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  • 1.
    Carlsson, Noomi
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Alehagen, Siw
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Andersson Gäre, Boel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Johansson, AnnaKarin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    "Smoking in children's environment test": a qualitative study of experiences of a new instrument applied in preventive work in child health care2011Ingår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 11, nr 113Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Despite knowledge of the adverse health effects of passive smoking, children are still   being exposed. Children's nurses play an important role in tobacco preventive work   through dialogue with parents aimed at identifying how children can be protected from   environmental tobacco smoke (ETS) exposure. The study describes the experiences of   Child Health Care (CHC) nurses when using the validated instrument SiCET (Smoking   in Children's Environment Test) in dialogue with parents.

    Method

    In an intervention in CHC centres in south-eastern Sweden nurses were invited to use   the SiCET. Eighteen nurses participated in focus group interviews. Transcripts were   reviewed and their contents were coded into categories by three investigators using   the method described for focus groups interviews.

    Results

    The SiCET was used in dialogue with parents in tobacco preventive work and resulted   in focused discussions on smoking and support for behavioural changes among parents.   The instrument had both strengths and limitations. The nurses experienced that the   SiCET facilitated dialogue with parents and gave a comprehensive view of the child's   ETS exposure. This gave nurses the possibility of taking on a supportive role by offering   parents long-term help in protecting their child from ETS exposure and in considering   smoking cessation.

    Conclusion

    Our findings indicate that the SiCET supports nurses in their dialogue with parents   on children's ETS exposure at CHC. There is a need for more clinical use and evaluation   of the SiCET to determine its usefulness in clinical practice under varying circumstances.

  • 2.
    Carlsson, Noomi
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Johansson, AnnaKarin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Abrahamsson, Agneta
    Jönköping University, School of Health Sciences, Jönköping, Sweden.
    Andersson-Gäre, Boel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    How to minimize children’s environmental tobacco smoke exposure: An intervention study in a child health service setting2013Ingår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, nr 76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Despite the low prevalence of daily smokers in Sweden, children are still being exposed to environmental tobacco smoke (ETS), primarily by their smoking parents. A prospective intervention study using methods from Quality Improvement was performed in Child Health Care (CHC). The aim was to provide nurses with new methods for motivating and supporting parents in their efforts to protect children from ETS exposure. Method: Collaborative learning was used to implement and test an intervention bundle. Twenty-two CHC nurses recruited 86 families with small children which had at least one smoking parent. Using a bundle of interventions, nurses met and had dialogues with the parents over a one-year period. A detailed questionnaire on cigarette consumption and smoking policies in the home was answered by the parents at the beginning and at the end of the intervention, when children also took urine tests to determine cotinine levels. Results: Seventy-two families completed the study. Ten parents (11%) quit smoking. Thirty-two families (44%) decreased their cigarette consumption. Forty-five families (63%) were outdoor smokers at follow up. The proportion of children with urinary cotinine values of >6 ng/ml had decreased. Conclusion: The intensified tobacco prevention in CHC improved smoking parents' ability to protect their children from ETS exposure.

  • 3.
    Carlsson, Noomi
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Johansson, AnnaKarin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Hermansson, Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Andersson-Gäre, Boel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Parents' attitudes to smoking and passive smoking and their experience of the tobacco preventive work in child health care2011Ingår i: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, nr 4, s. 272-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to describe parents' attitudes to smoking and their experience of the tobacco preventive work in antenatal care and in Child Health Care (CHC) in Sweden. A population based survey in which 62 percent of 3000 randomly selected parents with 1- and 3-year-old children answered a questionnaire. Fifty-six percent stated that smoking was registered in the health record of the child yet no further discussion regarding passive smoking took place. The parents' educational level and smoking status was related to the attitudes and experiences of the tobacco preventive work. The results indicated that the dialogue with parents regarding children and environmental tobacco smoke (ETS) exposure has to be redesigned and intensified in order to meet the needs of parents with different backgrounds.

  • 4.
    Rejler, Martin
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Spångeus, Anna
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrin- och magtarmmedicinska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin.
    Tholstrup, Jörgen
    Department of Medicine, Hoglands Hospital in Eksjö, Sweden.
    Andersson-Gäre, Boel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Improved population-based care: Implementing patient-and demand-directed care for inflammatory bowel disease and evaluating the redesign with a population-based registry2007Ingår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 16, nr 1, s. 38-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The gastroenterology unit at the Höglands Hospital in Eksjö is responsible for the care of all 466 patients with inflammatory bowel disease (IBD) in a geographic area including approximately 115,000 inhabitants. In 2000, the frustration over an inadequate traditional outpatient clinic inspired us to redesign our outpatient unit to become more patient and demand directed. The redesign included the following: A direct telephone line for patients to a specialized nurse, available during working hours, appointments were scheduled in accordance with expected needs, and emergency appointments were available daily, traditional follow-ups of IBD patients were replaced by an annual telephone contact with a specialized nurse, the team agreed on a patient-centered value base for its work, and the redesign was monitored using clinical outcome measures reflecting 4 dimensions (see parentheses below) of the care in a "Value compass", quality of life (functional) and routine blood samples (clinical) were followed yearly and collected in a computerized IBD registry together with basic information about the patients, access and waiting lists together with patient satisfaction (satisfaction) are followed regularly, and ward utilization (financial) was registered. Our study shows that the new design offers a more efficient outpatient clinic in which waiting lists are markedly reduced although production rates remains the same. Utilization data show a significant decrease in comparison with national data, showing that the new care is economically favorable. The clinical results regarding anemia frequency in the IBD population are highly comparable with or even better than those found in the literature. We also show good results regarding quality of life where more than 88% of patients achieve set goals. In conclusion, our new patient- and demand-directed care seems to be more efficient and with clinical and quality-of-life results remaining on a high standard. ©2007Lippincott Williams & Wilkins, Inc.

  • 5.
    Stevens, D.P.
    et al.
    Quality Literature Program, Dartmouth Institute for Health Policy and Patient Care, Lebanon, NH, United States, Quality Literature Program, Dartmouth Institute for Health Policy and Patient Care, 30 Lafayette Street, Lebanon, NH 03766, United States.
    Andersson-Gäre, Boel
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin.
    A proposal: Publication guidelines for healthcare improvement education reports2007Ingår i: Quality and Safety in Healthcare, ISSN 1475-3898, E-ISSN 1470-7934, Vol. 16, nr 6, s. 402-403Övrigt (Övrigt vetenskapligt)
    Abstract [en]

    [No abstract available]

  • 6.
    Thörne, Karin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Hult, Håkan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Pedagogik och vuxnas lärande. Linköpings universitet, Utbildningsvetenskap.
    Andersson Gäre, Boel
    Jönköping University, Sweden.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    The Dynamics of Physicians’ Learning and Support of Others’ Learning2014Ingår i: Professions & Professionalism, ISSN 1893-1049, E-ISSN 1893-1049, Vol. 4, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Learning has been defined as a condition for improving the quality of healthcare practice. The focus of this paper is on physicians’ learning and their support of others’ learning in the context of Swedish healthcare. Data were generated through individual and focus group interviews and analyzed from a socio-material practice theory perspective. During their workday, physicians dynamically alternated between their own learning and their support of others’ learning in individual patient processes. Learning and learning support were interconnected with the versatile mobility of physicians across different contexts and their participation in multiple communities of collaboration and through tensions between responsibilities in healthcare. The findings illustrate how learning enactments are framed by the existing “practice architectures.” We argue that productive reflection on dimensions of learning enactments in practice can enhance physicians’ professional learning and improve professional practice.

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