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  • 1.
    Farsi Razavi, Monireh
    et al.
    Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Falk, Lars
    Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Dermatology and Venerology in Östergötland. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Clinical and Experimental Medicine, Dermatology and Venerology. Linköping University, Faculty of Health Sciences.
    Bjorn, Ake
    Östergötlands Läns Landsting, Centre for Teaching and Research in Disaster Medicine and Traumatology.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    Experiences of the Swedish healthcare system: An interview study with refugees in need of long-term health care2011In: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, ISSN 1403-4948, Vol. 39, no 3, p. 319-325Article in journal (Refereed)
    Abstract [en]

    Background: Refugees needing long-term health care must adapt to new healthcare systems. The aim of this study was to examine the viewpoints of nine refugees in a county in Sweden, with a known chronic disease or functional impairment requiring long-term medical care, on their contacts with care providers regarding treatment and personal needs. Methods: Semi-structured interviews with nine individuals and/or their next of kin. Inductive content analysis was used to identify experiences. Results: "Care organisations/resources" and "professional competence" were the categories extracted. Participants felt cared for due to accessibility to and regular appointments with the same care provider. Visiting different clinics contributed to a negative experience and lack of trust. The staffs interest in participants lives and health contributed to a sense of professionalism. Most participants said the problems experienced were not related to their backgrounds as refugees. Many patients did not fully understand which clinic they were attending or the purpose of the care that the specific clinic provided. Some lacked knowledge of their disease. Conclusions: Health care was perceived as equal to other Swedish citizens and problems experienced were not explained by refugee backgrounds. Lack of information from care providers and being sent to various levels of care created feelings of a lack of overall medical responsibility.

  • 2. Johnson, Christina
    et al.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.
    Börjeson, Sussanne
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Lindberg, Malou
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.
    Improvement of communication and interpersonal competence in telenursing - development of a self-assessment tool2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 11-12, p. 1489-1501Article in journal (Refereed)
    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.

  • 3.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Lind, Mildrid
    Petersson, Susanne
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The use of clinical guidelines for asthma, diabetes, and hypertension in primary health care2005In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 17, p. 217-220Article in journal (Refereed)
  • 4.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Have national goals for public health been implemented in Swedish primary care?2006In: Ninth international congress of behavioral medicine,2006, 2006, p. 246-246Conference paper (Other academic)
    Abstract [en]

       

  • 5.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Health prevention and health promotion methods and methodology used by nurses in primary health care2005In: International Council of Nurses 23rd Quadrennial Congress,2005, 2005, p. 51-51Conference paper (Refereed)
  • 6.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    National public health target awareness of staff at two organisational levels in health care2007In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 84, p. 243-248Article in journal (Refereed)
  • 7.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The use of clinical guidelines for asthma, diabetes and hypertension in primary health care2004In: WONCA,2004, 2004, p. 99-99Conference paper (Refereed)
  • 8.
    Lindberg, Malou
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    "Vem bryr sig?" Distriktssköterskans förebyggande och hälsofrämjande arbete : ett svårprioriterat uppdrag och en outnyttjad resurs2005Report (Other academic)
  • 9.
    Lorefelt, Birgitta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Andersson, Agneta
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Wiréhn, Ann-Britt
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional status and health care costs for the elderly living in municipal residential homes — An intervention study2011In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 15, no 2, p. 92-97Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The aim was to study the effect of individualised meals on nutritional status among older people living in municipal residential homes and to compare the results with a control group. An additional aim was to estimate direct health care costs for both groups.

    SETTING:

    Six different municipal residential homes in the south-east of Sweden.

    PARTICIPANTS:

    Older people living in three residential homes constituted the intervention group n=42 and the rest constituted the control group n=67.

    INTERVENTION:

    A multifaceted intervention design was used. Based on an interview with staff a tailored education programme about nutritional care, including both theoretical and practical issues, was carried through to staff in the intervention group. Nutritional status among the elderly was measured by Mini Nutritional Assessment (MNA), individualised meals were offered to the residents based on the results of the MNA. Staff in the control group only received education on how to measure MNA and the residents followed the usual meal routines.

    MEASUREMENTS:

    Nutritional status was measured by MNA at baseline and after 3 months. Cost data on health care visits during 2007 were collected from the Cost Per Patient database.

    RESULTS:

    Nutritional status improved and body weight increased after 3 months in the intervention group. Thus, primary health care costs constituted about 80% of the total median cost in the intervention group and about 55% in the control group.

    CONCLUSION:

    With improved knowledge the staff could offer the elderly more individualised meals. One of their future challenges is to recognise and assess nutritional status among this group. If malnutrition could be prevented health care costs should be reduced.

  • 10.
    Lorefält, Birgitta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    A multifaceted intervention model can give a lasting improvement of older peoples nutritional status2012In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 16, no 4, p. 378-382Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was with a multifaceted intervention model improve the nutritional status of elderly people living in residential homes to increase their energy intake and to maintain improvements over time. less thanbrgreater than less thanbrgreater thanThree different municipal residential homes in the south-east of Sweden. less thanbrgreater than less thanbrgreater thanThe study population consisted of 67 elderly people. A within-subjects design was used which means that the participants were their own controls. less thanbrgreater than less thanbrgreater thanA multifaceted intervention model was chosen, which included education on both theoretical and practical issues, training and support for staff, and individualized snacks to the residents. less thanbrgreater than less thanbrgreater thanNutritional status was measured by Mini Nutritional Assessment (MNA), the consumption of food was recorded by the staff using a food record method for 3 consecutive days. The length of night-time fasting has been calculated from the food records. less thanbrgreater than less thanbrgreater thanNutritional status improved after 3 months of intervention and was maintained after 9 months. Weight increased during the whole study period. Night-time fasting decreased but not to the recommended level. less thanbrgreater than less thanbrgreater thanThis study shows that it is possible by a multifaceted intervention model to increase energy intake including expanding snacks and thereby improve and maintain nutritional status over a longer period in the elderly living in residential homes. This result was possible to achieve because staff received education and training in nutritional issues and by provision of support during a period when new routines were introduced.

  • 11.
    Roos, Susanne
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Women with coeliac disease living on a gluten-free diet for years continue to seek more health care - A controlled study2009Conference paper (Refereed)
  • 12.
    Roos, Susanne
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Hellström, Ingrid
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The Worried well: Women living with Coeliac disease in SwedenManuscript (preprint) (Other academic)
    Abstract [en]

    Aims and objectives: To explore how women with coeliac disease (CD) experience everyday life and their outlook on their future.

    Background: Women who are diagnosed with CD and who are recommended to eat a gluten-free diet for life is likely to undergo a transition. It is therefore important that health professionals have insight into what it is like to live with a chronic illness and the factors that affect the lives of women who have CD.

    Design: A qualitative approach with interviews was used. The inclusion criteria were: woman aged 20 years or more, CD diagnosed at least 2 years prior to inclusion, following a gluten-free diet and speaking Swedish fluently.

    Method: A conventional content analysis was used for the subjective interpretation of the data content.

    Results: Three main themes emerged in the analysis: illness trajectory and treatment, socializing with others and feelings of loneliness and worries. The findings indicate that living with CD affects the person’s entire life from the past, in the present, and into the future, especially when daily routines must be altered.

    Conclusions: The women expressed a sense of loneliness and invisibility and are constantly worried about their health, which extended to the management of their diet when socializing with others. The diet is viewed as a friend, an enemy, an obstacle and an opportunity to enjoy a good life.

    Relevance to clinical practice: Supporting women diagnosed with CD as adults during successful adaptation to their chronic illness appears to be a major task for health care professionals. Health care needs to address these women’s symptoms, worries and sense of invisibility.

  • 13.
    Roos, Susanne
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Ingrid, Hellström
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Susan, Wilhelmsson
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Everyday life for women with celiac disease2013In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 36, no 4, p. 266-273Article in journal (Refereed)
    Abstract [en]

    The aim of this research was to explore how women with celiac disease experience everyday life. It is important that healthcare professionals understand what it is like to live with a chronic illness, and also the factors that affect the lives of women who have celiac disease. The study has a qualitative approach and the data were collected using interviews with 16 women. A conventional content analysis was used for the subjective interpretation of the qualitative interviews. Three main themes emerged in the analysis: illness trajectory and treatment, socializing with others, and feelings of loneliness and worry. The findings indicate that living with celiac disease affects the person's entire life from the past, in the present, and into the future, especially when daily routines must be altered. The women expressed a sense of loneliness and invisibility, especially when socializing with others. The diet could be a friend, enemy, obstacle, or opportunity in terms of enjoying a good life. Supporting women diagnosed with celiac disease appears to be a major task for healthcare professionals. Such professionals need to pay attention to women's symptoms, worries, and their feeling of being invisible.

  • 14.
    Roos, Susanne
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Swedish women with coeliac disease in remission use more health care services than other women: a controlled study2011In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 46, no 1, p. 13-19Article in journal (Refereed)
    Abstract [en]

    Objective. To examine whether the perceived poor outcome of dietary treatment makes Swedish women with coeliac disease (CD) prone to use more health care services than other women. Material and methods. The health care consumption over 36 consecutive months was examined for 137 Swedish women aged 20-80 years with CD in remission after living on a gluten-free diet for a median of 4 years (range 1-8 years). Comparisons were made with the health care consumption of 411 women in the general population matched for age and residence. Results. The results show that women with CD use health care services annually a median of 5.0 times (range 0-76) that is more than female controls 3.6 (0-311) (p andlt; 0.05) mainly in primary care and for complaints related to mental and behavioral disorders (ICD F), diseases of the digestive system (ICD K) and diseases of the musculoskeletal system and connective tissue (ICD M). Conclusions. Women with CD used health care services in keeping with studies indicating reduced health-related quality of life of people with this condition. The results provide evidence that women with CD in remission suffer from co-morbidities that may signal a need for a multidisciplinary follow-up of subjects with CD in Sweden.

  • 15.
    Roos, Susanne
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    Vulcan, Alexandra
    Lunds universitet.
    Sjöberg, Klas
    Lunds universitet.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease2011In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 3, no 3, p. 302-309Article in journal (Refereed)
    Abstract [en]

    Aim. To explore if gastrointestinal (GI) symptoms, self-image and comorbidity are related to well-being in women with coeliac disease (CD) and whether a history of CD in childhood impacts on well-being in adulthood.

    Background. Women in Sweden living with CD show a reduced level of well-being and report a high rate of GI complaints for unclear reasons. The self-image of these women is unknown.

    Design. A cross-sectional survey of 231 Swedish women with CD on long-term treatment (≥5 years) with a gluten-free diet (GFD) was conducted in 2010.

    Results.  The study showed that well-being is related to a high rate GI symptoms (OR 16·9, 95% CI 5·6-50·7), a negative self-image (OR 8·9, 95% CI 3·5-22·9) and comorbidity (OR 3·3, 95% CI 1·7-6·4). There was no impact of childhood symptoms on well-being, GI symptoms, self-image or comorbidity in adulthood. Half of the study population showed reduced well-being compared with norms. Practically all women (97%) declared that they were always or usually following a GFD and 62% reported at least one disease besides CD.

    Conclusion. The study demonstrated that the well-being of women living with CD is affected by GI complaints, self-image and a high rate of comorbidity whereas a history of signs and symptoms of CD in childhood not seems to impact on the well-being in adulthood.

    Relevance to clinical practice. Gastrointestinal symptoms, self-image and comorbidity are factors contributing to a low level of well-being of CD women living on a GFD. Launching a multi-disciplinary team for follow-up would represent a novel approach to support these women and may prove valuable in improving their subjective health.

  • 16. Strandberg, E L
    et al.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The meaning of a holistic view in primary health care in Sweden2004In: WONCA,2004, 2004Conference paper (Refereed)
  • 17. Strandberg, Eva Lena
    et al.
    Ovhed, Ingvar
    Borgquist, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care: a qualitative study2007In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296Article in journal (Refereed)
  • 18.
    Strömfors, Lina
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Falk, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Dermatology and Venerology. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Höst, Gunnar E.
    Linköping University, Department of Science and Technology, Media and Information Technology. Linköping University, The Institute of Technology.
    Condition-related knowledge among children and adolescents with spina bifida in a Swedish county2014In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 16, no 2, p. 127-140Article in journal (Refereed)
    Abstract [en]

    Spina bifida is a congenital birth defect, resulting in physical and cognitive dysfunctions. Condition-related knowledge among children and adolescents with spina bifida is essential to facilitate independent management of their condition. The aim was to describe the condition-related knowledge among children and adolescents with spina bifida in a Swedish county. Thirteen persons with spina bifida (10 to 17 years) participated. Condition-related knowledge was assessed (n = 13) using a questionnaire (KOSB) and a semi-structured interview (n = 8). Interview data were analyzed using qualitative content analysis. The participants had well-developed knowledge concerning proper bladder management, but were lacking knowledge of signs of shunt malfunctioning and etiology. Some participants were uninterested in learning about their condition, despite being aware that they lacked knowledge. The findings indicate potential areas that may be included in local educational initiatives. It should be considered that persons with spina bifida may not be motivated to learn more about their condition.

  • 19.
    Strömfors, Lina
    et al.
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Child and Adult Habilitation in Norrköping. Linköping University, Faculty of Medicine and Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Falk, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Region Östergötland, Heart and Medicine Center, Department of Dermatology and Venerology.
    Höst, Gunnar E.
    Linköping University, Department of Science and Technology, Media and Information Technology. Linköping University, The Institute of Technology.
    Experiences among children and adolescents of living with spina bifida and their visions of the future2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 3, p. 261-271Article in journal (Refereed)
    Abstract [en]

    Purpose: Transitioning to independence may be problematic for persons with spina bifida (SB). Experiences of young persons with SB may provide insights into this group's needs for support. Therefore, the aim of this study was to investigate children'€™s and adolescents' experiences of living with SB, their social and emotional adjustment, and their thoughts about becoming independent adults. Method: Semi-structured interviews were conducted with young persons with SB (N = 8, age range 10 - 17 years). Social and emotional problems were assessed using Beck Youth Inventories. The interview transcripts were analyzed using qualitative content analysis. Results: Three main themes were found: being a person with SB; everyday living as a person with SB; and preparing for life as an adult with SB. Indications of emotional and social problems were most prominent among participants with milder physical disability. Conclusions: The findings indicate that young persons with SB may overestimate their independence. Other potentially problematic areas were lack of motivation, planning and preparedness for becoming independent. Research on transition to independence in this group should consider assistance at an early age in planning and executing strategies for independence. In addition, the potentially difficult situation for young persons with mild SB should be investigated further.

  • 20.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Advancing nursing documentation an intervention study using[X]patients with leg ulcer as an example2009In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 78, no 9, p. 605-617Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to implement and evaluate a standardised nursing record, using patients with leg ulcer as an example, regarding the content of the nursing record and district nurses experiences of documentation. Method: This was a prospective, stratified and randomised intervention study, with one intervention group and one control group. A standardised nursing wound care record was designed and implemented in the electronic patient record in the intervention group for a period of 3 months. Pre- and post-intervention audits of nursing records [n = 102 and n = 92, respectively] were carried out and 126 district nurses answered questionnaires pre-intervention and 83 post-intervention. Result: The standardised nursing wound care record led to more informative, comprehensive and knowledge-intensive documentation according to the audit and district nurses opinions. Furthermore, the district nurses self-reported knowledge of nursing documentation increased in the intervention group. When the standardised nursing wound care record was not used, the documentation was mostly incomplete with a lack of nursing relevance. There were no differences in the district nurses experiences of documentation in general between the two groups. Conclusion: Using the standardised nursing wound care record improved nursing documentation meeting legal demands, which should increase the safety of patient. There was however a discrepancy between the nurses stated knowledge and how they carried out the documentation. Regular in-service training together with use of evidence based standardised nursing records, as a link to clinical reasoning about nursing care, could be ways effecting change.

  • 21.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Impact of primary care management on nursing documentation2007In: Journal of Nursing Management, ISSN 0966-0429, Vol. 15, no 6, p. 634-642Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate whether perceptions of electronic nursing documentation and its performance differed because of primary health care management.

    Background: Success in leading people depends on the manager's personality, the context and the people who are led. Close proximity to clinical work, with manager and personnel sharing the same profession, promotes the authority to carry out changes.

    Methods: This study comprised a postal questionnaire to district nurses and an audit of nursing records from two primary health care organizations, one with a uniprofessional (nursing) organization, and one with multidisciplinary health care centres with general practitioners and/or another profession as managers.

    Results: Uniprofessional nurse management increased district nurses' positive perceptions of nursing documentation but did not affect documentation performance, which was inadequate regardless of management type.

    Conclusions: Positive perceptions of nursing documentation are bases for further development to a nursing documentation including a holistic view of the patient.

  • 22.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Nursing documentation for communicating and evaluating care2008In: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 17, no 16, p. 2116-2124Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate the utility of electronic nursing documentation by exploring to what extent and for what purpose general practitioners use nursing documentation and to what extent and in which cases care unit managers use nursing documentation for quality development of care.

    Background: As health care includes multidisciplinary activities, communication about the care given is essential. To assure delivery of good and safe care, quality development is necessary. The main tool available for communication and quality development is the patient record. In many studies, nursing documentation has been found to be inadequate for this purpose.

    Design: This study had a cross-sectional descriptive design.

    Methods: Data were collected by postal questionnaires, one to the general practitioners (n = 544) and one to care unit managers (n = 82) in primary health care. Data were analysed by descriptive statistical and qualitative content analysis.

    Results: The general practitioners usually used the nursing record as the foremost source of information for treatment follow-up. The results, however, point out weaknesses and shortcomings in the nursing records, such as difficulties in finding important information because of a huge amount of routine notes. The care unit managers generally (74%) used the record for statistical purposes, while only half of them used it to evaluate care.

    Conclusion: Nursing records need more clarity and need to be more prominent regarding specific nursing information to fulfil their purpose of transferring information and to constitute a base for quality development of care.

    Relevance to clinical practice: The results of this study can provide a part of a basis upon which a multi-professional patient record could be developed and which could also function as an alarm to managers at different levels to prioritise the development of nursing documentation.

  • 23.
    Törnvall, Eva
    et al.
    Östergötlands Läns Landsting. Linköping University. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Östergötlands Läns Landsting. Linköping University. Linköping University, Faculty of Health Sciences.
    Quality of Nursing care from the perspective of patients with leg ulcers2010In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, ISSN 0969-0700, Vol. 19, no 9, p. 388-395Article in journal (Refereed)
    Abstract [en]

     

    Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care. • Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate.They were given the short version of the Quality from the Patient's Perspective questionnaire (QPP) to fill in.This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them. • Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief. • Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers. • Conflict of interest: None.This study was funded by the county council of Östergötland and by Linköping University, Sweden.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care.

    Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate. They were given the short version of the Quality from Patient’s Perspective questionnaire (QPP) to fill in. This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them.

    Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief.

    Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers.

  • 24.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Wahren, Lis Karin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Electronic nursing documentation in primary health care2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 3, p. 310-317Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe and analyse nursing documentation based on an electronic patient record (EPR) system in primary health care (PHC) with emphasis on the nurses' opinions and what, according to the nursing process and the use of the keywords, the nurses documented. The study was performed in one county council in the south of Sweden and included 42 Primary Health Care Centres (PHCC). It consisted of a survey, an audit of nursing records with the Cat-ch-Ing instrument and calculation of frequencies of keywords used during a 1-year period. For the survey, district nurses received a postal questionnaire. The results from the survey indicated an overall positive tendency concerning the district nurses' opinions on documentation. Lack of in-service training in nursing documentation was noted and requested from the district nurses. All three parts of the study showed that the keywords nursing interventions and status were frequently used while nursing diagnosis and goal were infrequent. From the audit, it was noted that medical status and interventions appeared more often than nursing status. The study demonstrated limitations in the nursing documentation that inhibited the possibility of using it to evaluate the care given. In order to develop the nursing documentation, there is a need for support and education to strengthen the district nurses' professional identity. Involvement from the heads of the PHCC and the manufactures of the EPR system is necessary, in cooperation with the district nurses, to render the nursing documentation suitable for future use in the evaluation and development of care.

  • 25.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Dålig psykosocial arbetsmiljö för kvinnliga allmänläkare2003In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 20, p. 1789-1789Article in journal (Other academic)
  • 26.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Månadens forskare och Praktik och forskning2002In: Vårdfacket, ISSN 0347-0911, Vol. 26, p. 48-49Article in journal (Refereed)
  • 27.
    Wilhelmsson, Susan
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Psychosocial working conditions among general practitioners and district nurses: Organisational, professional and gender aspects2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis focuses on the psychosocial working conditions shared by general practitioners and district nurses in Sweden, in relation to the personal doctor reform and district nurses' right to prescribe drugs.

    First, a questionnaire was compiled and developed through a stepwise development phase, including key informant interviews, literature review, and review of other models and questionnaires used with a similar purpose. The questionnaire developed was used in a pilot study with 42 general practitioners and 39 district nurses. The questionnaire with 78 items in different parts, was tested for construct validity through factor analysis, and for reliability through Cronbach's alpha. It was then used in the main study.

    One aim was also to compare perceived changes in working conditions between general practitioners and district nurses during different degrees of implementation of a personal doctor system. A sample of 469 general practitioners and 466 district nurses participated. The cross-sectional design makes it difficult to distinguish the possible direct effects of a personal doctor from other regional differences. However, is it important to note that the personnel in a more far-reaching personal doctor system perceived less favourable psychosocial working conditions than personnel in a more traditional primary care system.

    Another aim was to investigate gender and professional differences in the shared psychosocial working conditions. Both general practitioners and district nurses were satisfied with the professional content of their work and experienced rather low or moderate levels of strains -and symptoms. However, female general practitioners perceived the most unfavourable working conditions compared with both male colleagues and female district nurses.

    The opinions among general practitioners and district nurses, to district nurses' right to prescribe drugs differed in all aspects studied. District nurses were positive and general practitioners negative. To gain a deeper understanding of the different opinions, six focus group interviews was carried out. The resistance to the refonn had turned into silence. General practitioners and district nurses hardly speak to each other about prescribing. The district nurses were uncertain whether the general practitioners trusted them and made up systems for self-control.

    The personnel within a more far-reaching personal doctor system perceived less-favourable psychosocial working conditions compared with personnel in more traditional primary care system. Female general practitioners seem to experience the most unfavourable working conditions. compared with both their male counterparts, and female district nurses. District nurses prescribing highlights professional differences. Quantitative and qualitative data complement each other and give more diverse information.

    List of papers
    1. Assessment of Psychosocial Work Environment in Primary Care: Development of a Questionnaire
    Open this publication in new window or tab >>Assessment of Psychosocial Work Environment in Primary Care: Development of a Questionnaire
    1999 (English)In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, no 6, p. 447-456Article in journal (Refereed) Published
    Abstract [en]

    Recent studies have indicated deteriorated working conditions of health care personnel. To have an efficient health care organization requires good working conditions and the well-being of the personnel. Today there are no 'gold-standard' assessment tools measuring psychosocial working conditions. The aim of this study was to develop two valid and reliable questionnaires, one generic and one specific, measuring psychosocial working conditions for general practitioners (GPs) and district nurses (DNs) in Sweden, with a special emphasis on organizational changes. The construction of the questionnaires were made after a stepwise developing phase including literature review, interviews, and a pilot study. The pilot study included GPs n = 42 and DNs n = 39. The questionnaires were later on used in a main study (GPs n = 465, DNs n = 465). A factor analysis was carried out and showed that there were fewer items in the main study that had factor loading ≥ 0.40 in more than one factor, compared to the pilot study. The factors from the main study were easier to label and had good correspondence with other studies. After this stepwise development phase good construct validity and internal consistency were established for the questionnaire.

    Keywords
    psychosocial working conditions, general practitioner, district nurses, questionnaire, factor analysis
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-49807 (URN)10.1023/A:1020516914688 (DOI)
    Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
    2. The personal doctor reform in Sweden: perceived changes in working conditions
    Open this publication in new window or tab >>The personal doctor reform in Sweden: perceived changes in working conditions
    1998 (English)In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 15, no 3, p. 192-197Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: In primary care in Sweden, several organizational changes have been implemented during the last decades in order to facilitate a shift from a high proportion of hospital care to a more primary-health-based care. The personal doctor reform has been one of the most important during recent years, for both personnel and patients.

    OBJECTIVES: We aimed to compare perceived changes in psychosocial working conditions for GP and district nurses in regions with traditional primary care and regions that have implemented a personal doctor system.

    METHODS: A questionnaire was mailed to 566 GPs and 554 district nurses in four selected county councils, two with traditional primary care and two with a personal doctor system. The overall response rate was 83%. A factor analysis of data concerning the experience of the organizational change revealed the following factors: fellowship at work, demands on the individual, influence and control, competence development and stimulation at work.

    RESULTS AND CONCLUSIONS: In the group as a whole, there was a general experience of deterioration of working conditions in all aspects except stimulation at work. This tendency was mostly marked in the regions with a personal doctor system. In these regions, GPs and district nurses reported significantly more impairments concerning demands on the individual and competence development. In addition, the district nurses also found themselves less able to exercise influence and control. These changes are neither desirable nor necessary consequences of an organizational development. It is important to follow continuously the personnel's experience in a changing primary health care system.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81078 (URN)10.1093/fampra/15.3.192 (DOI)
    Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2017-12-07Bibliographically approved
    3. Unfavourable Working Conditions for Female GPs: A Comparison between Swedish General Practitioners and District Nurses
    Open this publication in new window or tab >>Unfavourable Working Conditions for Female GPs: A Comparison between Swedish General Practitioners and District Nurses
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to investigate gender and occupational differences in the psychosocial work environment among general practitioners (GPs) and district nurses (DNs) in Sweden.

    Design: A stratified random sample of general practitioners (n = 566) and district nurses (n= 554) from four county councils in Sweden was selected. The overall participation rate was 83%. A mailed questionnaire including ten items of demographic and work sites characteristics, and 36 items of psychosocial working conditions was used. The questionnaire had been tested concerning validity and reliability. A factor analysis gave five factors: strains and symptoms, professional content, social support at work, workload, and job control.

    Results: In total, professional content was the most positively experienced aspect whereas workload was the most negatively. The GPs perceived a higher workload and fewer opportunities to social support at work compared with the DNs. The female GPs scored significantly more unfavourable than both male GPs and female DNs did in four out of the five factors. The female GPs reported a high workload, low job control and fewer opportunities to social support at work. The female DNs also reported a high workload, relatively low job control but a rather strong social support at work.

    Conclusion: Female GPs perceive more unfavourable psychosocial working conditions compared with both male GPs and female DNs in the same organisational setting.

    Keywords
    psychosocial working conditions, primary care, general practitioners, district nurses, females
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81081 (URN)
    Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2013-09-05Bibliographically approved
    4. Opinions about district nurses prescribing
    Open this publication in new window or tab >>Opinions about district nurses prescribing
    2001 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 4, p. 326-330Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to investigate the opinions of district nurses (DNs) and general practitioners (GPs) about nurse prescribing in Sweden in order to elucidate similarities and differences, and relate different opinions to background and psychosocial working factors. In a questionnaire about psychosocial working conditions, seven statements about DNs prescribing were included. The questionnaire was sent to 554 DNs and 566 GPs with a participant rate of 83%. On all items as well as on the total score DNs rated more positively compared with GPs. Amongst the DNs a positive opinion was related to a traditional primary care organization, age < 50, good social support at work, and high workload. A positive opinion amongst GPs was associated with working in a traditional primary care organization, being male GP, and a good social support at work. In a multiple regression analysis, occupation and organization were independently associated with the total score. The result shows a strong professional solidarity amongst GPs and seems to be based on concern about the profession rather than patient care.

    Keywords
    District nurses, General practitioner, Nurse prescribing, Opinions, Primary health care
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-47197 (URN)10.1046/j.1471-6712.2001.00036.x (DOI)
    Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13Bibliographically approved
    5. Exploring views on Swedish district nurses' prescribing: a focus group study in primary health care
    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
  • 28.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Opinions about district nurses prescribing2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 4, p. 326-330Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the opinions of district nurses (DNs) and general practitioners (GPs) about nurse prescribing in Sweden in order to elucidate similarities and differences, and relate different opinions to background and psychosocial working factors. In a questionnaire about psychosocial working conditions, seven statements about DNs prescribing were included. The questionnaire was sent to 554 DNs and 566 GPs with a participant rate of 83%. On all items as well as on the total score DNs rated more positively compared with GPs. Amongst the DNs a positive opinion was related to a traditional primary care organization, age < 50, good social support at work, and high workload. A positive opinion amongst GPs was associated with working in a traditional primary care organization, being male GP, and a good social support at work. In a multiple regression analysis, occupation and organization were independently associated with the total score. The result shows a strong professional solidarity amongst GPs and seems to be based on concern about the profession rather than patient care.

  • 29.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Foldevi, Mats
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    The personal doctor reform in Sweden: perceived changes in working conditions1998In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 15, no 3, p. 192-197Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In primary care in Sweden, several organizational changes have been implemented during the last decades in order to facilitate a shift from a high proportion of hospital care to a more primary-health-based care. The personal doctor reform has been one of the most important during recent years, for both personnel and patients.

    OBJECTIVES: We aimed to compare perceived changes in psychosocial working conditions for GP and district nurses in regions with traditional primary care and regions that have implemented a personal doctor system.

    METHODS: A questionnaire was mailed to 566 GPs and 554 district nurses in four selected county councils, two with traditional primary care and two with a personal doctor system. The overall response rate was 83%. A factor analysis of data concerning the experience of the organizational change revealed the following factors: fellowship at work, demands on the individual, influence and control, competence development and stimulation at work.

    RESULTS AND CONCLUSIONS: In the group as a whole, there was a general experience of deterioration of working conditions in all aspects except stimulation at work. This tendency was mostly marked in the regions with a personal doctor system. In these regions, GPs and district nurses reported significantly more impairments concerning demands on the individual and competence development. In addition, the district nurses also found themselves less able to exercise influence and control. These changes are neither desirable nor necessary consequences of an organizational development. It is important to follow continuously the personnel's experience in a changing primary health care system.

  • 30.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Foldevi, Mats
    Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
    Exploring views on Swedish district nurses' prescribing: a focus group study in primary health care2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 5, p. 643-650Article in journal (Refereed)
    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.

  • 31.
    Wilhelmsson, Susan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Foldevi, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Åkerlind, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Faresjö, T
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Unfavourable working conditions for female GPs. A comparison between Swedish general practitiners and district nurses2002In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 20, p. 74-78Article in journal (Refereed)
  • 32.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Foldevi, Mats
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Unfavourable Working Conditions for Female GPs: A Comparison between Swedish General Practitioners and District NursesManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to investigate gender and occupational differences in the psychosocial work environment among general practitioners (GPs) and district nurses (DNs) in Sweden.

    Design: A stratified random sample of general practitioners (n = 566) and district nurses (n= 554) from four county councils in Sweden was selected. The overall participation rate was 83%. A mailed questionnaire including ten items of demographic and work sites characteristics, and 36 items of psychosocial working conditions was used. The questionnaire had been tested concerning validity and reliability. A factor analysis gave five factors: strains and symptoms, professional content, social support at work, workload, and job control.

    Results: In total, professional content was the most positively experienced aspect whereas workload was the most negatively. The GPs perceived a higher workload and fewer opportunities to social support at work compared with the DNs. The female GPs scored significantly more unfavourable than both male GPs and female DNs did in four out of the five factors. The female GPs reported a high workload, low job control and fewer opportunities to social support at work. The female DNs also reported a high workload, relatively low job control but a rather strong social support at work.

    Conclusion: Female GPs perceive more unfavourable psychosocial working conditions compared with both male GPs and female DNs in the same organisational setting.

  • 33.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindberg, Malou
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Health promotion: Facilitators and barriers perceived by district nurses2009In: INTERNATIONAL JOURNAL OF NURSING PRACTICE, ISSN 1322-7114, Vol. 15, no 3, p. 156-163Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate district nurses (DN) opinions regarding facilitators and barriers in their work with health promotion. Methods: Qualitative descriptive study. Interviews with a purposeful sampling of 54 DNs. Data were analysed with content analysis. Results: The DNs expressed that nursing was the right profession to work with health promotion, and that it was an important task that was done by no one else. They experienced being stuck between disease-oriented and health promotion work and that priorities were wrong. The focus was not on health promotion and the time DNs could spend with health promotion was limited, and instead they had to perform elementary medical tasks. Conclusions: Tasks of a medical nature are given priority over health promotion. DNs lack support and no one asked or cared about the results from health promotion activities.

  • 34.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindberg, Malou
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Prevention and health promotion and evidence-based fields of nursing - A literature review2007In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 13, p. 254-266Article in journal (Refereed)
  • 35.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Assessment of Psychosocial Work Environment in Primary Care: Development of a Questionnaire1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, no 6, p. 447-456Article in journal (Refereed)
    Abstract [en]

    Recent studies have indicated deteriorated working conditions of health care personnel. To have an efficient health care organization requires good working conditions and the well-being of the personnel. Today there are no 'gold-standard' assessment tools measuring psychosocial working conditions. The aim of this study was to develop two valid and reliable questionnaires, one generic and one specific, measuring psychosocial working conditions for general practitioners (GPs) and district nurses (DNs) in Sweden, with a special emphasis on organizational changes. The construction of the questionnaires were made after a stepwise developing phase including literature review, interviews, and a pilot study. The pilot study included GPs n = 42 and DNs n = 39. The questionnaires were later on used in a main study (GPs n = 465, DNs n = 465). A factor analysis was carried out and showed that there were fewer items in the main study that had factor loading ≥ 0.40 in more than one factor, compared to the pilot study. The factors from the main study were easier to label and had good correspondence with other studies. After this stepwise development phase good construct validity and internal consistency were established for the questionnaire.

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