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  • 1.
    Adolfsson, Emelie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences.
    Smide, B.
    Dept. of Pub. Hlth. and Caring Sci., Uppsala University, Uppsala, Sweden.
    Gregeby, E.
    Köping Hospital, Köping, Sweden.
    Fernstrom, L.
    Fernström, L., Diabet. Educ. and Research Centre, Karolinska Hospital, Karolinska, Sweden.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning.
    Implementing empowerment group education in diabetes2004In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 53, no 3, p. 319-324Article, review/survey (Refereed)
    Abstract [en]

    The overall aim was to gain insight into and understand how physicians and nurses view the implementation of empowerment group education (EGE) in diabetes. Prior to the study the physicians and nurses attended a 2-day empowerment workshop. Further, they had implemented the empowerment approach in two groups of patients with type II diabetes. Three to 9 months later they (five physicians and 11 nurses from six family practices) participated in focus group interviews to evaluate the implementation of the EGE. The interviews were audio-taped, transcribed and analysed using the constant comparative method. The main result showed a conflict in roles. The physicians and nurses knew their role in the traditional approach but not with respect to the empowerment approach, which they needed to grow into. At the same time as they started a new way of working, their role had changed from being an expert to being a facilitator. As experts they felt secure, as facilitators they needed support in their educational process. To implement EGE they required support both from the family practice and from a supervisor in direct connection with the EGE. © 2004 Elsevier Ireland Ltd. All rights reserved.

  • 2.
    Ali, Lilas
    et al.
    Gothenburg University, Sweden Swedish Institute Health Science, Sweden Sahlgrens University Hospital, Sweden .
    Krevers, Barbro
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Vårdal Institute, The Swedish Institute for Health Science, Sweden.
    Sjostrom, Nils
    Gothenburg University, Sweden Sahlgrens University Hospital, Sweden .
    Skarsater, Ingela
    Gothenburg University, Sweden Swedish Institute Health Science, Sweden Sahlgrens University Hospital, Sweden Halmstad University, Sweden .
    Effectiveness of web-based versus folder support interventions for young informal carers of persons with mental illness: A randomized controlled trial2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, no 3, p. 362-371Article in journal (Refereed)
    Abstract [en]

    Objective: Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness. Methods: This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N = 241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes. Results: The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being. Conclusion: Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low wellbeing. This signals a need for support. Practice implications: The non-significant differences show that each intervention can be effective, and that it depends upon the individuals preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy.

  • 3.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Vaxjö University.
    Martensson, Jan
    Jönköping University.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Perceived informational needs, side-effects and their consequences on adherence-A comparison between CPAP treated patients with OSAS and healthcare personnel2009In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 74, no 2, p. 228-235Article in journal (Refereed)
    Abstract [en]

    Objective: To compare perceptions among continuous positive airway pressure (CPAP) treated patients with obstructive sleep apnoea syndrome (OSAS) and healthcare personnel with regard to informational needs, side-effects and their consequences on adherence.

    Methods: A cross-sectional descriptive design was used including 350 CPAP treated OSAS patients from three Swedish hospitals and 105 healthcare personnel from 26 Swedish hospitals. Data collection was performed using two questionnaires covering informational needs, side-effects and adherence to CPAP.

    Results: Both groups perceived all surveyed informational areas as very important. Patients perceived the possibilities to learn as significantly greater in all areas (p < 0.001) compared to healthcare personnel, and scored significantly higher regarding positive effects on adherence of information about pathophysiology (p < 0.05), self-care (p < 0.001) and troubleshooting (p < 0.01). A total of I I out of 15 surveyed side-effects were perceived to be more frequent by healthcare personnel (p < 0.01 - p < 0.001). They also scored all side-effects to cause greater problems and decrease the CPAP use to a greater extent (p < 0.001).

    Conclusion: Knowledge about these differences between patients and healthcare personnel regarding educational needs, side-effects and their effects on adherence can be important when designing educational programmes to increase CPAP adherence.

    Practice implications: Measurement of these parameters before, during and after educational programs are suggested.

  • 4.
    Byrne, Molly
    et al.
    National University of Ireland, Galway.
    Doherty, Sally
    Royal College of Surgeons in Ireland, Dublin.
    Murphy, Andrew W
    National University of Ireland, Galway.
    McGee, Hannah M
    Royal College of Surgeons in Ireland, Dublin.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Communicating about sexual concerns within cardiac health services: Do service providers and service users agree?2013In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 3, p. 398-403Article in journal (Refereed)
    Abstract [en]

    Objective

    Sexual assessment and counselling is a recommended, yet underprovided and challenging, aspect of cardiac rehabilitation. We compared the views of cardiac healthcare providers and patients in terms of their experiences of communication about sexual issues.

    Methods

    Cardiac patients (n = 382) completed telephone surveys and hospital cardiac rehabilitation staff (n = 60) and general practitioners (n = 61) returned postal questionnaires.

    Results

    Patients reported that sex was rarely discussed, yet nearly half of patients said they would have liked this opportunity. Most general practitioners (70%) reported not addressing sex with their patients and the majority of cardiac rehabilitators (almost 61%) reported that sexual problems were poorly addressed in their service. Patients perceived fewer barriers to communication (the main barrier was lack of privacy) than health professionals (the primary barrier for general practitioners was lack of time, and for cardiac rehabilitation staff, lack of training).

    Conclusion

    All participants agreed that sexual assessment and counselling is currently poorly implemented. A gap exists: patients, who generally want sexual issues to be addressed, perceive fewer barriers to communication than healthcare providers, who fear causing anxiety and discomfort by raising sexual issues with their patients.

    Practice implications

    Developing brief interventions for healthcare providers and information materials for patients are recommended.

  • 5.
    Ekdahl, Anne
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatric Medicine in Norrköping.
    Andersson, Lars
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    They do what they think is the best for me: Frail elderly patients' preferences for participation in their care during hospitalization.2010In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 80, no 2, p. 233-240Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To deepen the knowledge of frail elderly patients' preferences for participation in medical decision making during hospitalization. METHODS: Qualitative study using content analysis of semi-structured interviews.

    RESULTS: Patient participation to frail elderly means information, not the wish to take part in decisions about their medical treatments. They view the hospital care system as an institution of power with which they cannot argue. Participation is complicated by barriers such as the numerous persons involved in their care who do not know them and their preferences, differing treatment strategies among doctors, fast patient turnover in hospitals, stressed personnel and linguistic problems due to doctors not always speaking the patient's own language.

    CONCLUSION: The results of the study show that, to frail elderly patients, participation in medical decision making is primarily a question of good communication and information, not participation in decisions about medical treatments.

    PRACTICE IMPLICATIONS: More time should be given to thorough information and as few people as possible should be involved in the care of frail elderly. Linguistic problems should be identified to make it possible to take the necessary precautions to prevent negative impact on patient participation.

  • 6.
    Grankvist, Olov
    et al.
    Norrbotten County Council, Luleå, Sweden.
    Olofsson, Anders D.
    Umeå University, Sweden .
    Isaksson, Rose-Marie
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Norrbotten County Council, Luleå, Sweden.
    Can physicians be replaced with gynecological teaching women to train medical students in their first pelvic examination? A pilot study from Northern Sweden2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 96, no 1, p. 50-54Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The main objective was to gain a deeper understanding of how medical students perceive and experience learning from gynecological teaching women (GTW) instead of physicians in their first pelvic examination. A second aim was to describe how the women experience their roles as GTW.

    METHODS:

    Data were collected from individual interviews with 24 medical students from a medical school in Sweden and with 5 GTW. Discourse analysis was performed to acquire a deeper understanding of the informants' experiences and to understand social interactions.

    RESULTS:

    Five themes revealed in the medical students' experiences: "Hoping that anxiety will be replaced with security," "Meeting as equals creates a sense of calm," "Succeeding creates a sense of security for the future," "Wanting but not having the opportunity to learn more," and "Feeling relieved and grateful." One theme revealed in the GTW experiences: "Hoping to relate in a trustworthy way."

    CONCLUSION:

    To replace physicians with GTW may facilitate the learning process and may also help medical students improve their communicative skills. Using GTW will hopefully further improve students' basic medical examination techniques and physician-patient relationships.

    PRACTICE IMPLICATIONS:

    Since GTW seems to increase self-confidence and skills of medical students performing their first pelvic examination we recommend that the use of GTW is considered in the training of medical students.

  • 7. Göransson, A.
    et al.
    Dahlgren, Lars-Ove
    Linköping University, Faculty of Educational Sciences. Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education.
    Lennerstrand, G.
    Changes in conceptions of meaning, effects and treatment of amblyopia. A phenomenographic analysis of interview data from parents of strabismic children.1998In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, ISSN 0738-3991, Vol. 34, p. 213-225Article in journal (Refereed)
  • 8.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ben Gal, Tuvia
    Rabin Medical Centre, Israel.
    Cameron, Jan
    Australian Catholic University, Australia.
    Driscoll, Andrea
    Deakin University, Australia.
    Duengen, Hans-Dirk
    Charite, Germany.
    Inkrot, Simone
    Charite, Germany.
    Huang, Tsuey-Yuan
    Chang Gung University of Science and Technology, Taiwan.
    Ngoc Huyen, Nguyen
    University of Tokyo, Japan.
    Kato, Naoko
    University of Tokyo, Japan.
    Koeberich, Stefan
    University of Heart Centre Freiburg Bad Krozingen, Germany.
    Lupon, Josep
    Hospital University of Germans Trios and Pujol, Spain.
    Moser, Debra K.
    University of Kentucky, KY USA.
    Pulignano, Giovanni
    S Camillo Forlanini Hospital, Italy.
    Rejane Rabelo, Eneida
    University of Federal Rio Grande do Sul, Brazil.
    Suwanno, Jom
    Walailak University, Thailand.
    Thompson, David R.
    Australian Catholic University, Australia.
    Vellone, Ercole
    Tor Vergata University, Rome, Italy.
    Alvaro, Rosaria
    Tor Vergata University, Rome, Italy.
    Yu, Doris
    Chinese University of Hong Kong, Hong Kong.
    Riegel, Barbara
    University of Penn, USA.
    Comparison of self-care behaviors of heart failure patients in 15 countries worldwide2013In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 1, p. 114-120Article in journal (Refereed)
    Abstract [en]

    Objective

    Clinicians worldwide seek to educate and support heart failure patients to engage in self-care. We aimed to describe self-care behaviors of patients from 15 countries across three continents.

    Methods

    Data on self-care were pooled from 5964 heart failure patients from the United States, Europe, Australasia and South America. Data on self-care were collected with the Self-care of Heart Failure Index or the European Heart Failure Self-care Behavior Scale.

    Results

    In all the samples, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 samples, more than 50% of the patients reported low exercise levels. In 16 samples, less than half of the patients weighed themselves regularly, with large differences among the countries. Self-care with regard to receiving an annual flu shot and following a low sodium diet varied most across the countries.

    Conclusion

    Self-care behaviors are sub-optimal in heart failure patients and need to be improved worldwide.

    Practice implications

    Interventions that focus on specific self-care behaviors may be more effective than general educational programs. Changes in some health care systems and national policies are needed to support patients with heart failure to increase their self-care behavior.

  • 9.
    Jungner, Johanna Granhagen
    et al.
    Karolinska Inst, Sweden.
    Tiselius, Elisabet
    Karolinska Inst, Sweden; Stockholm Univ, Sweden.
    Wenemark, Marika
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Blomgren, Klas
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Lutzen, Kim
    Karolinska Inst, Sweden.
    Pergert, Pernilla
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Development and evaluation of the Communication over Language Barriers questionnaire (CoLB-q) in paediatric healthcare2018In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 9, p. 1661-1668Article in journal (Refereed)
    Abstract [en]

    Objective: To develop a valid and reliable questionnaire addressing the experiences of healthcare personnel of communicating over language barriers and using interpreters in paediatric healthcare. Methods: A multiple- methods approach to develop and evaluate the questionnaire, including focus groups, cognitive interviews, a pilot test and test-retest. The methods were chosen in accordance with questionnaire development methodology to ensure validity and reliability. Results: The development procedure showed that the issues identified were highly relevant to paediatric healthcare personnel and resulted in a valid and reliable Communication over Language Barriers questionnaire (CoLB-q) with 27 questions. Conclusion: The CoLB-q is perceived as relevant, important and easy to respond to by respondents and has satisfactory validity and reliability.amp; nbsp; Practice implications: The CoLB-q can be used to map how healthcare personnel overcome language barriers through communication tools and to identify problems encountered in paediatric healthcare. Furthermore, the transparently described process could be used as a guide for developing similar questionnaires. (C) 2018 The Authors. Published by Elsevier B.V.

  • 10. Kjellgren, K.I.
    et al.
    Svensson, Samuel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Pharmacology .
    Ahlner, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology .
    Saljo, R.
    Antihypertensive treatment and patient autonomy - The follow-up appointment as a resource for care2000In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 40, no 1, p. 39-49Article in journal (Refereed)
    Abstract [en]

    Since hypertension is a chronic condition which generally requires long-term commitment to pharmacological therapy as well as alterations of patient lifestyle, the patient-physician communication in the clinical setting is an important determinant of the quality of care and health outcome. The aim of the present study was to explore the structure and content of the communication between the patient and the physician, and the process of decision-making at a routine follow-up appointment for hypertension. The study was based on 51 audio-recordings of authentic consultations. Most patients had a passive role in the consultations, and initiated few topics of conversation. The few topics that the patients initiated were usually not about hypertension. Patients' questions about medication mainly referred to unwanted effects of the drugs. Little time was invested in discussing risks related to hypertension. A collaborative shared decision-making was seldom observed in the consultations. Copyright (C) 2000 Elsevier Science Ireland Ltd.

  • 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.
    Madson, Michael B.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Rubak, Sune
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. 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.
    A systematic review of motivational interviewing training for general health care practitioners2011In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 84, no 1, p. 16-26Article in journal (Refereed)
    Abstract [en]

    Objectiv: This article systematically reviews empirical studies that have evaluated different aspects of motivational interviewing (MI) training for general health care professionals.

    Method: Studies were obtained from several databases. To be included, the MI training had to be provided specifically for general health care practitioners for use in their regular face-to-face counselling. The training outcomes had to be linked to the MI training.

    Result: Ten studies were found. The median length of the training was 9 h. The most commonly addressed training elements were basic MI skills, the MI spirit, recognizing and reinforcing change talk, and rolling with resistance. Most studies involved follow-up training sessions. The study quality varied considerably. Five studies assessed training outcomes at a single point in time, which yields low internal validity. Four studies used random assignment of practitioners to the MI training and comparison conditions. The training generated positive outcomes overall and had a significant effect on many aspects of the participants’ daily practice, but the results must be interpreted with caution due to the inconsistent study quality.

    Conclusion: The generally favourable training outcomes suggest that MI can be used to improve client communication and counselling concerning lifestyle-related issues in general health care. However, the results must be interpreted with caution due to inconsistent methodological quality of the studies.

    Practice implication: This review suggests that MI training outcomes are generally favourable, but more high-quality research is needed to help identify the best practices for training in MI.

  • 12.
    Luhr, Kristina
    et al.
    University Health Care Research Center, Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Holmefur, Marie
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Theander, Kersti
    Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Eldh, Ann Catrine
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Dalarna University, Sweden; Uppsala University, Sweden.
    Patient participation during and after a self-management programme in primary healthcare: The experience of patients with chronic obstructive pulmonary disease or chronic heart failure2018In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 6, p. 1137-1142Article in journal (Refereed)
    Abstract [en]

    Objective

    Patient participation is facilitated by patients’ ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation.

    Methods

    Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis.

    Results

    Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals’ personal traits and the context.

    Conclusion

    Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF.

    Practice implications

    A self-management programme can complement regular primary care regarding enhanced understanding of one’s disease and support patient participation and the patient’s own resources in self-management.

  • 13.
    Lundgren, Johan
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Kärner Köhler, Anita
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Johansson, Peter
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Internet-based cognitive behavior therapy for patients with heart failure and depressive symptoms: A proof of concept study2015In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 98, no 8, p. 935-942Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was (1) to describe the development of a guided internet-based CBT (ICBT) program adapted to patients with heart failure (HF) and (2) to evaluate the feasibility of the ICBT program in regard to depressive symptoms, the time used by health care providers to give feedback, and participants perceptions of the ICBT program. Method: A multi-professional team developed the program and seven HF patients with depressive symptoms were recruited to the study. The Patient Health Questionnaire-9 (PHQ-9) and the Montgomery Asberg Depression Rating-Self-rating scale (MADRS-S) were used to measure depression, and patients were interviewed about their perceptions of the program. Results: Based on research in HF and CBT, a nine-week program was developed. The median depression score decreased from baseline to the end of the study (PHQ-9: 11-8.5; MADRS-S: 25.5-16.5) and none of the depression scores worsened. Feedback from health care providers required approximately 3 h per patient. Facilitating perceptions.(e.g. freedom of time) and demanding perceptions (e.g. part of the program demanded a lot of work) were described by the patients. Conclusion: The program appears feasible and time-efficient. However, the program needs to be evaluated in a larger randomized study.

  • 14. Magnusson, M.
    et al.
    Hergils, Leif
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Late diagnosis of congenital hearing impairment in children. The parents´experiences and opinions.2000In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 41, no 3, p. 285-294Article in journal (Refereed)
    Abstract [en]

    The purpose of the present investigation is to describe how parents experience a delayed identification of their child's hearing impairment. Ten parents of 8 children were interviewed. The impairment was confirmed when the children were between 2 years, and 5 years and 8 months. The results show that the parents and their child pass through a series of distinct phases: Unawareness, Suspicion, Confirmation and Habilitation. After the birth of the child there was first a calm period, which lasted until the possibility of a hearing impairment was suspected. Once the suspicion was raised, a time of much anxiety and frustration ensued. The parents described how defective communication and misunderstanding lead to frequent conflicts with their child. The differing behaviour of the child, in combination with poor language development, initiated referral to audiological assessment and confirmation of the hearing impairment. After confirmation, the parents felt relief but at the same time a sorrow. When hearing aids had been fitted and education in sign language was under way, the child's language and social behaviour improved. Supposedly, the late detection is explained by the combination of an insufficient test method that cannot detect all children with a hearing impairment and, in cases of uncertainty, a tendency to let the child pass rather than 'bringing bad news'. All parents in the present study would have wished to participate in a hearing screening program for new-borns, had the opportunity been present.

  • 15.
    Matsuoka, Shiho
    et al.
    Tokyo Medical and Dent University, Japan.
    Tsuchihashi-Makaya, Miyuki
    Kitasato University, Japan.
    Kayane, Takahiro
    Edogawa Hospital, Japan.
    Yamada, Michiyo
    Edogawa Hospital, Japan.
    Wakabayashi, Rumi
    Tokyo Womens Medical University Hospital, Japan.
    Perkiö Kato, Naoko
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Yazawa, Miyuki
    Saiseikai Karatsu Hospital, Japan.
    Health literacy is independently associated with self-care behavior in patients with heart failure2016In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 99, no 6, p. 1026-1032Article in journal (Refereed)
    Abstract [en]

    Objective: Health literacy (HL) has been recognized as an important concept in patient education and disease management for heart failure (HF). However, previous studies on HL have focused predominantly on the relationships between functional HL (the ability to read and write), comprehensive HL including the ability to access information (communicative HL), and the ability to critically evaluate information (critical HL). Self-care behavior has not been evaluated. This study determined the relationship between functional, communicative, and critical HL and self-care behavior in HF patients. Methods: Cross-sectional analysis of the data was completed for HL, HF-related knowledge, and HF-related self-care behaviors. Sociodemographic and clinical characteristics were also assessed. Multivariate linear regression analysis was used to estimate the associations between literacy and self-care behavior. Results: 249 patients with HF were assessed (mean age, 67.7 +/- 13.9 years). Patients with low HL had poorer knowledge and self-care behavior than those with high HL. Critical HL was an independent determinant of self-care behavior (s beta = -0.154, P = 0.027). Conclusions: Critical HL was independently associated with self-care behavior in HF patients. Practice implications: Effective intervention should be developed to improve patient skills for critically analyzing information and making decisions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 16.
    Rönning, Helén
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nielsen, Niels Erik
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Swahn, Eva
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Description and initial evaluation of an educational and psychosocial support model for adults with congenitally malformed hearts2011In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 83, no 2, p. 247-251Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Various programmes for adults with congenitally malformed hearts have been developed, but detailed descriptions of content, rationale and goals are often missing. The aim of this study was to describe and make an initial evaluation of a follow-up model for adults with congenitally malformed hearts, focusing on education and psychosocial support by a multidisciplinary team (EPS).

    METHODS: The model is described in steps and evaluated with regards to perceptions of knowledge, anxiety and satisfaction.

    RESULTS: The EPS model included a policlinic visit to the physician/nurse (medical consultation, computer-based and individual education face-to-face as well as psychosocial support) and a 1-month telephone follow-up. Fifty-five adults (mean age 34, 29 women) with the nine most common forms of congenitally malformed hearts participated in the EPS model as well as the 3-months follow-up. Knowledge about congenital heart malformation had increased in 40% of the participants at the 3-months follow-up.

    CONCLUSION: This study describes and evaluates a model that combines a multidisciplinary approach and computer-based education for follow-up of adults with congenitally malformed hearts. The EPS model was found to increase self-estimated knowledge, but further evaluations need to be conducted to prove patient-centred outcomes over time.

    PRACTICE IMPLICATIONS: The model is now ready to be implemented in adults with congenitally malformed hearts.

  • 17.
    Sedlar, Natasa
    et al.
    National Institute Public Heatlh, Slovenia.
    Socan, Gregor
    University of Ljubljana, Slovenia.
    Farkas, Jerneja
    National Institute Public Heatlh, Slovenia; Gen Hospital Murska Sobota, Slovenia.
    Mårtensson, Jan
    Jonköping University, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic University, Australia.
    Lainscak, Mitja
    Gen Hospital Murska Sobota, Slovenia; University of Ljubljana, Slovenia.
    Measuring self-care in patients with heart failure: A review of the psychometric properties of the European Heart Failure Self-Care Behaviour Scale (EHFScBS)2017In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 100, no 7, p. 1304-1313Article, review/survey (Refereed)
    Abstract [en]

    Objective: The aim of this study was to review and evaluate the evidence related to psychometric properties of the European Heart Failure Self-Care Behaviour Scale (EHFScBS) that was developed and tested to measure health maintenance behaviours of heart failure (HF) patients and translated into several languages. Methods: PRISMA guidelines were used to search major health databases (PubMed, Scopus and ScienceDirect), to identify relevant studies. A literature search was undertaken in November 2015. An integrative review, aiming to bring together all evidence relating to the psychometric properties (validity, reliability) of the EHFScBS was conducted. Results: 13 eligible studies were included. The results showed content, discriminant and convergent validity of the 9-and 12-item scale across the samples, while the factor structure of both versions of the scale was inconsistent. Most commonly used reliability estimates (Cronbachs alpha) of the total scale were satisfactory. Conclusion: Overall, published data demonstrate satisfactory psychometric properties of the EHFScBS, indicating that the scale is a reliable and valid tool for measuring health maintenance behaviours of HF patients. Practice implications: Taking the findings regarding the factorial structure of the scale into account, we recommend the use of the total EHFScBS score or scores on specific items. (C) 2017 Elsevier B.V. All rights reserved.

  • 18.
    Siwe, Karin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Silén, Charlotte
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Performing the First Pelvic Examination: Female Medical Students’ Transition to Examiners2007In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 69, no 1-3, p. 55-62Article in journal (Refereed)
    Abstract [en]

    Objective: To gain a deeper understanding of how female medical students perceive and experience performing their first pelvic examination (PE).

    Methods: A qualitative study. In-depth interviews after the students’ involvement in a learning session about the PE, with professional patients (PPs) as instructors and a gynaecologist as supervisor. The interviews were analysed according to the constant comparative method to acquire a deeper understanding of the students’ experiences and the ongoing social processes.

    Results: “Transcending unspoken boundaries and taboos, a prerequisite for learning” was the essence of the entire material and was identified from two categories: “A didactic design facilitates the transition to examiner” and “Interactive support enables creative learning of interpersonal and palpation skills”.

    Conclusion: Through interactive guidance from the PPs, the students overcame affective obstacles and achieved the aim of becoming an examiner. The favourable learning experience heightened their awareness of their own bodies and promoted a deeper interest in PEs, both as examiners and as patients.

    Practice implications: Engaging voluntary, healthy and knowledgeable women as instructors in the PE situation creates a safe learning environment and promotes interaction with students. Immediate feedback teaches students to integrate communicative and behavioural skills in a professional manner and to palpate the uterus.

  • 19.
    Siwe, Karin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
    Stjernquist, Martin
    Department of Clinical Sciences/Obstetrics & Gynaecology, University Hospital MAS, Malmö, Sweden.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Medical students learning the pelvic examination: Comparison of outcome in terms of skills between a professional patient and a clinical patient model2007In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 68, no 3, p. 211-217Article in journal (Refereed)
    Abstract [en]

    Objective: To compare two models of learning the pelvic examination (PE) for medical students, with professional patients (PP) or with clinical patients (CP), by measuring perceived distress and learning outcome in terms of skills.

    Methods: Prospective longitudinal study. Assessments of self-perceived distress on four occasions at the prospect of performing a PE. Evaluation of the learning session (LS) and clinical clerkship concerning outcome of palpation skills.

    Results: During the LS, students in the PP model (PP students) received enough guidance from their coaches, were certain they had palpated the uterus and at least one ovary, and were less distressed afterwards compared with students who were instructed using the CP model (CP students). During the clinical clerkship, the PP students performed twice as many PEs as CP students did and had more often confirmed palpating the uterus and an ovary.

    Conclusion: PP students were more skilful in palpating the uterus and ovaries and performed more PEs during the clinical clerkship than did CP students.

    Practice implications: Engaging healthy and voluntary women as PPs takes time and effort. It is, however, worthwhile as it increases the confidence of students who perform PEs, makes them more competent, and ultimately improves their skills in performing the examination during their clinical clerkship.

  • 20.
    Strömberg, Anna
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Ahlén, Henrik
    Gravity, Stockholm, Sweden.
    Fridlund, Bengt
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Interactive education on CD-ROM: a new tool in the education of heart failure patients2002In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 46, no 1, p. 75-81Article in journal (Refereed)
    Abstract [en]

    The study aimed to develop and evaluate whether a computer-based program for patients with heart failure was user-friendly, could be operated by elderly patients and gave sufficient information about heart failure. The program was developed by a multidisciplinary group and designed with large, clear illustrations and buttons. A total of 42 patients aged 51-92 years tested the program and completed afterwards a questionnaire. Three heart failure nurses evaluated how the patients used the program and their attitudes towards the computer. All patients could use the program, despite the fact that only six had used a computer before. The patients were satisfied with the computer-based information and appreciated that the program was interactive, flexible and contained a self-test. They thought it was a better way of receiving information than reading a booklet or watching a video about heart failure. The nurses reported that the patients were positive towards the computer and seemed to understand the information and that the patient education was less time-consuming, when the patients could seek knowledge on their own.

  • 21.
    Strömberg, Anna
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden and School of Social and Health Sciences, Halmstad University, Sweden.
    Computer-based education for patients with chronic heart failure: A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life2006In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 64, no 1-3, p. 128-135Article in journal (Refereed)
    Abstract [en]

    Objective

    To evaluate the effects of a single-session, interactive computer-based educational program on knowledge, compliance and quality of life in heart failure patients with special emphasis on gender differences.

    Methods

    One hundred and fifty-four patients, mean age 70 years, from five heart failure clinics were randomised to either receiving only standard education (n = 72) or standard education and additional computer-based education (n = 82).

    Results

    Knowledge was increased in both groups after 1 month with a trend towards higher knowledge (P = 0.07) in the computer-based group. The increase in knowledge was significantly higher in the computer-based group after 6 months (P = 0.03). No differences were found between the groups with regard to compliance with treatment and self-care or quality of life. The women had significantly lower quality of life and did not improve after 6 months as the men did (P = 0.0001).

    Conclusion

    Computer-based education gave increased knowledge about heart failure.

    Practice implications

    Computers can be a useful tool in heart failure education, but to improve compliance a single-session educational intervention is not sufficient. Gender differences in learning and quality of life should be further evaluated.

  • 22.
    Thomas, Kristin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Krevers, Barbro
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Implementation of healthy lifestyle promotion in primary care: Patients as coproducers2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 97, no 2, p. 283-290Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore and theorize how patients perceive, interpret, and reactin healthy lifestyle promotion situations in primary care and to investigate patients role in implementation of lifestyle promotion illustrated by typologies. Methods: Grounded theory was used to assess qualitative interview data from 22 patients with varied experience of healthy lifestyle promotion. Data were analyzed by constant comparative analysis. Results: A substantive theory of being healthy emerged from the data. The theory highlights the processes that are important for implementation before, during, and after lifestyle promotion. Three interconnected categories emerged from the data: conditions for being healthy, managing being healthy, and interactions about being healthy; these formed the core category: being healthy. A typology proposed four patient trajectories on being healthy: resigned, receivers, coworkers, and leaders. Conclusion: Patients coproduced the implementation of lifestyle promotion through the degree of transparency, which was a result of patients expectations and situation appraisals. Practice implications: Different approaches are needed during lifestyle promotion depending on a variety of patient-related factors. The typology could guide practitioners in their lifestyle promotion practice.

  • 23.
    Tingström, Pia
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Kamwendo, Kitty
    Department of Caring Sciences, Örebro University, Örebro, Sweden.
    Göransson, Anne
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Bergdahl, Björn
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Validation and feasibility of problem-based learning in rehabilitation of patients with coronary artery disease2002In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 47, no 4, p. 337-345Article in journal (Refereed)
    Abstract [en]

    A patient education programme applying problem-based learning (PBL) was developed for patients with coronary artery disease (CAD). Groups with 6–8 patients and a tutor from the rehabilitation team met nine times for 1.5 h each. The feasibility and validity of the model was evaluated using patient questionnaires, interviews with tutors and video observations of tutorials. The participants were active (69% of all input) and discussions of acquired knowledge and lifestyle changes took place in all groups. A total of 89% of the patients reported implementation of lifestyle changes and over 90% rated their learning and overall experience of the programme as acceptable or high and the demands as acceptable. Shortcomings were the limited use of some of the steps in the problem-solving process and tutors’ difficulties in adapting to their new role; their answering of questions was higher than planned (35% of their total input). The programme was feasible in clinical routine.

  • 24.
    Trappenburg, Jaap
    et al.
    University Medical Center Utrecht, The Netherlands.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    van Os-Medendorp, Harmieke
    University Medical Center Utrecht, The Netherlands.
    Kort, Helianthe
    Eindhoven University of Technology/University of Applied Sciences, The Netherlands.
    de Wit, Niek
    University Medical Center Utrecht, The Netherlands.
    Hoes, Arno
    University Medical Center Utrecht, The Netherlands.
    Schuurmans, Marieke
    University Medical Center Utrecht, The Netherlands.
    Self-management: one size does not fit all2013In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 1, p. 134-137Article in journal (Refereed)
    Abstract [en]

    Self-management for people with chronic diseases is now widely recognized as an essential part of treatment. Despite the high expectations and the growing body of evidence in terms of its effectiveness, a wide application of self-management programs is inhibited due to several challenges. Worldwide, a variety of complex and multifactorial interventions have been evaluated in very heterogeneous patient populations leaving healthcare professionals in doubt about what works best and what works in whom. In this letter to the editor the authors systematically reflect on the current evidence of patient-specific determinants of success of self-management and argument the urge for increased scientific efforts to establish tailored self-management in patients with chronic disease.

  • 25.
    Vellone, Ercole
    et al.
    University of Roma Tor Vergata, Italy .
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Fida, Roberta
    University of Roma La Sapienza, Italy .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Rocco, Gennaro
    Centre Excellence Nursing Scholarship, Italy .
    Cocchieri, Antonello
    University of Roma Tor Vergata, Italy .
    Alvaro, Rosaria
    University of Roma Tor Vergata, Italy .
    The European Heart Failure Self-care Behaviour Scale: New insights into factorial structure, reliability, precision and scoring procedure2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, no 1, p. 97-102Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate a new factorial structure of the European Heart Failure Self-care Behaviour Scale 9-item version (EHFScBS-9), and to test its reliability, floor and ceiling effect, and precision. To propose a new 0-100 score with a higher score meaning better self-care. Methods: A sample of 1192 Heart Failure (HF) patients (mean age 72 years, 58% male) was enrolled. Psychometric properties of the EHFScBS-9 were tested with confirmative factor analysis, factor score determinacy, determining the floor and ceiling effect, and evaluating the precision with the standard error of measurement (SEM) and the smallest real difference (SRD). Results: We identified three well-fitting factors: consulting behaviour, autonomy-based adherence, and provider-based adherence (comparative fit index = 0.96). Reliability ranged from 0.77 to 0.95. The EHFScBS-9 showed no floor and ceiling effect except for the provider-based adherence which had an expected ceiling effect. The SEM and the SRD indicated good precision of the EHFScBS-9. Conclusion: The new factorial structure of the EHFScBS-9 showed supportive psychometric properties. Practice implications: The EHFScBS-9 can be used to compute a total and specific scores for each identified factor. This may allow more detailed assessment and tailored interventions to improve self-care. The new score makes interpretation of the EHFScBS-9 easier.

  • 26.
    Woolhead, G.
    et al.
    MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, United Kingdom.
    Tadd, W.
    Academic Department of Geriatric Medicine, Wales College of Medicine, Cardiff University, Academic Centre, Cardiff CF64 2XX, United Kingdom.
    Boix-Ferrer, J.A.
    Fundacio Hospital Asil de Granollers (FHAG), Department of Geriatric Medicine, Avenida Fransisco Ribas s/n, 08400 Granollers, Spain.
    Krajcik, S.
    Slovak Health University (SHU), Krajinska 91-101, 82556 Bratislava, Slovakia.
    Schmid-Pfahler, B.
    Aquitaine Organisation of Research, Information and Co-ordination on Older people (OAREIL), Universite Victor Segalen, 33076 Bordeaux Cedex, France.
    Spjuth, Barbro
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medicine and Health Sciences, Health and Society.
    Stratton, D.
    Age Action Ireland Ltd, Dublin, 2, Ireland.
    Dieppe, P.
    MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, United Kingdom.
    "Tu" or "Vous?". A European qualitative study of dignity and communication with older people in health and social care settings2006In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 61, no 3, p. 363-371Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the experiences of communication between older people and health and social care providers in six European countries. Methods: Focus groups were carried out with groups of older people (91 focus groups, 391 participants), and health and social care professionals (85 focus groups, 424 participants), in order to gain insights into concepts of good communications. Data collection and analysis continued concurrently according to the method of constant comparison. Results: Different styles of communication between professionals and older people were found to be capable of enhancing or jeopardising dignity. The use of appropriate forms of address, listening, giving people choice, including them, respecting their need for privacy and politeness, and making them feel valued emerged as significant ways to maintain older peoples' sense of self-worth and dignity. Despite being aware of good communication practices, health and social care professionals often failed to implement them. Lack of time, staff, resource scarcity, regulation and bureaucracy were cited as barriers, as was a lack of awareness and effort. Conclusions and practice implications: The findings have important implications for health and social care professionals when they engage with older people. © 2005 Elsevier Ireland Ltd. All rights reserved.

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