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  • 1.
    Barajas, Josefin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Intervention Elucidate Intra Organisational Hindrance to Employee Development2002In: Humans in a Complex Environment,2002, 2002, p. 67-70Conference paper (Refereed)
  • 2. Barnett, NP
    et al.
    Monti, PM
    Cherpitel, C
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Beroendekliniken IHS. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Dependency.
    Borges, G
    Colby, SM
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Johansson, Kjell
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Identification and brief treatment of alcohol problems with medical patients: An international perspective2003In: Alcoholism: Clinical and Experimental Research, ISSN 0145-6008, E-ISSN 1530-0277, Vol. 27, no 2, p. 262-270Article in journal (Refereed)
    Abstract [en]

    This article summarizes the proceedings of a symposium at the 2002 RSA meeting in San Francisco, California. The chair was Peter Monti and co-chair was Nancy Barnett. The aim of the symposium was to bring together researchers from the United States, Sweden, and Mexico to present current findings on the development and implementation of screening and intervention research in Emergency Departments (ED). Cheryl Cherpitel presented findings on the performance of the Rapid Alcohol Problems Screen (RAPS4), a 4-item instrument used for screening for alcohol dependence and harmful drinking in the ED. Dr. Cherpitel also presented for her collaborator, Guilherme Borges, their research on the performance of a number of screening measures including the RAPS among Mexicans and Mexican-Americans with alcohol-related disorders in the ED. Preben Bendtsen described the implementation of an alcohol screening and intervention procedure delivered by ordinary ED staff in Sweden. Nancy Barnett presented data on characteristics related to readiness to change alcohol use in a sample of young adults who were treated in an ED for injury or intoxication.

  • 3.
    Bendtsen, Preben
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Beroendekliniken IHS. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Dependency.
    Johansson, Kjell
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    How to implement screening for high alcohol consumption in the daily routine in an emergency department2002In: 2002 Scieentific Meeting of the RSA and the 11th Congress of the ISBRA, San Fransisco 2002,2002, 2002Conference paper (Refereed)
  • 4.
    Boman, John
    et al.
    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.
    Lindfors, Sara
    Karolinska Institutet, Stockholm.
    Nordqvist, Cecilia
    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.
    Nordström, Louise
    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.
    Alexanderson, Kristina
    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.
    Konstruktiva strategier för att hantera stress bland disputerade specialistläkare vid ett universitetssjukhus2005Report (Other academic)
  • 5.
    Boman, John
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Richt, Bengt
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ett bättre liv: Ett bidrag till utvärderingen av dagverksamheten vid Cedersborgs Resurscentrum i Norrköping1997Report (Other academic)
  • 6.
    Iacobaeus, Helena
    et al.
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Francisco, Marie
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Sefyrin, Johanna
    Linköping University, Department of Management and Engineering, Information Systems. Linköping University, Faculty of Arts and Sciences.
    Skill, Karin
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Wihlborg, Elin
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Digitalt utanförskap: En forskningsöversikt2019Report (Other academic)
    Abstract [sv]

    Den här rapporten bygger på en kartläggande litteraturstudie om internationell forskning av digitalt utanförskap. Digitalt utanförskap är ett demokratiskt problem när alltfler välfärdstjänster digitaliseras. Rapportens syfte är att undersöka vilken forskning som har publicerats inom området digital exkludering, samt vilka faktorer som nämns som bidrar till digital exkludering och vilka grupper som studerats som digitalt exkluderade tidigare.

    Modell

    En användbar modell för att analysera digitalt utanförskap har utarbetats av forskaren Jan van Dijk. Den har tidigare illustrerats som en triangel med motivation som bred bas, men utifrån vårt arbete med denna forskningsöversikt föreslår vi att den illustreras som en trappa med stegen: motivation, tillgång, färdigheter, användning. Denna modell visar hur forskningen har gått från fokus på tillgång till digital teknik, till att se det som ett mer komplext fenomen.

    Resultat

    Resultatet visar att tidigare forskning har förklarat och förstått individuellt digitalt utanförskap utifrån följande faktorer:

    • Bristande motivation
    • Bristande infrastruktur/tillgång
    • Bristande kunskap och färdigheter
    • Låg socioekonomisk status
    • Bristande tillit/självtillit

    När det kommer till samhälleliga faktorer som kan bidra till digitalt utanförskap så nämns:

    • Bristande styrning och ledning

    Motsatsen till digitalt utanförskap är digital delaktighet och inkludering. Det främsta resultatet visar att det är en pågående process som här liknas vid en trappa. Eftersom den digitala utvecklingen är pågående kan inte digital kompetens och inkludering ses som avslutade processer; människor måste ständigt uppgradera sina kompetenser för att kunna hänga med. Människor som befinner sig på de övre stegen kan dock halka ner vid en förändrad livssituation,

    som att gå från anställning till arbetslöshet.

    Slutsatser

    • Det saknas enhetliga begrepp om vad som avses med digitalt utanförskap, inkludering och kompetens, vilket kan försvåra jämförelser
    • Digital inkludering är pågående process, som människor kan halka efter i
    • Digitalt utanförskap kan förstås utifrån situationer snarare än utifrån människors karaktär eller identitet (som implicit innebär att det kan undvikas)
    • Digitalt utanförskap kan handla om komplexa samband mellan flera faktorer
    • Digitalt utanförskap kan förekomma i olika sociala grupper och ålderskategorier

    Rapporten har en sammanställning över faktorer som lyfts fram i tidigare forskning som gynnsamma för insatser som syftar till digital inkludering. Det handlar om faktorer som i stort återspeglas i ovan nämnda modell:

    1. Motivera
    2. Skapa tillgång
    3. Främja färdigheter
    4. Främja användning

    Idéer för fortsatt forskning

    Med slutsatsen i tidigare forskning om att digital inkludering är en pågående och komplex process eftersom den digitala tekniken ständigt utvecklas behövs fortsatt forskning som visar hur olika faktorer hänger samman och kan bidra till inkludering eller exkludering. Det behövs även fortsatt forskning om olika grupper, till exempel nyanlända och migranter samt människor med olika funktionsvariationer. Att fokusera på hur olika situationer påverkar digital delaktighet och inkludering framstår som relevant. Mer tillämpad forskning om hur offentliga digitala system och tjänster designas inom ett svenskt sammanhang skulle också vara värdefull, liksom utvecklandet av nydanande metoder för att studera digital delaktighet.

  • 7.
    Karlsson, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Johansson, Kjell
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Feasibility of a computorized alcohol screening and personalized written advice in the ED: opportunities and obstacles2005In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 13, p. 44-53Article in journal (Refereed)
  • 8.
    Kullberg, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Examining quality function deployment in safety promotion in Sweden.2014In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 29, no 3, p. 414-426Article in journal (Refereed)
    Abstract [en]

    The first-hand needs and demands of laypersons are not always considered when safety promotion programmes are being developed. We compared focal areas for interventions identified from residents' statements of safety needs with focal areas for interventions identified by local government professionals in a Swedish urban community certified by the international Safe Community movement supported by the World Health Organization. Quantitative and qualitative data on self-expressed safety needs from 787 housing residents were transformed into an intervention design, using the quality function deployment (QFD) technique and compared with the safety intervention programme developed by professionals at the municipality administrative office. The outcome of the comparison was investigated with regard to implications for the Safe Community movement. The QFD analysis identified the initiation and maintenance of social integrative processes in housing areas as the most highly prioritized interventions among the residents, but failed to highlight the safety needs of several vulnerable groups (the elderly, infants and persons with disabilities). The intervention programme designed by the public health professionals did not address the social integrative processes, but it did highlight the vulnerable groups. This study indicates that the QFD technique is suitable for providing residential safety promotion efforts with a quality orientation from the layperson's perspective. Views of public health professionals have to be included to ascertain that the needs of socially deprived residents are adequately taken into account. QFD can augment the methodological toolbox for safety promotion programmes, including interventions in residential areas.

  • 9.
    Kullberg, Agneta
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Integrating residents’ demands into the design of safety promotion interventions in housing areas: a case study application of quality function deployment in a Safe Community programManuscript (preprint) (Other academic)
    Abstract [en]

    Background: The needs and demands of the residents are rarely considered in community-based design of safety services and planning in housing areas. We therefore set out to compare safety promotion intervention design based on residents’ self-expressed safety needs with interventions designed by local government professionals. A secondary aim was to use the results to suggest improvements for the safety promotion indicators targeting Safe Homes within the Safe Community movement.

    Methods: Case study research methods based on a nested single-case design were used for the study. Data collected from 787 residents in a case study community were analyzed using the quality function deployment (QFD) technique. Quantitative and qualitative data on residents’ self-expressed safety needs were transformed into an intervention design. The resulting design was then compared with the safety intervention program designed by professionals at the municipality administrative office. The results from this comparison were then investigated to identify improvements for the indicators for Safe Homes in the Safe Community program.

    Results: The QFD analysis showed that the initiation and maintenance of social integrative processes in housing areas were the most highly prioritized interventions among the residents, but the analysis did not highlight the safety needs of several vulnerable groups (e.g. the old elderly, infants, and persons with disabilities). The Safe Community program designed by professionals did not address the social integrative processes, but did cover the vulnerable groups. Our results indicate that the current Safe Homes concept in the Safe Community program would benefit from being widened to Safe Housing.

    Conclusions: The QFD technique can be added to the methodological toolbox for residential safety promotion. The technique is particularly suitable for providing a quality orientation from the lay perspective of residents. Residents and professionals can contribute with different perspectives on safety promotion and injury prevention in local residential areas. In developing safe housing, these different views should be identified and considered. Socio-economic differences and social inequalities in safety-related housing conditions between areas also need to be considered in the programs.

  • 10.
    Kullberg, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Residents’ perspectives on safety support needs in different types of housing areas2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, p. 590-597Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about conditions that are understood to support safety is important for planning residential safety promotion in interactions with residents. How residents themselves perceive and reason about their own safety needs has seldom been investigated in Scandinavia. Aim: To identify factors perceived to be necessary to feel safe by residents in areas with blocks of flats and detached houses.

    Methods: Residents in a Swedish municipality were asked an open-ended question on the research topic by a mail survey; 787 residents provided narrative data that were fed into a summative qualitative and quantitative content analysis.

    Results: A stable social structure in the housing area was perceived to be the central factor in a safety-supportive residential environment. Whereas maintenance of good and reassuring relations was emphasized in detached housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. This finding emphasizes the need to reduce the differential exposure to safety-related factors in the living environment.

    Conclusions: The results of our study encourage the continued use of a setting-orientated safety promotion approach in which residents and other stakeholders are involved. The policy recommendation that can be drawn from the study is that both the subjective and objective dimensions of safety should be identified and considered when developing local safety promotion interventions in community contexts.

  • 11.
    Lindhe Söderlund, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Angbratt, Marianne
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Applying motivational interviewing to counselling overweight and obese children2009In: Health Education Research, ISSN 0268-1153, E-ISSN 1465-3648, Vol. 24, no 3, p. 442-449Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify barriers and facilitators to nurses’ application of motivational interviewing (MI) to counselling overweight and obese children aged 5 and 7 years, accompanied by their parents. Ten welfare centre and school health service nurses trained and practiced MI for 6 months, then participated in focus group interviews concerning their experiences with applying MI to counselling overweight and obese children. Important barriers were nurses’ lack of recognition that overweight and obesity among children constitute a health problem, problem ambivalence among nurses who felt that children’s weight might be a problem although there was no immediate motivation to do anything and parents who the nurses believed were unmotivated to deal with their children’s weight problem. Facilitators included nurses’ recognition of the advantages of MI, parents who were cooperative and aware of the health problem and working with obese children rather than those who were overweight.

  • 12.
    Nilsen, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Holmqvist, Marika
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Frequency of heavy episodic drinking among nonfatal injury patients attending an emergency room.2007In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 39, p. 757-766Article in journal (Refereed)
  • 13.
    Nilsen, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Holmqvist, Marika
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Linking drinking to injury--causal attribution of injury to alcohol intake among patients in a Swedish emergency room.2007In: International journal of injury control and safety promotion, ISSN 1745-7300, Vol. 14, no 2, p. 93-102Article in journal (Refereed)
    Abstract [en]

    This study analysed the drinking patterns and motivation to change drinking behaviours among injury patients who acknowledged alcohol as a factor in their injuries. A cross-sectional study was conducted over 18 months at a Swedish emergency department. A total of 1930 injury patients aged 18 - 70 years were enrolled in the study (76.8% completion rate). Of those who reported drinking, 10% acknowledged alcohol as a factor in their injury. A patient was more likely to report a causal attribution of the injury to alcohol the higher the weekly intake and the higher the frequency of heavy episodic drinking. The motivation to change variables showed a similar pattern of increased likelihood of attributing a causal link of alcohol and injury with increasing discontent with drinking behaviours and increasing desire to change drinking behaviours. The findings suggest that the ability to measure causal attribution of alcohol to injuries could be a promising tool to help patients explore the association between their injuries and alcohol use and motivate patients to modify drinking behaviours in order to avoid future injuries.

  • 14.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Holmqvist, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Arbetsgivarens betydelse vid sjukskrivning - om att återgå i arbete.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 5, p. 429-437Article in journal (Other (popular science, discussion, etc.))
  • 15.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Barajas, Josefin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Keberg, K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Rehabilitering inom Samhall - att finna ett annat arbete.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 77, p. 438-444Article in journal (Other (popular science, discussion, etc.))
  • 16.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Beroendekliniken IHS. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Dependency.
    Johansson, Kjell
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Lindqvist, Kent
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Sekundärprevention av alkoholproblem på Motala lasaretts akutmottagning2002In: Riksstämman 2002,2002, 2002Conference paper (Refereed)
  • 17.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Holmqvist, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Att komma igen. Om att återgå i arbete efter sjukskrivning för rygg-, nack- eller skulderbesvär, en pilotstudie med fokusgrupper.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 4, p. 347-356Article in journal (Other (popular science, discussion, etc.))
  • 18.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hanberger, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nordfeldt, Sam
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry. Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment and Health Economics.
    Health professionals' attitudes towards using a Web 2.0 portal for child and adolescent diabetes care: qualitative study.2009In: Journal of medical Internet research, ISSN 1438-8871, Vol. 11, no 2, p. e12-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Internet, created and maintained in part by third-party apomediation, has become a dynamic resource for living with a chronic disease. Modern management of type 1 diabetes requires continuous support and problem-based learning, but few pediatric clinics offer Web 2.0 resources to patients as part of routine diabetes care. OBJECTIVES: To explore pediatric practitioners' attitudes towards the introduction of a local Web portal for providing young type 1 diabetes patients with interactive pedagogic devices, social networking tools, and locally produced self-care and treatment information. Opportunities and barriers related to the introduction of such systems into clinical practice were sought. METHODS: Twenty clinicians (seven doctors, nine nurses, two dieticians, and two social welfare officers) from two pediatric diabetes teams participated in the user-centered design of a local Web 2.0 portal. After completion of the design, individual semi-structured interviews were performed and data were analyzed using phenomenological methods. RESULTS: The practitioners reported a range of positive attitudes towards the introduction of a local Web 2.0 portal to their clinical practice. Most interviewees were satisfied with how the portal turned out, and a sense of community emerged during the design process and development of the portal's contents. A complementary role was suggested for the portal within the context of health practice culture, where patients and their parents would be able to learn about the disease before, between, and after scheduled contacts with their health care team. Although some professionals expected that email communication with patients and online patient information would save time during routine care, others emphasized the importance of also maintaining face-to-face communication. Online peer-to-peer communication was regarded as a valuable function; however, most clinicians did not expect that the portal would be used extensively for social networking amongst their patients. There were no major differences in attitudes between different professions or clinics, but some differences appeared in relation to work tasks. CONCLUSIONS: Experienced clinical practitioners working in diabetes teams exhibited positive attitudes towards a Web 2.0 portal tailored for young patients with type 1 diabetes and their parents. The portal included provision of third-party information, as well as practical and social means of support. The practitioners' early and active participation provides a possible explanation for these positive attitudes. The findings encourage close collaboration with all user groups when implementing Web 2.0 systems for the care of young patients with chronic diseases, particularly type 1 diabetes. The study also highlights the need for efforts to educate clinical practitioners in the use of Web publishing, social networking, and other Web 2.0 resources. Investigations of attitudes towards implementing similar systems in the care of adults with chronic diseases are warranted.

  • 19.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Holmqvist, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Views of laypersons on the role employers play in return to work when sick-listed2003In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 13, no 1, p. 11-20Article in journal (Refereed)
    Abstract [en]

    Sickness absenteeism is an increasing public health problem, but few studies have examined the views of laypersons regarding factors that promote return to work. The present investigation concerns the opinions of such individuals on the role employers play in this context. Data from five focus-group interviews of laypersons with experience of long-term sickness absence were subjected to grounded theory analysis. When asked about factors that hinder or promote return to work, the laypersons spontaneously emphasized the importance of the employer. Specifically, they stressed the need for a structured back-to-work program at each workplace, which should include contacting absent employees and informing fellow workers of possible changes in task assignments upon return of the absent person. Reported hindering factors included lack of such information, leading to envy and harassment. Respondents also asserted the importance of work supervisors in creating a positive emotional atmosphere.

  • 20.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Holmqvist, Marika
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care.
    Intention to change heavy episodic drinking and actual change seen among emergency care patients2008In: Journal of Drug Addiction, Education and Eradication, ISSN 1546-6965, Vol. 3, no 3, p. 263-276Article in journal (Refereed)
  • 21.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Holmqvist, Marika
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Usual drinking pattern and non‐fatal injury among patients seeking medical care2006In: Public Health, ISSN 0033-3506, Vol. 120, no 11, p. 1064-1073Article in journal (Refereed)
    Abstract [en]

    Objectives

    To explore the association between drinking patterns, irrespective of whether alcohol was consumed in the event of the injury or not, and different injury variables; and to identify settings and situations in which risky drinkers have an increased likelihood of injury.

    Study design

    The study population consisted of all patients aged 18–70 years registered for an injury according to ICD-10 at a Swedish emergency department during an 18-month period. After informed consent, the injury patients were screened for drinking habits by the AUDIT-C questionnaire. The gender, age and drinking pattern of injury patients were compared with the general population.

    Methods

    A total of 2782 patients aged 18–70 years were registered for an injury during the study period. The number of drop-outs was 631. Drop-outs include those who did not consent to participate, were severely injured, too intoxicated or did not fill out the questionnaire satisfactory. Thus, 77.3% of the target group were included for further analysis (1944 drinkers and 207 abstainers). The patients were categorized into three drinking categories: abstainers, non-risky and risky drinkers. Risky drinkers were defined according to usual weekly consumption of 80 g or more of alcohol for women and 110 g or more for men and/or heavy episodic drinking (i.e. having six glasses or more one glass=12 g alcohol), or both, on one occasion at least once a month, valid for both women and men. To estimate the relationship between drinking patterns and the injury variables (environment, cause of injury, activity and diagnosis), odds ratios (OR) were calculated by logistic regression. Multiple logistic regression was used in order to control for age and sex differences between the various drinking and injury categories.

    Results

    The proportion of risky drinkers was higher in the study population compared with the general population in the same area. When controlling for age and sex, risky drinkers (OR 6.4adj Confidence interval CI 1.9–21.2) and non-risky drinkers (OR .4.5adj CI 1.4–14.5) displayed an increased risk for injury compared with abstainers, in amusement locations, parks, by or on lakes or seas, especially while engaged in play, hobby or other leisure activities (risky drinkers: OR 2.8adj CI 1.3–5.6; non-risky drinkers: OR 2.4adj CI 1.2–4.6). All differences between drinking patterns in external cause of injury disappeared when age and sex were considered. During rest, meals and attending to personal hygiene, the non-risky drinkers had a lower probability of injury compared with abstainers (OR 0.3adj CI 0.1–0.8). Non-risky drinkers had a higher probability than abstainers of suffering luxation (dislocation) or distortion (OR 1.6adj CI 1.1–2.5). Nine per cent of the study population reported that they believed that their injury was related to intake of alcohol. Half of this group were non-risky drinkers (CI for the 13.7% difference was 9.7–17.6).

    Conclusions

    Few significant associations between drinking pattern and injury remained when age and sex were controlled for.

  • 22.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Johansson, Kjell
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Routine screening for risky alcohol consumption at an emergency department using the AUDIT-C questionnaire2004In: Drug and Alcohol Dependence, ISSN 0376-8716, Vol. 74, no 1, p. 71-75Article in journal (Refereed)
    Abstract [en]

    A questionnaire including the three AUDIT-C items was used to screen for alcohol use among trauma patients. The aim was to display, in a pragmatic way, how the AUDIT-C scores can be converted into different levels and kind of risky drinking. Using AUDIT-C scores with a cut-off score of 4 points for women and 5 for men indicated that 28% of the women and 40% of the men were risky drinkers. When calculating weekly alcohol consumption from the answers in AUDIT-C, 3% of the women and 7% of the men were hazardous and/or harmful drinkers. Regarding heavy episodic drinking 7% of the women and 30% of the men was drinking 72 g alcohol or more at on at least one occasion a month. These results indicate that the AUDIT-C score as such give little information about the pattern of alcohol consumption and that evaluation of risky drinking must be calculated from the three items in order to differentiate between risky drinking in terms of alcohol consumed per week and heavy episodic drinking.

  • 23.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Johansson, Kjell
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alcohol prevention measures at an emergency department: physicians` perspectives. Short communication2005In: Public Health, ISSN 0033-3506, Vol. 119, no 9, p. 789-791Article in journal (Refereed)
  • 24.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Johansson, Kjell
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Attitude changes among emergency department triage staff after conducting routine alcohol screening2006In: Addictive Behaviors, ISSN 0306-4603, Vol. 31, no 2, p. 191-202Article in journal (Refereed)
    Abstract [en]

    Excessive alcohol consumption is common among injury patients, but routine alcohol interventions seem to be difficult to implement in emergency departments. An obstacle seen in previous studies is the limited time available in a real-world setting for staff to participate in routine alcohol screening and interventions. In the present study, ordinary staff participated in a simple alcohol screening procedure. The aim of the study was to evaluate the feasibility of this procedure and if there was any change in attitudes and practices among triage staff after the implementation. We analyzed interviews with six staff members and questionnaires completed by 29 nurses and medical secretaries before and after a period of systematic routine screening. The staff reported that the routine worked well and that few patients reacted negatively. A positive change was seen in attitudes towards alcohol preventive measures in general. However, this seems not to be sufficient for the staff to spontaneously engage more actively. In fact, more of the staff were uncertain after the study period whether the emergency department is an appropriate place for alcohol screening and intervention despite an increased role legitimacy and perceived competence. There is a need for further development of alcohol prevention models that are acceptable for the staff to implement as part of the daily routine.

  • 25.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Lindqvist, Kent
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Wilhelm, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Olycksfall och alkoholvanor2004In: Svenska läkarsällskapets riksstämma,2004, Katrineholm: Sörmlands grafiska Quebecor AB , 2004, p. 46-46Conference paper (Other academic)
  • 26.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    What promotes sustainability in Safe Community programmes?2009In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 9, no 4Article in journal (Refereed)
    Abstract [en]

    Background: The theory and practice of safety promotion has traditionally focused on the safety of individuals. This study also includes systems, environments, and organizations. Safety promotion programmes are designed to support community health initiatives taking a bottom-up approach. This is a long-term and complex process. The aim of this study was to try to empirically identify factors that promote sustainability in the structures of programmes that are managed and coordinated by the local government.

    Methods: Four focus group sessions with local government politicians and administrators in designated Safe Communities were conducted and analyzed using qualitative content analysis.

    Results: Collaboration was found to be the basis for sustainability. Networks, enabling municipalities to exchange ideas, were reported to positively influence the programmes. Personal contacts rather than organizations themselves, determine whether collaboration is sustained. Participants reported an increase in cross-disciplinary collaboration among staff categories. Administrators and politicians were reported to collaborate well, which was perceived to speed up decision-making and thus to facilitate the programme work. Support from the politicians and the county council was seen as a prerequisite. Participants reported an increased willingness to share information between units, which, in their view, supports sustainability. A structure in which all local authorities offices were located in close proximity to one another was considered to support collaboration. Appointing a public health coordinator responsible for the programme was seen as a way to strengthen the relational resources of the programme.

    Conclusion: With a public health coordinator, the external negotiating power was concentrated in one person. Also, the internal programme strength increased when the coordination was based on a bureaucratic function rather than on one individual. Increased relational resources facilitated the transfer of information. A regular flow of information to policy-makers, residents, and staff was needed in order to integrate safety programmes into routines. Adopting a bottom-up approach requires that informal and ad hoc activities in information management be replaced by formalized, organizationally sanctioned routines. In contrast to injury prevention, which focuses on technical solutions, safety promotion tries to influence attitudes. Collaboration with the media was an area that could be improved.

  • 27.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Wihlborg, Elin
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Digitalt först?: kommuners och professionellas arbete för ökad digital inkludering2019Report (Other academic)
    Abstract [sv]

    I takt med att digitaliseringen ökar i samhället har bland andra biblioteken fått i uppdrag att verka för medborgarnas digitala inkludering. För att kunna vara digitalt inkluderade behöver medborgarna ha tillgång till digitala verktyg, kunskap om hur de hanteras och internetuppkoppling. Många som behöver stöd i frågor om digitalisering och inte får det på andra sätt vänder sig till bibliotekets medarbetare. Därför behöver personalen på biblioteken i sin tur både ha kompetensen och att kunna lära ut den. Kungliga biblioteket (KB) genomför under 2018–2020 regeringsuppdraget ”Digitalt först med användaren i fokus”. Projektet innebär att KB finansierar regionbibliotekens samordning av utbildning för medarbetare på folkbiblioteken.

    Den här rapporten beskriver kommuners och biblioteksledningars stöd till bibliotekens arbete för digital kompetens och inkludering. I fokus är att olika professioner som inte har utbildning i digitala tekniker ändå stöttar medborgare i tekniska frågor och med e-tjänster.

    Resultatet visar att styrningen från kommun och verksamhetsledning är svag men att medarbetare ändå stöttar sina besökare i deras frågor om digitalisering. De gör det trots olika dilemman de upplever. Till exempel risken att göra fel när de hanterar andra myndigheters e-tjänster, eller att de med sin skattefinansierade lön utför privata företags e-tjänster. De gör detta därför att det oftast inte finns någon annan att hänvisa till och medborgaren riskerar allvarliga konsekvenser om uppgiften inte blir utförd. Det kan handla om en redovisning till arbetsförmedlingen eller att betala en räkning.

    Bristen på styrning gör att medarbetarna till stor del får dra egna gränser för hur mycket och med vad de ska stötta medborgarna.

    Slutsatserna är att beslutsfattare behöver kompetens för att kunna fatta beslut för en bra styrning av digitaliseringen. Dessutom behöver frågan om vilka som inte nås av stöd alls diskuteras, och hur de ska få stöd, om de behöver.

  • 28.
    Nordqvist, Cecilia
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Wilhelm, Elisabeth
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Can screening and simple written advice reduce excessive alcohol consumption among emergency care patients?2005In: Alcohol & Alcoholism, ISSN 0735-0414 (print) 1464-3502 (online), Vol. 40, no 5, p. 401-408Article in journal (Refereed)
    Abstract [en]

    Aims: Emergency care patients have an overrepresentation of risky drinkers. Despite the evidence on the effectiveness of a short feedback on screening or self-help material, most studies performed so far have required considerable time from staff and thus been difficult to implement in the real world. The present study evaluates the effect of the screening and whether simple written advice has any additional effect on risky drinking.

    Methods: An alcohol screening routine was implemented among injury patients in a Swedish emergency care department. Over 12 months, two cohorts were invited to answer an alcohol screening questionnaire in the waiting room. In the first 6 months, 771 patients were screened without any written advice (cohort A) and in the following 6 months, 563 were screened and in addition received simple written advice about sensible drinking (cohort B). None of the patients received one-to-one feedback. Six months after the screening, a follow-up interview by telephone explored the changes in drinking.

    Results: In cohort A 182 (24%) of the patients were defined as risky drinkers and in cohort B 125 (22%). Reached at follow-up after 6 months were 81 (44%) risky and 278 (47%) non-risky drinkers in cohort A, and 40 (32%) risky and 220 (50%) non-risky drinkers in cohort B. The number of patients with heavy episodic drinking decreased significantly in cohort A from 76 (94% of the risky drinkers) to 49 (59%). In cohort B a similar change was seen from 37 (92%) to 27 (68%). Only in cohort B, was a significant increase in readiness to change drinking habits seen [from 3 (8%) to 9 (23%)]. The reduction in heavy episodic drinking was comparable with previous reports from more extensive interventions. However, at the time of follow-up, drinking among non-risky drinkers at baseline had increased. When considering the greater numbers of non-risky drinkers, the total consumption in the study group increased during the study period.

    Conclusions: Owing to the reported difficulties of integrating more time-consuming alcohol interventions in emergency departments, it is suggested that at least screening for drinking should be implemented as routine in emergency departments. More research is needed in order to establish the optimal balance between effective alcohol intervention, and acceptable time and effort requirement from staff.

  • 29.
    Nordqvist, Cecilila
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alcohol screening and simple advice in emergency care: staffs’ attitudes and injured patients’ drinking pattern2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: About 800,000 people are risky drinkers in Sweden and the alcohol consumption has increased around 30% during the last 6 years. In order to counteract the negative effects of drinking there is a need to implement preventive measures at various levels in society. One place where risky drinkers could be identified is the healthcare setting. More than 10% of the visits at emergency departments and 20% of the injuries have been found to be alcohol‐related. So far, very few risky drinkers attending emergency departments receive advice about sensible drinking although there is good research evidence of the efficacy of such advice. Aim: The main aim was to explore the effects of a simple alcohol preventive routine in emergency care on staffs´ attitudes towards alcohol prevention and injury patients´ drinking pattern. Material and methods: A screening and simple advice routine was introduced at the emergency department of Motala County hospital. The staffs´ attitudes were explored by interviews with 12 staff members before the introduction and in 6 follow‐up interviews after a year. All the triage staffs´ attitudes were also measured by a questionnaire before the start of the routine and after 6 months. During the first 6 months of the routine 878 injury patients between 16 and 70 completed an alcohol screening questionnaire. During the next 6 months 647 patients received written advice about sensible drinking after having completed the screening questionnaire. A total of 619 patients included in the 12 months study period were followed‐up by telephone interview and changes in drinking pattern were analyzed. After a further 6 months of intervention a total of 2151 patients had been completing the questionnaire during the total study period of 18 months. The association between drinking pattern and different injury variables was analyzed in order to identify special risk groups and situations. Results: The staff was generally positive to alcohol prevention before the routine started and it was completed as intended. After 6 months of screening the staffs´ role legitimacy and perceived skills had increased. Despite of a further positive change in attitudes towards alcohol prevention the staff was uncertain after the study period whether emergency departments are appropriate settings for alcohol prevention. A total of 9% of the women and 31% of the men attending the emergency department for an injury were defined as risky drinkers. One single item in the questionnaire, concerning frequency of heavy episodic drinking, identified the majority of risky drinkers. In the cohort of patients,who was only screened, 34% was no longer engaged in heavy episodic drinking after 6 months and in the cohort that received written advice in addition to the screening the proportion was 25%. The latter group also increased readiness to change by 14%. The proportion of risky drinkers was higher among injury patients, 21% compared to 15% in the general population in the cathment area. This was mostly explained by a higher proportion of young men in the study group. When drinking pattern was compared, both risky and non‐risky drinkers proved to be significantly more likely than abstainers to be injured in amusement locations, parks, lakes or seas and during play or other recreational activities, when controlling for age and sex. Nine percent of the injury patients reported that they believed that their injury was related to alcohol. Half of this group was non risky‐drinkers. Conclusions: The triage staff performed the intervention as agreed, and in some aspects, which could facilitate further development of alcohol preventive measures, their attitudes changed positively. However, it appears difficult to expect alcohol preventive measures to involve more of the staff’s time than the routine tried, and other practical solutions have to be evaluated. A question about frequency of heavy episodic drinking identified the majority of risky drinkers and could be used as a single screening question. There was a reasonable reduction in heavy episodic drinking among the injury patients. The lack of a control group makes it difficult to fully explain whether this change is a result of the injury per se, the screening and the written advice procedure or a natural fluctuation in the patients´ drinking pattern. More studies are needed in order to establish the minimal levels of intervention in routine care that is accepted by the staff, and has a reasonable effect on risky drinkers’ alcohol consumption.

    List of papers
    1. Alcohol prevention measures at an emergency department: physicians` perspectives. Short communication
    Open this publication in new window or tab >>Alcohol prevention measures at an emergency department: physicians` perspectives. Short communication
    2005 (English)In: Public Health, ISSN 0033-3506, Vol. 119, no 9, p. 789-791Article in journal (Refereed) Published
    Keywords
    Physicians' attitudes; Routine alcohol screening; Prevention of alcohol problems; Emergency department
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13756 (URN)10.1016/j.puhe.2004.10.008 (DOI)
    Available from: 2006-01-16 Created: 2006-01-16
    2. Attitude changes among emergency department triage staff after conducting routine alcohol screening
    Open this publication in new window or tab >>Attitude changes among emergency department triage staff after conducting routine alcohol screening
    2006 (English)In: Addictive Behaviors, ISSN 0306-4603, Vol. 31, no 2, p. 191-202Article in journal (Refereed) Published
    Abstract [en]

    Excessive alcohol consumption is common among injury patients, but routine alcohol interventions seem to be difficult to implement in emergency departments. An obstacle seen in previous studies is the limited time available in a real-world setting for staff to participate in routine alcohol screening and interventions. In the present study, ordinary staff participated in a simple alcohol screening procedure. The aim of the study was to evaluate the feasibility of this procedure and if there was any change in attitudes and practices among triage staff after the implementation. We analyzed interviews with six staff members and questionnaires completed by 29 nurses and medical secretaries before and after a period of systematic routine screening. The staff reported that the routine worked well and that few patients reacted negatively. A positive change was seen in attitudes towards alcohol preventive measures in general. However, this seems not to be sufficient for the staff to spontaneously engage more actively. In fact, more of the staff were uncertain after the study period whether the emergency department is an appropriate place for alcohol screening and intervention despite an increased role legitimacy and perceived competence. There is a need for further development of alcohol prevention models that are acceptable for the staff to implement as part of the daily routine.

    Keywords
    Nurses; Medical secretaries; Attitude change; Emergency department; Obstacles to screening; Role legitimacy; Routine screening
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13757 (URN)10.1016/j.addbeh.2005.04.021 (DOI)
    Available from: 2006-01-16 Created: 2006-01-16
    3. Routine screening for risky alcohol consumption at an emergency department using the AUDIT-C questionnaire
    Open this publication in new window or tab >>Routine screening for risky alcohol consumption at an emergency department using the AUDIT-C questionnaire
    2004 (English)In: Drug and Alcohol Dependence, ISSN 0376-8716, Vol. 74, no 1, p. 71-75Article in journal (Refereed) Published
    Abstract [en]

    A questionnaire including the three AUDIT-C items was used to screen for alcohol use among trauma patients. The aim was to display, in a pragmatic way, how the AUDIT-C scores can be converted into different levels and kind of risky drinking. Using AUDIT-C scores with a cut-off score of 4 points for women and 5 for men indicated that 28% of the women and 40% of the men were risky drinkers. When calculating weekly alcohol consumption from the answers in AUDIT-C, 3% of the women and 7% of the men were hazardous and/or harmful drinkers. Regarding heavy episodic drinking 7% of the women and 30% of the men was drinking 72 g alcohol or more at on at least one occasion a month. These results indicate that the AUDIT-C score as such give little information about the pattern of alcohol consumption and that evaluation of risky drinking must be calculated from the three items in order to differentiate between risky drinking in terms of alcohol consumed per week and heavy episodic drinking.

    Keywords
    AUDIT-C, Increased-risk drinking, Screening, Emergency department, Alcohol consumption
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13758 (URN)10.1016/j.drugalcdep.2003.11.010 (DOI)
    Available from: 2006-01-16 Created: 2006-01-16
    4. Can screening and simple written advice reduce excessive alcohol consumption among emergency care patients?
    Open this publication in new window or tab >>Can screening and simple written advice reduce excessive alcohol consumption among emergency care patients?
    2005 (English)In: Alcohol & Alcoholism, ISSN 0735-0414 (print) 1464-3502 (online), Vol. 40, no 5, p. 401-408Article in journal (Refereed) Published
    Abstract [en]

    Aims: Emergency care patients have an overrepresentation of risky drinkers. Despite the evidence on the effectiveness of a short feedback on screening or self-help material, most studies performed so far have required considerable time from staff and thus been difficult to implement in the real world. The present study evaluates the effect of the screening and whether simple written advice has any additional effect on risky drinking.

    Methods: An alcohol screening routine was implemented among injury patients in a Swedish emergency care department. Over 12 months, two cohorts were invited to answer an alcohol screening questionnaire in the waiting room. In the first 6 months, 771 patients were screened without any written advice (cohort A) and in the following 6 months, 563 were screened and in addition received simple written advice about sensible drinking (cohort B). None of the patients received one-to-one feedback. Six months after the screening, a follow-up interview by telephone explored the changes in drinking.

    Results: In cohort A 182 (24%) of the patients were defined as risky drinkers and in cohort B 125 (22%). Reached at follow-up after 6 months were 81 (44%) risky and 278 (47%) non-risky drinkers in cohort A, and 40 (32%) risky and 220 (50%) non-risky drinkers in cohort B. The number of patients with heavy episodic drinking decreased significantly in cohort A from 76 (94% of the risky drinkers) to 49 (59%). In cohort B a similar change was seen from 37 (92%) to 27 (68%). Only in cohort B, was a significant increase in readiness to change drinking habits seen [from 3 (8%) to 9 (23%)]. The reduction in heavy episodic drinking was comparable with previous reports from more extensive interventions. However, at the time of follow-up, drinking among non-risky drinkers at baseline had increased. When considering the greater numbers of non-risky drinkers, the total consumption in the study group increased during the study period.

    Conclusions: Owing to the reported difficulties of integrating more time-consuming alcohol interventions in emergency departments, it is suggested that at least screening for drinking should be implemented as routine in emergency departments. More research is needed in order to establish the optimal balance between effective alcohol intervention, and acceptable time and effort requirement from staff.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13759 (URN)10.1093/alcalc/agh175 (DOI)
    Available from: 2006-01-16 Created: 2006-01-16 Last updated: 2009-05-28
    5. Usual drinking pattern and non‐fatal injury among patients seeking medical care
    Open this publication in new window or tab >>Usual drinking pattern and non‐fatal injury among patients seeking medical care
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    2006 (English)In: Public Health, ISSN 0033-3506, Vol. 120, no 11, p. 1064-1073Article in journal (Refereed) Published
    Abstract [en]

    Objectives

    To explore the association between drinking patterns, irrespective of whether alcohol was consumed in the event of the injury or not, and different injury variables; and to identify settings and situations in which risky drinkers have an increased likelihood of injury.

    Study design

    The study population consisted of all patients aged 18–70 years registered for an injury according to ICD-10 at a Swedish emergency department during an 18-month period. After informed consent, the injury patients were screened for drinking habits by the AUDIT-C questionnaire. The gender, age and drinking pattern of injury patients were compared with the general population.

    Methods

    A total of 2782 patients aged 18–70 years were registered for an injury during the study period. The number of drop-outs was 631. Drop-outs include those who did not consent to participate, were severely injured, too intoxicated or did not fill out the questionnaire satisfactory. Thus, 77.3% of the target group were included for further analysis (1944 drinkers and 207 abstainers). The patients were categorized into three drinking categories: abstainers, non-risky and risky drinkers. Risky drinkers were defined according to usual weekly consumption of 80 g or more of alcohol for women and 110 g or more for men and/or heavy episodic drinking (i.e. having six glasses or more one glass=12 g alcohol), or both, on one occasion at least once a month, valid for both women and men. To estimate the relationship between drinking patterns and the injury variables (environment, cause of injury, activity and diagnosis), odds ratios (OR) were calculated by logistic regression. Multiple logistic regression was used in order to control for age and sex differences between the various drinking and injury categories.

    Results

    The proportion of risky drinkers was higher in the study population compared with the general population in the same area. When controlling for age and sex, risky drinkers (OR 6.4adj Confidence interval CI 1.9–21.2) and non-risky drinkers (OR .4.5adj CI 1.4–14.5) displayed an increased risk for injury compared with abstainers, in amusement locations, parks, by or on lakes or seas, especially while engaged in play, hobby or other leisure activities (risky drinkers: OR 2.8adj CI 1.3–5.6; non-risky drinkers: OR 2.4adj CI 1.2–4.6). All differences between drinking patterns in external cause of injury disappeared when age and sex were considered. During rest, meals and attending to personal hygiene, the non-risky drinkers had a lower probability of injury compared with abstainers (OR 0.3adj CI 0.1–0.8). Non-risky drinkers had a higher probability than abstainers of suffering luxation (dislocation) or distortion (OR 1.6adj CI 1.1–2.5). Nine per cent of the study population reported that they believed that their injury was related to intake of alcohol. Half of this group were non-risky drinkers (CI for the 13.7% difference was 9.7–17.6).

    Conclusions

    Few significant associations between drinking pattern and injury remained when age and sex were controlled for.

    Keywords
    Usual alcohol drinking patterns; Non-fatal injury; Risky drinkers; Emergency care
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13760 (URN)10.1016/j.puhe.2006.06.007 (DOI)
    Available from: 2006-01-16 Created: 2006-01-16 Last updated: 2009-05-28
  • 30.
    Richt, Bengt
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Ett krympande liv2005In: Sjukdomsvärldar.: Människors erfarenheter av kroppslig ohälsa / [ed] Bengt Richt, Gunilla Tegern, Lund: Studentlitteratur , 2005, 1, p. 231-256Chapter in book (Other academic)
    Abstract [sv]

        

    En stor andel av befolkningen i de västerländska samhällena och en växande andel världen över lever med långvarig kroppslig ohälsa. Den utbredda förekomsten har en djupgående påverkan på sättet att leva, både bland de redan sjuka och bland dem som är friska. Kunskap om den kroppsliga ohälsans personliga, sociala och kulturella dimensioner är därför av grundläggande betydelse för förståelsen av tendenser och processer i samtiden.

    Boken bygger på berättelser från personer som själva lever med olika former av långvarig och ibland svår kroppslig ohälsa. Några kapitel är rättframt rapporterande, medan andra ansluter till sådana förståelseramar som fenomenologi, symbolisk interaktionism och analytisk filosofi. Texten ansluter sig till den internationella vetenskapliga tradition som under senare tid har försökt ge den levda erfarenheten av ohälsa ett språk och en röst, i opposition mot eller som komplement till ett rent biomedicinskt perspektiv. Den är utpräglat tvärvetenskaplig och skriven av personer med olika ämnesbakgrund, alltifrån omvårdnadsvetenskap, filosofi, sociologi och pedagogik till sjukgymnastik och arbetsterapi.

    Sjukdomsvärldar vänder sig till alla med intresse för vad det kan innebära att leva med kroppslig ohälsa i vardagslivet och för hur de möjliga innebörderna formas av mer övergripande sociala och kulturella omständigheter. Den tvärvetenskapliga inriktningen gör boken väl användbar på såväl olika vårdutbildningar som kurser i både samhällsvetenskap och humaniora.

  • 31.
    Svensson, Tommy
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Karlsson, A
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Shame-inducing encounters. Negative emotional aspects of sickness-absentees' interactions with rehabilitation professionals2003In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 13, no 3, p. 183-195Article in journal (Refereed)
    Abstract [en]

    There is little knowledge on how sickness absentees experience encounters with rehabilitation professionals. This paper explores and describes negative emotions ("shame " in a broad sense) experienced by individuals on sick leave in their interactions with rehabilitation professionals. We performed a qualitative analysis of data from five focus-group interviews. The participants had experience of sickness absence with back diagnoses and discussed factors that facilitate or impede return to work. Reports of demeaning experiences in encounters with rehabilitation workers were frequent and could be divided into two major categories: 1) subjects perceived the behavior of rehabilitation professionals as distanced in a negative way, and felt that they were treated in an indifferent and nonchalant manner or fairly routinely, 2) subjects felt that they were disqualified, which included being discredited or belittled. This explorative study indicates the need for further, more directed investigations of emotional aspects of interactions between sickness absentees and rehabilitation professionals.

  • 32.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Health and Developmental Care, Centre for Public Health.
    Nordqvist, Cecilia
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Festin, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Quality indicators for implementation of safety promotion: Towards valid and reliable global certification of local programmes2012In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 7, no 6, p. 588-602Article in journal (Refereed)
    Abstract [en]

    The theoretical underpinnings of safety promotion have not yet been integrated with implementation practice to ascertain between-community programme quality. This study sets out to develop a framework for verifying of the quality of community-based safety-promotion programmes in the global context. We analysed the certification indicators deployed in the international Safe Community movement in light of systems theory. Data were collected from focus group interviews with representatives from 10 certified Swedish communities and then analysed by qualitative methods. The community representatives were found to have used the present indicators mainly for marketing the safety-promotion concept to stakeholders rather than as benchmarks for safety practice. When appraised in regard to systems theory, it was found that the indicators did not cover important aspects of health-services implementation. Attainment of outcomes at the population level was not included. Consequently, that information about programme effects in high-risk groups and in risk environments could be neglected. We conclude that programme processes and outcomes at both organisational and population levels must be assessed when the quality of safety-promotion programmes is being certified. A revised set of indicators for certification of safety-promotion programmes fulfilling these criteria is presented.

  • 33.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nordqvist, Cecilia
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Lindqvist , Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Infrastructural requirements for local implementation of safety policies: the discordance between top-down and bottom-up systems of action2009In: BMC HEALTH SERVICES RESEARCH, ISSN 1472-6963 , Vol. 9, no 45Article in journal (Refereed)
    Abstract [en]

    Background: Safety promotion is planned and practised not only by public health organizations, but also by other welfare state agencies, private companies and non-governmental organizations. The term infrastructure originally denoted the underlying resources needed for warfare, e. g. roads, industries, and an industrial workforce. Today, infrastructure refers to the physical elements, organizations and people needed to run projects in different societal arenas. The aim of this study was to examine associations between infrastructure and local implementation of safety policies in injury prevention and safety promotion programs.

    Methods: Qualitative data on municipalities in Sweden designated as Safe Communities were collected from focus group interviews with municipal politicians and administrators, as well as from policy documents, and materials published on the Internet. Actor network theory was used to identify weaknesses in the present infrastructure and determine strategies that can be used to resolve these.

    Results: The weakness identification analysis revealed that the factual infrastructure available for effectuating national strategies varied between safety areas and approaches, basically reflecting differences between bureaucratic and network-based organizational models. At the local level, a contradiction between safety promotion and the existence of quasi-markets for local public service providers was found to predispose for a poor local infrastructure diminishing the interest in integrated inter-agency activities. The weakness resolution analysis showed that development of an adequate infrastructure for safety promotion would require adjustment of the legal framework regulating injury data exchange, and would also require rational financial models for multi-party investments in local infrastructures.

    Conclusion: We found that the "silo" structure of government organization and assignment of resources was a barrier to collaborative action for safety at a community level. It may therefore be overly optimistic to take for granted that different approaches to injury control, such as injury prevention and safety promotion, can share infrastructure. Similarly, it may be unrealistic to presuppose that safety promotion can reach its potential in terms of injury rate reductions unless the critical infrastructure for this is in place. Such an alignment of the infrastructure to organizational processes requires more than financial investments.

1 - 33 of 33
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