 2167, or 33%. The total cost was EUR 4471 in the intervention group and EUR 6638 in the control group.

Conclusions: Introducing HFMP in Swedish PHC in patients with HF entails a significant reduction in resource utilization and costs, and maintains QoL. Based on these results, a broader implementation of HFMP in PHC may be recommended. However, results should be confirmed with extended follow-up to verify  long-term effects.

Keywords
Heart failure. Disease management. Primary health care. Resource utilization. Health care cost.
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-104953 (URN)10.1016/j.ijcard.2014.07.105 (DOI)000343893300049 ()25131925 (PubMedID)
Note

On the day of the defence day of this article the status of the article was Manuscript and the original title was Resource use and cost implications of implementing a heart failure programme in Swedish Primary Health Care.

Available from: 2014-03-04 Created: 2014-03-04 Last updated: 2018-12-19Bibliographically approved
Lööf-Johansson, M., Foldevi, M. & Rudebeck, C.-E. (2013). Breastfeeding as a Specific Value in Womens Lives: The Experiences and Decisions of Breastfeeding Women. Breastfeeding Medicine, 8(1), 38-44
Open this publication in new window or tab >>Breastfeeding as a Specific Value in Womens Lives: The Experiences and Decisions of Breastfeeding Women
2013 (English)In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 8, no 1, p. 38-44Article in journal (Refereed) Published
Abstract [en]

Background: Worldwide, breastfeeding is recommended for every woman who gives birth to a child. The propensity to breastfeed varies. There is considerable knowledge about the experiences and circumstances that affect the decision to breastfeed, but knowledge about what actually generates the decision's force still needs to be increased. The aim of this study was to gain knowledge of how the decision to breastfeed is initiated and upheld.

Subjects and Methods: Eighteen women from three generations were interviewed, and the data were analyzed by qualitative content analysis.

Results: Six categories were revealed: “Task,” “Instinct,” “Silent Impact,” “Conflicts,” “Job,” and “Joy.” The women took on the Task of breastfeeding during pregnancy. The will to breastfeed was also recognized as an Instinct. The older women remained more in the background, exerting a Silent Impact. Parents' agreement that mothers remain at home and breastfeed for the first 6 months could be considered disturbing from a gender equality perspective. Competition arose between spouses, which could lead to Conflicts at weaning. The mothers in the study chose to stay home to do the Job and experience the Joy of breastfeeding.

Conclusions: A summarizing theme was the specific life value of breastfeeding, encompassing feelings of coherence, pleasure, and pride, regardless of generation affiliation. As the favorable interplay of biological, sensual, relational, and social elements this value upheld the decision to breastfeed. It compensated for the effort and negative experiences, and as a finding, it appears to be transferable among breastfeeding mothers in other developed countries.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90209 (URN)10.1089/bfm.2012.0008 (DOI)000314580600007 ()
Note

Funding Agencies|Research Council of Southern Sweden||

Available from: 2013-03-21 Created: 2013-03-21 Last updated: 2017-12-06Bibliographically approved
Johansson, K., Bergström, A., Schröder, K. & Foldevi, M. (2011). Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care-a randomized clinical trial. Family Practice, 28(4), 355-365
Open this publication in new window or tab >>Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care-a randomized clinical trial
2011 (English)In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 28, no 4, p. 355-365Article in journal (Refereed) Published
Abstract [en]

bjective. To compare the efficacy of subacromial corticosteroids injected by a GP with physiotherapy combining acupuncture and home exercises as treatments for SIS. less thanbrgreater than less thanbrgreater thanMethods. A randomized clinical trial was performed in primary health care. Patients diagnosed with SIS were randomized to either subacromial corticosteroid injection (s) or 10 acupuncture treatments combined with home- exercises. The main outcomes were pain and shoulder function (Adolfsson-Lysholm shoulder assessment score). Secondary outcomes were health-related quality of life (HRQL) (EuroQol-five dimension self-report questionnaire) and the patients global assessment of change. All patients were assessed at baseline and after 6 weeks and 3, 6 and 12 months. less thanbrgreater than less thanbrgreater thanResults. One hundred and seventeen patients with SIS were included, of which 91 complied with the study protocol. There were no significant differences between treatments with regard to pain, shoulder function and HRQL in change over time. However, both treatment groups improved significantly from baseline over time. less thanbrgreater than less thanbrgreater thanConclusions. Both subacromial corticosteroid injection and a series of acupuncture treatments combined with home exercises significantly decreased pain and improved shoulder function in patients with SIS, but neither treatment was significantly superior to the other.

Place, publisher, year, edition, pages
Oxford University Press, 2011
Keywords
Acupuncture, corticosteroids, physiotherapy, rotator cuff, subacromial impingement syndrome
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-69983 (URN)10.1093/fampra/cmq119 (DOI)000293302900003 ()
Available from: 2011-08-12 Created: 2011-08-12 Last updated: 2018-10-19
Hansson, A., Foldevi, M. & Mattsson, B. (2010). Medical students attitudes toward collaboration between doctors and nurses - a comparison between two Swedish universities. JOURNAL OF INTERPROFESSIONAL CARE, 24(3), 242-250
Open this publication in new window or tab >>Medical students attitudes toward collaboration between doctors and nurses - a comparison between two Swedish universities
2010 (English)In: JOURNAL OF INTERPROFESSIONAL CARE, ISSN 1356-1820, Vol. 24, no 3, p. 242-250Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate differences in attitudes towards collaboration between doctors and nurses among medical students in two medical schools Gothenburg University (GU), which did not offer interprofessional education, and Linkoping University (LiU), with a curriculum containing an interprofessional education programme; between male and female students; and between those with previous working experience in medical care and those without. A questionnaire, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, was distributed to 314 first year and final year students at GU and LiU 261 (82%) answers were received. There was no significant difference in attitudes toward collaboration, between first students at GU and LiU, between final year students at the two universities; and between those who had or did not have earlier experience of working in health care. There was a significant difference between male and female students (p = 0.0017) implying a more positive attitude among female students. Females were in majority among final year students (females 80 and males 46) final year, yet, students at both universities did not show a more positive attitude towards collaboration, than did first year students. It was concluded that students who had an interprofessional thread within their medical curriculum did not show different attitudes towards collaboration. The impact of the interprofessional teaching and training programme is discussed and further, especially longitudinal, studies are advocated.andlt;/.

Place, publisher, year, edition, pages
Taylor and Francis, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-55521 (URN)10.3109/13561820903163439 (DOI)000276624100004 ()
Available from: 2010-04-30 Created: 2010-04-30 Last updated: 2010-04-30
Johansson, K., Adolfsson, L. & Foldevi, M. (2006). "Effects of Acupuncture Versus Ultrasound in Patients With Impingement Syndrome: A Randomized Clinical Trial" comment and author reply. Physical Therapy, 86, 143-145
Open this publication in new window or tab >>"Effects of Acupuncture Versus Ultrasound in Patients With Impingement Syndrome: A Randomized Clinical Trial" comment and author reply
2006 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, p. 143-145Article in journal (Other academic) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-33401 (URN)19417 (Local ID)19417 (Archive number)19417 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Faresjö (Olsen), Å., Grodzinsky, E., Johansson, S., Foldevi, M. & Wallander, M.-A. (2006). Patients with irritable bowel syndrome in primary care appear not to be heavy health care utilisers. Alimentary Pharmacology and Therapeutics, 23(6), 807-814
Open this publication in new window or tab >>Patients with irritable bowel syndrome in primary care appear not to be heavy health care utilisers
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2006 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 23, no 6, p. 807-814Article in journal (Refereed) Published
Abstract [en]

Background

Irritable bowel syndrome is a frequently diagnosed gastrointestinal condition in general practice. Managing this chronic condition requires a co-ordinated effort between patient and doctor.

Aim

To explore the patterns of treatment and healthcare utilization of irritable bowel syndrome cases in a Swedish primary care setting.

Methods

All cases with a registered diagnosis of irritable bowel syndrome were identified retrospectively for a 5-year period through computerized medical records at three primary healthcare centres in Sweden. Documentation of diagnosis, healthcare visits, treatments, investigations, medications, referrals, laboratory tests, mental and demographic data were retrieved from the records.

Results

Of all 723 irritable bowel syndrome patients identified, only 37% had a follow-up appointment to their General Practitioner during the study period. For 80%, the General Practitioner initiated some treatment during the initial consultation and 75% were prescribed medication. Fibre and bulking laxatives and acid-suppressive drugs were the most common medication. Almost a quarter was referred for complementary investigations at hospital, only 8.9% of the irritable bowel syndrome patients were referred to a specialist investigation. Laboratory investigations varied and were ordered more frequently (P = 0.05) for men.

Conclusions

Irritable bowel syndrome patients appear not to be heavy utilizers of primary care and, of those who attend, the majority are managed by their General Practitioner.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13966 (URN)10.1111/j.1365-2036.2006.02815.x (DOI)
Available from: 2006-09-19 Created: 2006-09-19 Last updated: 2017-12-13
Faresjö (Olsen), Å., Grodzinsky, E., Johansson, S., Wallander, M.-A. & Foldevi, M. (2006). Patients with irritable bowel syndrome in Swedish primary care. European Journal of General Practice, 12(2), 88-90
Open this publication in new window or tab >>Patients with irritable bowel syndrome in Swedish primary care
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2006 (English)In: European Journal of General Practice, ISSN 1381-4788, Vol. 12, no 2, p. 88-90Article in journal (Refereed) Published
Keywords
Consultation; consulting incidence; IBS; primary health care; stress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13965 (URN)10.1080/13814780600872937 (DOI)
Available from: 2006-09-19 Created: 2006-09-19 Last updated: 2013-09-05
Agvall, B., Borgquist, L., Foldevi, M. & Dahlström, U. (2005). Cost of heart failure in Swedish primary healthcare. Scandinavian Journal of Primary Health Care, 23, 227-232
Open this publication in new window or tab >>Cost of heart failure in Swedish primary healthcare
2005 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 23, p. 227-232Article in journal (Refereed) Published
Abstract [en]

Objectives. To calculate the cost for patients with heart failure (HF) in a primary healthcare setting. Design. Retrospective study of all available patient data during a period of one year. Setting. Two healthcare centers in Linköping in the southeastern region of Sweden, covering a population of 19 400 inhabitants. Subjects. A total of 115 patients with a diagnosis of HF. Main outcome measures. The healthcare costs for patients with HF and the healthcare utilization concerning hospital days and visits to doctors and nurses in hospital care and primary healthcare. Results. The mean annual cost for a patient with HF was SEK 37 100. There were no significant differences in cost between gender, age, New York Heart Association functional class, and cardiac function. The distribution of cost was 47% for hospital care, 22% for primary healthcare, 18% for medication, 5% for nursing home, and 6% for examinations. Conclusion. Hospital care accounts for the largest cost but the cost in primary healthcare is larger than previously shown. The total annual cost for patients with HF in Sweden is in the range of SEK 5.0–6.7 billion according to this calculation, which is higher than previously known.Read More: http://informahealthcare.com/doi/abs/10.1080/02813430500197647

Keywords
cost heart failure
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-32240 (URN)10.1080/02813430500197647 (DOI)18115 (Local ID)18115 (Archive number)18115 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Johansson, K., Adolfsson, L. & Foldevi, M. (2005). Effects of acupuncture versus ultrasound for patients with impingement syndrome: Randomized clinical trial. Physical Therapy, 85(6), 490-501
Open this publication in new window or tab >>Effects of acupuncture versus ultrasound for patients with impingement syndrome: Randomized clinical trial
2005 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 85, no 6, p. 490-501Article in journal (Refereed) Published
Abstract [en]

Background and Purpose. There is no definitive evidence for the efficacy of the physical therapy interventions used for patients with impingement syndrome. The purpose of this study was to compare manual acupuncture and continuous ultrasound, both applied in addition to home exercises, for patients diagnosed with impingement syndrome.

Subjects and Methods. Eighty-five patients with clinical signs of impingement syndrome were randomly assigned to either a group that received acupuncture (n=44) or a group that received ultrasound (n=41). Both interventions were given by physical therapists twice a week for 5 weeks in addition to a home exercise program. Scores from 3 shoulder disability measures, combined in the analysis, measured change during a period of 12 months.

Results. Both groups improved, but the acupuncture group had a larger improvement in the combined score.

Discussion and Conclusion. The results suggest that acupuncture is more efficacious than ultrasound when applied in addition to home exercises.

Keywords
Family practice, Home exercise program, Physical therapy, Rotator cuff, Subacromial pain
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14393 (URN)
Note
Original Publication: Kajsa Johansson, Lars Adolfsson and Mats Foldevi, Effects of acupuncture versus ultrasound for patients with impingement syndrome: Randomized clinical trial, 2005, Physical Therapy, (85), 6, 490-501. http://ptjournal.apta.org/cgi/reprint/85/6/490 Copyright2005 Apta American Physical Therapy Association http://www.apta.org/ Available from: 2007-04-05 Created: 2007-04-05 Last updated: 2017-12-13
Wilhelmsson, S. & Foldevi, M. (2003). Exploring views on Swedish district nurses' prescribing: a focus group study in primary health care. Journal of Clinical Nursing, 12(5), 643-650
Open this publication in new window or tab >>Exploring views on Swedish district nurses' prescribing: a focus group study in primary health care
2003 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 5, p. 643-650Article in journal (Refereed) Published
Abstract [en]

• Since 1994 district nurses (DNs) in Sweden have been permitted to prescribe drugs from a limited list. This reform has met severe resistance from doctors and the opinions of general practitioners (GPs) and DNs have differed in many aspects.

•  The aim of this study was to gain deeper understanding of the different opinions about DNs' prescribing and to explore the impact of the reform on primary care.

• Six focus group interviews were conducted, four with DNs and two with GPs.

•  Data analysis revealed six categories, which were condensed into two dimensions. The dimensions were individual prerequisites, with the categories responsibility and knowledge, and organizational prerequisites, with the categories distribution of work, climate of co-operation, resistance and economic considerations.

•  District nurses were very positive towards prescribing and had gained new knowledge through the compulsory training course and via discussions with pharmacists. Because of the responsibility required for prescribing, some nurses had introduced systems for self-monitoring. Prescribing was seen as a natural part of the nursing process. All interviewees could describe periods of resistance against the reform, and the head of the health centre was a key person for attitudes at the workplace.

• The DNs found the nurse prescribing reform very positive. They experienced a strengthening of professionalism and also thought that the reform was a natural development. Negative attitudes and opinions offset the positive feelings. The resistance that had appeared in the beginning had now turned into silent acceptance.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-28308 (URN)10.1046/j.1365-2702.2003.00716.x (DOI)13440 (Local ID)13440 (Archive number)13440 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
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