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Lindberg, Malou
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Publications (10 of 30) Show all publications
Johnson, C., Wilhelmsson, S., Börjeson, S. & Lindberg, M. (2015). Improvement of communication and interpersonal competence in telenursing - development of a self-assessment tool. Journal of Clinical Nursing, 24(11-12), 1489-1501
Open this publication in new window or tab >>Improvement of communication and interpersonal competence in telenursing - development of a self-assessment tool
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 11-12, p. 1489-1501Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesThe aim of this study was to develop a self-assessment tool aiming to raise telenurses awareness of their communication and interpersonal competence, and highlight areas in need of improvement. BackgroundSeveral studies have revealed the need for development of communication competence in telenursing. Structured analyses of conversations with patients/callers, is one way to increase telenurses awareness of their unique communication and interpersonal competence. DesignInstrument development, Validation assessment using the method Content Validity Index. MethodThe process to determine content validity was done in two stages; the development stage and the assessment stage. The development stage started with a literature search. The assessment stage was separated into two phases, assessment by an expert group and assessment and test by telenurses. The telenurses also participated in consensus discussions. ResultsA telenursing self-assessment tool with 58 items was developed. The items were sorted into five sections according to the nursing process. ConclusionThis study describes the thorough development process of the telenursing self-assessment tool to be used by telenurses in order to become aware of their unique communication and interpersonal competence when analysing their own conversations with patients/callers. As a formative tool it is meant to provide self-direction, feedback and coaching, and create learning opportunities. Relevance to clinical practiceThe self-assessment tool helps the telenurse to follow the nursing process, to be patient-centred, and it is meant to provide self-direction, feedback, and coaching, as well as create learning opportunities. The tool can contribute to the development of communication and interpersonal competence in telephone advice nursing. Further development of the tool may provide an objective scoring instrument for evaluating communication training and education in the field.

Place, publisher, year, edition, pages
Wiley: 12 months, 2015
Keywords
clinical competence; communication; hotlines; instrument development; nurse-patient relations; self-assessment; telenursing; triage
National Category
Communication Studies
Identifiers
urn:nbn:se:liu:diva-119577 (URN)10.1111/jocn.12705 (DOI)000355331300006 ()25393698 (PubMedID)
Note

Funding Agencies|National Medical Advisory Service Ltd (in Swedish Sjukvardsradgivningen SVR AB); County Council of Ostergotland, Sweden

Available from: 2015-06-23 Created: 2015-06-22 Last updated: 2019-01-04
Josefsson, A., Wiréhn, A.-B., Lindberg, M., Foldemo, A. & Brynhildsen, J. (2013). Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005-2010. BMJ Open, 3(10)
Open this publication in new window or tab >>Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005-2010
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2013 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 10Article in journal (Refereed) Published
Abstract [en]

Objective To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives.                                

Design A longitudinal national population-based registry study.                                

Setting The Swedish prescribed drug register.                                

Participants All women born between 1977 and 1994 defined as first-time users of hormonal contraceptives from 2007 to 2009 (n=226 211).                                

Main outcome measures A tendency to switch the type of hormonal contraceptive within 6 months use and repeated dispensation identical to the first were estimated as percentages and relative risks (RRs). Physicians’ and midwives’ prescription patterns concerning the women's                                    continuation rates of oral hormonal contraceptive type.                                

Results In Sweden, there were 782 375 women born between 1977 and 1994 at the time of the study. Of these, 226 211 women were identified as first-time users of hormonal contraceptives. Ethinylestradiol+levonorgestrel, desogestrel-only and ethinylestradiol+drospirenone were the hormonal contraceptives most commonly dispensed to first-time users at rates of 43.3%, 24.4% and 11.1%, respectively. The overall rate of switching contraceptive types in the first 6 months was 11.3%, which was highest for desogestrel-only (14.3%) and lowest for ethinylestradiol+drospirenone (6.6%). The switching rate for all three products was highest in the 16-year to 19-year age group. Having a repeated dispensation identical to the initial dispensation was highest for users of ethinylestradiol either combined with levonorgestrel or drospirenone, 81.4% and 81.2%, respectively, whereas this rate for the initial desogestrel-only users was 71.5%. The RR of switching of contraceptive type within the first 6 months was 1.35 (95% CI 1.32 to 1.39) for desogestrel-only and 0.63 (0.59 to 0.66) for ethinylestradiol+drospirenone compared with ethinylestradiol+levonorgestrel as the reference category. There were no differences in the women's continuation rates depending on the prescriber categories.                                

Conclusions Desogestrel-only users conferred the highest switcher rate to another hormonal contraceptive within a 6-month period. Users of ethinylestradiol+levonorgestrel were more prone to switch to another product within 6 months than women using ethinylestradiol+drospirenone. These findings may be of clinical importance when tailoring hormonal contraceptives on an individual basis.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100021 (URN)10.1136/bmjopen-2013-003401 (DOI)000326882800028 ()
Available from: 2013-10-25 Created: 2013-10-25 Last updated: 2019-06-28Bibliographically approved
Carlfjord, S., Lindberg, M. & Andersson, A. (2013). Sustained use of a tool for lifestyle intervention implemented in primary health care: a 2-year follow-up. Journal of Evaluation In Clinical Practice, 19(2), 327-334
Open this publication in new window or tab >>Sustained use of a tool for lifestyle intervention implemented in primary health care: a 2-year follow-up
2013 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 19, no 2, p. 327-334Article in journal (Refereed) Published
Abstract [en]

Rational, aims and objectives: Sustainability of new methods implemented in health care is one of the most central issues in addressing the gap between research and practice, but is seldom assessed in implementation studies. The aim of this study was to evaluate the implementation of a new tool for lifestyle intervention in primary health care (PHC) 2 years after the introduction, and assess if the implementation strategy used influenced sustainability.

Method: A computer-based lifestyle intervention tool (CLT) was introduced at six PHC units in Sweden in 2008, using two implementation strategies: explicit and implicit. The main difference between the strategies was a 4-week test period followed by a decision session, included in the explicit strategy. Evaluations were performed after 6, 9 and 24 months. After 24 months, the RE-AIM framework was applied to assess and compare outcome according to strategy.

Results: A more positive outcome regarding Reach, Effectiveness, Adoption and Implementation in the explicit group could be almost completely attributed to one of the units. Maintenance was low and after 24 months, differences according to strategy were negligible.

Conclusion: After 24 months the most positive outcomes regarding all RE-AIM dimensions were found in one of the units where the explicit strategy was used. The explicit strategy per se had some effect on the dimension Effectiveness, but was not associated with sustainability overall. Staff at the most successful unit earlier had positive expectations regarding the CLT and found it compatible with existing routines.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
Keywords
implementation, lifestyle, primary health care, sustainability
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-74877 (URN)10.1111/j.1365-2753.2012.01827.x (DOI)000315964800017 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS)||Swedish Council for Working Life and Social Research (FAS)||

Available from: 2012-02-10 Created: 2012-02-10 Last updated: 2017-12-07Bibliographically approved
Carlfjord, S., Andersson, A., Bendtsen, P., Nilsen, P. & Lindberg, M. (2012). Applying the RE-AIM framework to evaluate two implementation strategies used to introduce a tool for lifestyle intervention in Swedish primary health care. Health Promotion International, 27(2), 167-176
Open this publication in new window or tab >>Applying the RE-AIM framework to evaluate two implementation strategies used to introduce a tool for lifestyle intervention in Swedish primary health care
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2012 (English)In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 27, no 2, p. 167-176Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate two implementation strategies for the introduction of a lifestyle intervention tool in primary health care (PHC), applying the RE-AIM framework to assess outcome. A computer-based tool for lifestyle intervention was introduced in PHC. A theory-based, explicit, implementation strategy was used at three centers, and an implicit strategy with a minimum of implementation efforts at three others. After 9 months a questionnaire was sent to staff members (n= 159) and data from a test database and county council registers were collected. The RE-AIM framework was applied to evaluate outcome in terms of reach, effectiveness, adoption and implementation. The response rate for the questionnaire was 73%. Significant differences in outcome were found between the strategies regarding reach, effectiveness and adoption, in favor of the explicit implementation strategy. Regarding the dimension implementation, no differences were found according to the implementation strategy. A theory-based implementation strategy including a testing period before using a new tool in daily practice seemed to be more successful than a strategy in which the tool was introduced and immediately used for patients.                 

Place, publisher, year, edition, pages
Oxford University Press, 2012
Keywords
Implementation; Primary health care; RE-AIM
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-73379 (URN)10.1093/heapro/dar016 (DOI)000304016100004 ()
Available from: 2012-01-13 Created: 2012-01-02 Last updated: 2017-12-08Bibliographically approved
Lindberg, M., Foldemo, A., Josefsson, A. & Wiréhn, A.-B. (2012). Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: A nationwide population-based study with age-specific analyses. European journal of contraception & reproductive health care, 17(2), 106-118
Open this publication in new window or tab >>Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: A nationwide population-based study with age-specific analyses
2012 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 17, no 2, p. 106-118Article in journal (Refereed) Published
Abstract [en]

Objectives To examine, among young women, the association of individual hormonal contraceptives, within two broad groupings, with antidepressant therapy. less thanbrgreater than less thanbrgreater thanMethods In a nationwide register-based study, we examined the prescription rates of antidepressant drugs in relation to individual combined hormonal and progestin-only contraceptives among Swedish women aged 16-31 years (N = 917,993). Drug data were obtained from the Swedish Prescribed Drug Register for the period 1 July 2005-30 June 2008. Data on the total population of women aged 16-31 in 2008 were obtained from the Total Population Register of Statistics Sweden. The proportion of women using both hormonal contraception and antidepressants, and odds ratios (ORs) for antidepressant use for hormonal contraceptive users versus non-users, were calculated, the latter by logistic regression, for each formulation. less thanbrgreater than less thanbrgreater thanResults The highest antidepressant OR in all age groups, particularly in the 16-19 years age group, related to medroxyprogesterone-only, followed by etonogestrel-only, levonorgestrel-only and ethinylestradiol/norelgestromin formulations. Oral contraceptives containing ethinylestradiol combined with lynestrenol or drospirenone had considerably higher ORs than other pills. ORs significantly lower than 1 were observed when ethinylestradiol was combined with norethisterone, levonorgestrel or desogestrel. less thanbrgreater than less thanbrgreater thanConclusion The association between use of hormonal contraceptives and antidepressant drugs varies considerably within both the combined hormonal contraceptive and the progestin-only groups.

Place, publisher, year, edition, pages
Informa Healthcare, 2012
Keywords
Antidepressants, Combined hormonal contraceptives, Depression, Hormonal contraceptives, Progestin-only contraceptives, Mood, Registries
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-76525 (URN)10.3109/13625187.2012.658925 (DOI)000301493800003 ()
Note
Funding Agencies|Swedish Society of Medicine Soderstrom-Konigska Foundation||Available from: 2012-04-12 Created: 2012-04-11 Last updated: 2019-06-28
Lindberg, M., Foldemo, A., Josefsson, A. & Wiréhn, A.-B. (2012). Differences in prescription rates of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study. Paper presented at Reproductive epidemiology in a life course perspective. Lund, Sweden, 2012.
Open this publication in new window or tab >>Differences in prescription rates of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study
2012 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76900 (URN)
Conference
Reproductive epidemiology in a life course perspective. Lund, Sweden, 2012
Available from: 2012-04-24 Created: 2012-04-24 Last updated: 2019-06-28
Carlfjord, S., Lindberg, M. & Andersson, A. (2012). Staff perceptions of addressing lifestyle in primary health care: a qualitative evaluation 2 years after the introduction of a lifestyle intervention tool. BMC Family Practice, 13(99)
Open this publication in new window or tab >>Staff perceptions of addressing lifestyle in primary health care: a qualitative evaluation 2 years after the introduction of a lifestyle intervention tool
2012 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 13, no 99Article in journal (Refereed) Published
Abstract [en]

Background: Preventive services and health promotion in terms of lifestyle counselling provided through primary health care (PHC) has the potential to reduce morbidity and mortality in the population. Health professionals in general are positive about and willing to develop a health-promoting and/or preventive role. A number of obstacles hindering PHC staff from addressing lifestyle issues have been identified, and one facilitator is the use of modern technology. When a computer-based tool for lifestyle intervention (CLT) was introduced at a number of PHC units in Sweden, this provided an opportunity to study staff perspectives on the subject. The aim of this study was to explore PHC staffs perceptions of handling lifestyle issues, including the consultation situation as well as the perceived usefulness of the CLT. less thanbrgreater than less thanbrgreater thanMethods: A qualitative study was conducted after the CLT had been in operation for 2 years. Six focus group interviews, one at each participating unit, including a total of 30 staff members with different professions participated. The interviews were designed to capture perceptions of addressing lifestyle issues, and of using the CLT. Interview data were analysed using manifest content analysis. less thanbrgreater than less thanbrgreater thanResults: Two main themes emerged from the interviews: a challenging task and confidence in handling lifestyle issues. The first theme covered the categories responsibilities and emotions, and the second theme covered the categories first contact, existing tools, and role of the CLT. Staff at the units showed commitment to health promotion/prevention, and saw that patients, caregivers, managers and politicians all have responsibilities regarding the issue. They expressed confidence in handling lifestyle-related conditions, but to a lesser extent had routines for general screening of lifestyle habits, and found addressing alcohol the most problematic issue. The CLT, intended to facilitate screening, was viewed as a complement, but was not considered an important tool for health promotion/prevention. less thanbrgreater than less thanbrgreater thanConclusion: Additional resources, for example in terms of manpower, may help to build the structures necessary for the health promotion/prevention task. Committed leaders could enhance the engagement among staff. Cooperation in multi-professional teams seems to be important, and methods or tools perceived by staff as compatible have a potential to be successfully implemented. Economic incentives rewarding quantity rather than quality appear to be frustrating to PHC staff.

Place, publisher, year, edition, pages
BioMed Central, 2012
Keywords
Staff perception, Lifestyle counselling, Primary health care, Computerized tool
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-87253 (URN)10.1186/1471-2296-13-99 (DOI)000312275300001 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS)||Swedish Council for Working Life and Social Research (FAS)||

Available from: 2013-01-14 Created: 2013-01-14 Last updated: 2017-12-06
Carlfjord, S., Andersson, A. & Lindberg, M. (2011). Experiences of the implementation of a tool for lifestyle intervention in primary health care: a qualitative study among managers and professional groups. BMC Health Services Research, 11(195)
Open this publication in new window or tab >>Experiences of the implementation of a tool for lifestyle intervention in primary health care: a qualitative study among managers and professional groups
2011 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 11, no 195Article in journal (Refereed) Published
Abstract [en]

Background:In recent years there has been increasing interest in transferring new knowledge into health care practices, a process often referred to as implementation. The various subcultures that exist among health care workers may be an obstacle in this process. The aim of this study was to explore how professional groups and managers experienced the implementation of a new tool for lifestyle intervention in primary health care (PHC). The computer-based tool was introduced with the intention of facilitating the delivery of preventive services.

Methods:Focus group interviews with staff and individual interviews with managers at six PHC units in the southeast of Sweden were performed 9 months after the introduction of the new working tool. Staff interviews were conducted in groups according to profession, and were analysed using manifest content analysis. Experiences and opinions from the different staff groups and from managers were analysed.

Results: Implementation preconditions, opinions about the lifestyle test, and opinions about usage were the main areas identified. In each of the groups, managers and professionals, factors related to the existing subcultures seemed to influence their experiences of the implementation. Managers were visionary, GPs were reluctant, nurses were open, and nurse assistants were indifferent.

Conclusion: This study indicates that the existing subcultures in PHC influence how the implementation of an innovation is perceived by managers and the different professionals. In PHC, an organization with several subcultures and an established hierarchical structure, an implementation strategy aimed at all groups did not seem to result in a successful uptake of the new method.

Place, publisher, year, edition, pages
BioMed Central, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71112 (URN)10.1186/1472-6963-11-195 (DOI)000294735700002 ()
Available from: 2011-09-30 Created: 2011-09-30 Last updated: 2017-12-08
Carlfjord, S., Kristenson, M. & Lindberg, M. (2011). Experiences of Working with the Tobacco Issue in the Context of Health Promoting Hospitals and Health Services: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 8(2), 498-513
Open this publication in new window or tab >>Experiences of Working with the Tobacco Issue in the Context of Health Promoting Hospitals and Health Services: A Qualitative Study
2011 (English)In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, ISSN 1660-4601, Vol. 8, no 2, p. 498-513Article in journal (Refereed) Published
Abstract [en]

The worldwide Health Promoting Hospital and Health Services (HPH) network was initiated by the World Health Organizations in the late 1980s. The goal of the network is to change the focus of health services from curing patients to also embrace disease prevention and health promotion. In Sweden the network started in 1996, and involves mainly hospitals and primary care. The network members collaborate in task forces, one of which is working on the tobacco issue. There is limited evidence on the value of working within an HPH organization. The aim of this study was to investigate the experiences of members of the Swedish HPH network tobacco task force. Focus group interviews with task force members were analyzed using implementation theory. Three themes, overall experiences of working with tobacco issues, experiences of working with. free from tobacco in connection with surgery., and experiences of work in the HPH tobacco task force, emerged from the interviews. The results show that working with the tobacco issue in the context of health-promoting hospitals and health services met with difficulties involving the following important factors: evidence, context, facilitation and adopter characteristics. Leadership, one contextual factor, at national and local level, seems to be crucial if the work is going to succeed. The tobacco task force of the HPH network is an important facilitator supporting the task.

Place, publisher, year, edition, pages
MDPI AG, 2011
Keywords
health-promoting hospitals, setting-based health promotion, smoking cessation, tobacco, public health, anti-tobacco policy making
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-66296 (URN)10.3390/ijerph8020498 (DOI)000287733200013 ()
Available from: 2011-03-11 Created: 2011-03-11 Last updated: 2014-09-25
Carlfjord, S., Andersson, A., Bendtsen, P., Nilsen, P. & Lindberg, M. (2010). IMPLEMENTING A LIFESTYLE INTERVENTION TOOL INTO PRIMARY HEALTH CARE: IDENTIFICATION OF KEY FACTORS THAT INFLUENCE ADOPTION in INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, vol 17, issue , pp 92-92. In: INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (pp. 92-92). Springer Science Business Media, 17
Open this publication in new window or tab >>IMPLEMENTING A LIFESTYLE INTERVENTION TOOL INTO PRIMARY HEALTH CARE: IDENTIFICATION OF KEY FACTORS THAT INFLUENCE ADOPTION in INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, vol 17, issue , pp 92-92
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2010 (English)In: INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, Springer Science Business Media , 2010, Vol. 17, p. 92-92Conference paper, Published paper (Refereed)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Springer Science Business Media, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-60239 (URN)000280088500215 ()
Available from: 2010-10-08 Created: 2010-10-08 Last updated: 2013-09-30
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