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  • 401.
    Trinks, Anna
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Festin, Karin
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis.
    What makes emergency department patients reduce their alcohol consumption? - A computer-based intervention study in Sweden2013In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    Objectives: This study investigates the effectiveness of a computerized emergency department intervention for alcohol consumption and identifies explanation factors associated with reduced alcohol consumption from risk to non-risk drinking. less thanbrgreater than less thanbrgreater thanMethods: Patients aged 18-69 years registered at the ED triage answered alcohol-related questions on a touch-screen computer. Follow-up data were collected by means of a postal questionnaire that was mailed to the patients 6 months after their ED visit. less thanbrgreater than less thanbrgreater thanResults: There were four independent explanations for reduced alcohol consumption: being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider. 339 patients could be followed up and of these were 97 categorized as risk drinkers at baseline and 45 became non-risk drinker 6 month later. less thanbrgreater than less thanbrgreater thanConclusions: Being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider were predictors for change from risk to non-risk drinking 6 months later.

  • 402.
    Trinks, Anna
    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.
    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.
    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 the West of Östergötland, Department of Medical Specialist.
    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.
    What makes emergency department patients reduce their alcoholconsumption?: A computer-based intervention study in Sweden2011Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: This study investigates the effectiveness of a computerized emergency department intervention for alcohol consumption and identifies explanation factors associated with reduced alcohol consumption from risk to non-risk drinking.

    Methods: Patients aged 18–69 years registered at the ED triage answered alcohol-related questions on a touch-screen computer. Follow-up data were collected by means of a postal questionnaire that was mailed to the patients 6 months after their ED visit.

    Results: There were four independent explanations for reduced alcohol consumption: being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider. 339 patients could be followed up and of these were 97 categorized as risk drinkers at baseline and 45 became non-risk drinker 6 month later.

    Conclusions: Being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider were predictors for change from risk to non-risk drinking 6 months later.

  • 403.
    Trygg, Tomas
    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.
    Lundberg, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Rosenlund, Elisabeth
    Department of Psychology, Lund University, Sweden.
    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.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre. Linköping University, Faculty of Health Sciences.
    Personality characteristics of women with fibromyalgia and of women with chronic neck, shoulder, or low back complaints in terms of Minnesota Multiphasic Personality Inventory and defense mechanism technique modified2002In: Journal of Musculoskeletal Pain, ISSN 1058-2452, E-ISSN 1540-7012, Vol. 10, no 3, p. 33-55Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare personality features of fibro-myalgia patients with those of a disease control group with regional pain.

    Methods: A group of 33 women with fibromyalgia [FMS-group] was compared on the Minnesota Multiphasic Personality Inventory [MMPI] and the Defense Mechanism Technique modified [DMTm] with 31 women [C-group] without this diagnosis who had localized chronic pain in their neck, shoulder, and/or low back areas and were very similar in chronological age, intelligence, and basic personality patterns.

    Results: As hypothesized the FMS-group scored higher than the C-group on the MMPI-scales of Hypochondriasis, Depression, and Hysteria. They also scored higher on Admission of symptoms, Psych-asthenia, Anxiety, Schizophrenia, Social introversion, and a number of nonclinical subscales. The differences were not found to be due to differences in pain intensity. The only statistically significant difference in DMTm between the groups was that of FMS patients more often reporting the projected self to be positive and/or to be afraid, suggesting them to be more vulnerable than the comparison group to threatening experiences. Significant relationships between the disability level and the number of tender points, group membership, pain intensity, and various of the MMPI scales were found.

    Conclusions: There were no signs on the MMPI of serious psychological disturbances in either group, and at the “deeper” psychological level, assessed in DMTm, there were no marked differences between the two groups, a proneness to somaticize psychological pain being found in both groups. Both the MMPI and the DMTm results were interpreted as suggesting that a cognitive coping strategy program be considered for rehabilitation. The fact that both different symptoms and signs had importance when regressing disability might indicate that univariate approaches is not sufficient when investigating factors of importance for disability.

  • 404.
    Ulander, Martin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences.
    Stahlkrantz, A
    City Hospital Ryhov.
    Albers, J
    City Hospital Ryhov.
    Wiberg, J
    City Hospital Ryhov.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . 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.
    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.
    Patient education in CPAP initiation - a problem based learning approach using small tutorial groups2008In: JOURNAL OF SLEEP RESEARCH,ISSN 0962-1105: Volume 17, 2008, Vol. 17, p. 172-172Conference paper (Refereed)
  • 405.
    Upmark, Marianne
    et al.
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Instituter, Stockholm, .
    Borg (Festin), Karin
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Section of Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska Instituter, Stockholm, .
    Gender differences in experiencing negative encounters with healthcare: a study of long-term sickness absentees.2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 6, p. 577-584Article in journal (Refereed)
    Abstract [en]

    AIM: In most countries there are gender differences in sickness absence and in absentees' return to work (RTW). According to different theories sick-listed persons' experiences of encounters with healthcare professionals can influence self-esteem and RTW. The aim was to analyse gender differences in sickness absentees' experiences of negative encounters with healthcare professionals. METHODS: A questionnaire, comprising numerous questions on experiences of positive and negative encounters with professionals, was constructed and sent to 10,100 individuals who had been on sick leave for the last 6-8 months. The response rate was 58% (n = 5,802). RESULTS: Almost one-third (32%) of the female respondents and one-quarter of the male (24%), respectively, had experienced negative encounters. The most common of such experiences among both women and men were: that they were treated with indifference, with disrespect, that the professional did not take his/her time, did not listen, did not believe in, or doubted complaints. In regression analyses the women had higher significant crude odds ratios, ranging from 1.29 to 1.71, for agreeing to the separate statements on negative encounters. When adjusting for age, ethnicity, and level of education the gender differences were still significant for 14 of the 23 the statements. CONCLUSION: Women's high rate of sickness absence is considered a problem in most countries. The subjective experiences of women are an important factor to consider in efforts aiming at reducing the sick-leave rates. One important endeavour among professionals in healthcare could be to shift the focus towards a more empowering professional role.

  • 406.
    Vaez, Marjan
    et al.
    Karolinska Institute.
    Hagberg, Jan
    Karolinska Institute.
    Alexanderson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    The panorama of future sick-leave diagnoses among young adults initially long-term sickness absent due to neck, shoulder, or back diagnoses. An 11-year prospective cohort study2009In: BMC MUSCULOSKELETAL DISORDERS, ISSN 1471-2474, Vol. 10, no 84Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about future sick-leave diagnoses among individuals on long-term sickness absence. The aim of this study was to describe the panorama of sick-leave diagnoses over time among young adults initially sick-listed for andgt;= 28 days due to back, neck, or shoulder diagnoses Methods: An 11-year prospective population-based cohort study including all 213 individuals in a Swedish municipality who, in 1985, were aged 25-34 years and had a new sick-leave spell andgt;= 28 days due to neck, shoulder, or back diagnoses. Results: Over the 11-year period, the young adults in this cohort had 176,825 sick-leave days in 7,878 sick-leave periods (in 4,610 sick-leave spells) due to disorders in 17 of the 18 ICD-8 diagnostic categories (International Classification of Diseases, Revision 8). Musculoskeletal or mental diagnoses accounted for most of the sick-leave days, whereas most of the sick-leave periods were due to musculoskeletal, respiratory, or infectious disorders, or to unclassified symptoms. Most cohort members had had four to eight different sick-leave diagnoses over the 11 years, although some had had up to 11 diagnoses. Only two individuals (1%) had been sickness absent solely due to musculoskeletal diagnoses. Conclusion: Although the young adults initially were sick listed with back, neck, or shoulder diagnoses, their sickness absence during the follow up were due to a wide variety of other medical diagnoses. It might be that the ill-health content of sickness absence due to back pain is greater than usually assumed. More research on prognoses of sick-leave diagnoses among long-term sick listed is warranted.

  • 407.
    Vimarlund, Vivian
    et al.
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Eriksson, Henrik
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    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.
    Economic motives to use participatory design approach in the development of public health information systems2001In: Proceedings of Medinfo 2001, 2001Conference paper (Refereed)
  • 408.
    Vimarlund, Vivian
    et al.
    Linköping University, Department of Computer and Information Science, EISLAB - Economic Information Systems. Linköping University, The Institute of Technology.
    Söderberg, Elsy
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Stöd för uppföljning av kontakter mellan handläggare på Försäkringskassan och läkare på vårdcentral i sjukskrivningsårenden2002Other (Other academic)
  • 409.
    Vimarlund, Vivian
    et al.
    Linköping University, Department of Computer and Information Science, EISLAB - Economic Information Systems. Linköping University, The Institute of Technology.
    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.
    Individual Preferences and On-line Public Health Services2002In: Proceedings of AMIA annual fall Symposium in San Antonio Texas Nov 9-13, 2002Conference paper (Refereed)
  • 410.
    Vimarlund, Vivian
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum.
    To choose to be poor today but have good future prospects: Consumer participation in the development of information systems in healthcare organizations.2000In: JAMIA Journal of the American Medical Informatics Association, ISSN 1067-5027, E-ISSN 1527-974X, p. 1150-1150Conference paper (Other academic)
  • 411.
    Vimarlund, Vivian
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum.
    Patel, VL
    Linkoping Univ, Dept Social Med, Linkoping, Sweden McGill Univ, Montreal, PQ, Canada Linkoping Univ, Dept Comp Sci, MDA, Linkoping, Sweden.
    Information technology and knowledge exchange in health-care organizations1999In: JAMIA Journal of the American Medical Informatics Association, ISSN 1067-5027, E-ISSN 1527-974X, p. 632-636Article in journal (Refereed)
    Abstract [en]

    Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, Le. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the generation of new ideas is unrestricted Using all the intellectual potential of market actors and thereby releasing economic resources can reduce today's global budget conflicts in the public sector, Le. the necessity to choose between health care services and for instance, schools and support for the elderly. In conclusion, global collaboration and coordination would reduce the transaction costs inherent in knowledge administration and allow a more effective total use of scarce health-care resources.

  • 412.
    Waldén, Markus
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Epidemiology of injuries in elite football2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The purpose of this thesis was to study the injury characteristics in elite football, and risk factors for injury with special emphasis on anterior cruciate ligament injury. All five papers followed a prospective design using a standardised methodology. Individual training and match exposure was recorded for all players participating as well as all injuries resulting in time loss. Severe injury was defined as absence from play longer than 4 weeks.

    In Paper I, all 14 teams in the Swedish men’s elite league were studied during the 2001 season. In this paper, all tissue damage regardless of subsequent time loss was also recorded. There were no differences in injury incidence between the two injury definitions during match play (27.2 vs. 25.9 injuries per 1000 hours, p=0.66) or training (5.7 vs. 5.2 injuries per 1000 hours, p=0.65). Significantly higher injury incidences for training injury, overuse injury and re-injury were found during the pre-season compared to the competitive season. Thigh strain was the single most common injury (14%).

    In Paper II, 8% of all players in the Swedish men’s elite league 2001 had a history of previous ACL injury at the start of the study period. These players had a higher incidence of new knee injury during the season than players without previous ACL injury (4.2 vs. 1.0 injuries per 1000 hours, p=0.02). The higher incidence of new knee injury was seen both when using the player (relative risk 3.4, 95% CI 1.8-6.3) and the knee (relative risk 4.5, 95% CI 2.3-8.8) as the unit of analysis.

    In Paper III, eleven clubs in the men’s elite leagues of five European countries were studied during the 2001-2002 season. The incidence of match injury was higher for the English and Dutch teams compared to the Mediterranean teams (41.8 vs. 24.0 injuries per 1000 hours, p=0.008) as well as the incidence of severe injury (2.0 vs. 1.1 injuries per 1000 hours, p=0.04). Players having international duty had a higher match exposure (42 vs. 28 matches, p<0.001), but a tendency to a lower training injury incidence (4.1 vs. 6.2 injuries per 1000 hours, p=0.051). Thigh strain was the most common injury (16%) with posterior strains being more frequent than anterior ones (67 vs. 36, p<0.0001).

    In Paper IV, the national teams of all 32 countries that qualified for the men’s European Championship 2004, the women’s European Championship 2005 and the men’s Under-19 European Championship 2005 were studied during the tournaments. There were no differences in match and training injury incidences between the championships. Teams eliminated after the group stage in the women’s championship had a significantly higher match injury incidence compared to teams going to the semi-finals (65.4 vs. 5.0 injuries per 1000 hours, p=0.02). Non-contact mechanisms were ascribed for 41% of the match injuries and these injuries were more common in the second half.

    In Paper V, all 12 clubs in the Swedish women’s elite league and 11 of 14 clubs in the men’s elite league were studied during the 2005 season. The prevalence of a history of previous ACL injury at the start of the study was three times higher among the female players (15% vs. 5%, p=0.0002). During the season, 16 new ACL injuries were recorded. There was a tendency to a lower mean age at injury among the women (20 vs. 24 years, p=0.069). Adjusted for age, no gender-related difference in the incidence of ACL injury was seen (relative risk 0.99, 95% CI 0.37-2.6). Age was associated with ACL injury incidence in women where the risk decreased by 24% for each year increase in age (relative risk 0.76, 95% CI 0.59-0.96).

    List of papers
    1. Injuries in Swedish elite football - a prospective study on injury definitions, risk for injury and injury pattern during 2001
    Open this publication in new window or tab >>Injuries in Swedish elite football - a prospective study on injury definitions, risk for injury and injury pattern during 2001
    2005 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, Vol. 15, no 2, p. 118-125Article in journal (Refereed) Published
    Abstract [en]

    The purpose of this study was to study the risk for injury and injury pattern in Swedish male elite football and to compare two different injury definitions. A prospective cohort study was conducted during 2001 on all 14 teams (310 players) in the Swedish top division. Injuries and individual exposure were recorded. Injury was defined as time-lost injury (715 injuries) and for comparison as tissue injury (765 injuries). No significant difference in the risk for injury between tissue injuries and time-lost injuries was found during matches (27.2 vs. 25.9 injuries per 1000 match hours, P=0.66) or training sessions (5.7 vs. 5.2 injuries per 1000 training hours, P=0.65). The risk for injury during training was significantly higher during the pre-season compared with the competitive season (P=0.01).

    Thigh strain was the single most common injury (14%). Knee sprain was the most common major injury (absence >4 weeks). Overuse injuries and re-injuries were frequent and constituted 37% and 22% of all injuries. Re-injuries caused significantly longer absence than their corresponding initial injuries (P=0.02). The risk for re-injury (P=0.02) and overuse injury (P<0.01) was significantly higher during the pre-season compared with the competitive season.

    Keywords
    definition, epidemiology, incidence, soccer, sports injuries
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14381 (URN)10.1111/j.1600-0838.2004.00393.x (DOI)
    Available from: 2013-04-03 Created: 2007-04-05 Last updated: 2013-09-04Bibliographically approved
    2. High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury
    Open this publication in new window or tab >>High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury
    2006 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, Vol. 40, no 2, p. 158-162Article in journal (Refereed) Published
    Abstract [en]

    Background: Anterior cruciate ligament (ACL) injury is a severeevent for a footballer, but it is unclear if the knee injuryrate is higher on returning to football after ACL injury.

    Objective: To study the risk of knee injury in elite footballerswith a history of ACL injury compared with those without.

    Method: The Swedish male professional league (310 players) wasstudied during 2001. Players with a history of ACL injury atthe study start were identified. Exposure to football and alltime loss injuries during the season were recorded prospectively.

    Results: Twenty four players (8%) had a history of 28 ACL injuriesin 27 knees (one rerupture). These players had a higher incidenceof new knee injury of any type than the players without ACLinjury (mean (SD) 4.2 (3.7) v 1.0 (0.7) injuries per 1000 hours,p = 0.02). The risk of suffering a knee overuse injury wassignificantly higher regardless of whether the player (relativerisk 4.8, 95% confidence interval 2.0 to 11.2) or the knee (relativerisk 7.9, 95% confidence interval 3.4 to 18.5) was used as theunit of analysis. No interactive effects of age or any otheranthropometric data were seen.

    Conclusion: The risk of new knee injury, especially overuseinjury, was significantly increased on return to elite footballafter ACL injury regardless of whether the player or the kneewas used as the unit of analysis.

    Keywords
    football; injury incidence; knee; prevalence; anterior cruciate ligament
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14382 (URN)10.1136/bjsm.2005.021055 (DOI)
    Available from: 2013-04-03 Created: 2007-04-05 Last updated: 2013-09-04Bibliographically approved
    3. UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season
    Open this publication in new window or tab >>UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season
    2005 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, Vol. 39, no 8, p. 542-546Article in journal (Refereed) Published
    Abstract [en]

    Background: No previous study on adult football involving severaldifferent countries has investigated the incidence and patternof injuries at the highest club competitive level.

    Objective: To investigate the risk exposure, risk of injury,and injury pattern of footballers involved in UEFA ChampionsLeague and international matches during a full football season.

    Method: Eleven top clubs (266 players) in five European countrieswere followed prospectively throughout the season of 2001–2002.Time-lost injuries and individual exposure times were recordedduring all club and national team training sessions and matches.

    Results: A total of 658 injuries were recorded. The mean (SD)injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5(11.0) injuries per 1000 match hours and 5.8 (2.1) injuriesper 1000 training hours). The risk of match injury was significantlyhigher in the English and Dutch teams than in the teams fromFrance, Italy, and Spain (41.8 (3.3) v 24.0 (7.9) injuries per1000 hours; p = 0.008). Major injuries (absence >4 weeks)constituted 15% of all injuries, and the risk of major injurywas also significantly higher among the English and Dutch teams(p = 0.04). National team players had a higher match exposure,with a tendency towards a lower training injury incidence thanthe rest of the players (p = 0.051). Thigh strain was themost common injury (16%), with posterior strains being significantlymore common than anterior ones (67 v 36; p<0.0001).

    Conclusions: The risk of injury in European professional footballis high. The most common injury is the thigh strain typicallyinvolving the hamstrings. The results suggest that regionaldifferences may influence injury epidemiology and traumatology,but the factors involved are unclear. National team playershave a higher match exposure, but no higher risk of injury thanother top level players.

    Keywords
    elite; epidemiology; injury incidence; professional; football; soccer
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14383 (URN)10.1136/bjsm.2004.014571 (DOI)
    Available from: 2013-04-03 Created: 2007-04-05 Last updated: 2013-09-04Bibliographically approved
    4. Football injuries during European Championships 2004-2005
    Open this publication in new window or tab >>Football injuries during European Championships 2004-2005
    2007 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 15, no 9, p. 1155-1162Article in journal (Refereed) Published
    Abstract [en]

    The risk of injury in football is high, but few studies have compared men's and women's football injuries. The purpose of this prospective study was to analyse the exposure and injury characteristics of European Championships in football and to compare data for men, women and male youth players. The national teams of all 32 countries (672 players) that qualified to the men's European Championship 2004, the women's European Championship 2005 and the men's Under-19 European Championship 2005 were studied. Individual training and match exposure was documented during the tournaments as well as time loss injuries. The overall injury incidence was 14 times higher during match play than during training (34.6 vs. 2.4 injuries per 1000 h, P < 0.0001). There were no differences in match and training injury incidences between the championships. Teams eliminated in the women's championship had a significantly higher match injury incidence compared to teams going to the semi-finals (65.4 vs. 5.0 injuries per 1000 h, P = 0.02). Non-contact mechanisms were ascribed for 41% of the match injuries. One-fifth of all injuries were severe with absence from play longer than 4 weeks. In conclusion, injury incidences during the European Championships studied were very similar and it seems thus that the risk of injury in international football is at least not higher in women than in men. The teams eliminated in the women's championship had a significantly higher match injury incidence than the teams going to the final stage. Finally, the high frequency of non-contact injury is worrying from a prevention perspective and should be addressed in future studies.

    Keywords
    Athletic injuries, Epidemiology, Football, Incidence
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14384 (URN)10.1007/s00167-007-0290-3 (DOI)
    Available from: 2013-04-03 Created: 2007-04-05 Last updated: 2017-12-13Bibliographically approved
    5. Anterior cruciate ligament injury in elite football: a prospective three-cohort study.
    Open this publication in new window or tab >>Anterior cruciate ligament injury in elite football: a prospective three-cohort study.
    2011 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 19, no 1, p. 11-19Article in journal (Refereed) Published
    Abstract [en]

    Anterior cruciate ligament (ACL) injury causes long lay-off time and is often complicated with subsequent new knee injury and osteoarthritis. Female gender is associated with an increased ACL injury risk, but few studies have adjusted for gender-related differences in age although female players are often younger when sustaining their ACL injury. The objective of this three-cohort study was to describe ACL injury characteristics in teams from the Swedish men's and women's first leagues and from several European men's professional first leagues. Over a varying number of seasons from 2001 to 2009, 57 clubs (2,329 players) were followed prospectively and during this period 78 ACL injuries occurred (five partial). Mean age at ACL injury was lower in women compared to men (20.6 ± 2.2 vs. 25.2 ± 4.5 years, P = 0.0002). Using a Cox regression, the female-to-male hazard ratio (HR) was 2.6 (95% CI 1.4-4.6) in all three cohorts studied and 2.6 (95% CI 1.3-5.3) in the Swedish cohorts; adjusted for age, the HR was reduced to 2.4 (95% CI 1.3-4.2) and 2.1 (95% CI 1.0-4.2), respectively. Match play was associated with a higher ACL injury risk with a match-to-training ratio of 20.8 (95% CI 12.4-34.8) and 45 ACL injuries (58%) occurred due to non-contact mechanisms. Hamstrings grafts were used more often in Sweden than in Europe (67 vs. 34%, P = 0.028), and there were no differences in time to return to play after ACL reconstruction between the cohorts or different grafts. In conclusion, this study showed that the ACL injury incidence in female elite footballers was more than doubled compared to their male counterparts, but also that they were significantly younger at ACL injury than males. These findings suggest that future preventive research primarily should address the young female football player.

    Place, publisher, year, edition, pages
    Springer, 2011
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-64457 (URN)10.1007/s00167-010-1170-9 (DOI)000286529200003 ()20532869 (PubMedID)
    Note

    Titled "Anterior cruciate ligament injuries in elite football: the influence of gender and age" in while in manuscript.

    Available from: 2011-01-25 Created: 2011-01-25 Last updated: 2017-12-11
  • 413.
    Waldén, Markus
    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.
    Atroshi, Isam
    Hassleholm Kristianstad Ystad Hospital.
    Magnusson, Henrik
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Wagner, Philippe
    Lund University.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial2012In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 344Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate the effectiveness of neuromuscular training in reducing the rate of acute knee injury in adolescent female football players. less thanbrgreater than less thanbrgreater thanDesign Stratified cluster randomised controlled trial with clubs as the unit of randomisation. less thanbrgreater than less thanbrgreater thanSetting 230 Swedish football clubs (121 in the intervention group, 109 in the control group) were followed for one season (2009, seven months). less thanbrgreater than less thanbrgreater thanParticipants 4564 players aged 12-17 years (2479 in the intervention group, 2085 in the control group) completed the study. Intervention 15 minute neuromuscular warm-up programme (targeting core stability, balance, and proper knee alignment) to be carried out twice a week throughout the season. less thanbrgreater than less thanbrgreater thanMain outcome measures The primary outcome was rate of anterior cruciate ligament injury; secondary outcomes were rates of severe knee injury (andgt;4 weeks absence) and any acute knee injury. less thanbrgreater than less thanbrgreater thanResults Seven players (0.28%) in the intervention group, and 14 (0.67%) in the control group had an anterior cruciate ligament injury. By Cox regression analysis according to intention to treat, a 64% reduction in the rate of anterior cruciate ligament injury was seen in the intervention group (rate ratio 0.36, 95% confidence interval 0.15 to 0.85). The absolute rate difference was -0.07 (95% confidence interval -0.13 to 0.001) per 1000 playing hours in favour of the intervention group. No significant rate reductions were seen for secondary outcomes. less thanbrgreater than less thanbrgreater thanConclusions A neuromuscular warm-up programme significantly reduced the rate of anterior cruciate ligament injury in adolescent female football players. However, the absolute rate difference did not reach statistical significance, possibly owing to the small number of events.

  • 414.
    Waldén, Markus
    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.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Football injuries during European Championships 2004-20052007In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 15, no 9, p. 1155-1162Article in journal (Refereed)
    Abstract [en]

    The risk of injury in football is high, but few studies have compared men's and women's football injuries. The purpose of this prospective study was to analyse the exposure and injury characteristics of European Championships in football and to compare data for men, women and male youth players. The national teams of all 32 countries (672 players) that qualified to the men's European Championship 2004, the women's European Championship 2005 and the men's Under-19 European Championship 2005 were studied. Individual training and match exposure was documented during the tournaments as well as time loss injuries. The overall injury incidence was 14 times higher during match play than during training (34.6 vs. 2.4 injuries per 1000 h, P < 0.0001). There were no differences in match and training injury incidences between the championships. Teams eliminated in the women's championship had a significantly higher match injury incidence compared to teams going to the semi-finals (65.4 vs. 5.0 injuries per 1000 h, P = 0.02). Non-contact mechanisms were ascribed for 41% of the match injuries. One-fifth of all injuries were severe with absence from play longer than 4 weeks. In conclusion, injury incidences during the European Championships studied were very similar and it seems thus that the risk of injury in international football is at least not higher in women than in men. The teams eliminated in the women's championship had a significantly higher match injury incidence than the teams going to the final stage. Finally, the high frequency of non-contact injury is worrying from a prevention perspective and should be addressed in future studies.

  • 415.
    Waldén, Markus
    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.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury2006In: British Journal of Sports Medicine, ISSN 0306-3674, Vol. 40, no 2, p. 158-162Article in journal (Refereed)
    Abstract [en]

    Background: Anterior cruciate ligament (ACL) injury is a severeevent for a footballer, but it is unclear if the knee injuryrate is higher on returning to football after ACL injury.

    Objective: To study the risk of knee injury in elite footballerswith a history of ACL injury compared with those without.

    Method: The Swedish male professional league (310 players) wasstudied during 2001. Players with a history of ACL injury atthe study start were identified. Exposure to football and alltime loss injuries during the season were recorded prospectively.

    Results: Twenty four players (8%) had a history of 28 ACL injuriesin 27 knees (one rerupture). These players had a higher incidenceof new knee injury of any type than the players without ACLinjury (mean (SD) 4.2 (3.7) v 1.0 (0.7) injuries per 1000 hours,p = 0.02). The risk of suffering a knee overuse injury wassignificantly higher regardless of whether the player (relativerisk 4.8, 95% confidence interval 2.0 to 11.2) or the knee (relativerisk 7.9, 95% confidence interval 3.4 to 18.5) was used as theunit of analysis. No interactive effects of age or any otheranthropometric data were seen.

    Conclusion: The risk of new knee injury, especially overuseinjury, was significantly increased on return to elite footballafter ACL injury regardless of whether the player or the kneewas used as the unit of analysis.

  • 416.
    Waldén, Markus
    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.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Injuries in Swedish elite football - a prospective study on injury definitions, risk for injury and injury pattern during 20012005In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, Vol. 15, no 2, p. 118-125Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to study the risk for injury and injury pattern in Swedish male elite football and to compare two different injury definitions. A prospective cohort study was conducted during 2001 on all 14 teams (310 players) in the Swedish top division. Injuries and individual exposure were recorded. Injury was defined as time-lost injury (715 injuries) and for comparison as tissue injury (765 injuries). No significant difference in the risk for injury between tissue injuries and time-lost injuries was found during matches (27.2 vs. 25.9 injuries per 1000 match hours, P=0.66) or training sessions (5.7 vs. 5.2 injuries per 1000 training hours, P=0.65). The risk for injury during training was significantly higher during the pre-season compared with the competitive season (P=0.01).

    Thigh strain was the single most common injury (14%). Knee sprain was the most common major injury (absence >4 weeks). Overuse injuries and re-injuries were frequent and constituted 37% and 22% of all injuries. Re-injuries caused significantly longer absence than their corresponding initial injuries (P=0.02). The risk for re-injury (P=0.02) and overuse injury (P<0.01) was significantly higher during the pre-season compared with the competitive season.

  • 417.
    Waldén, Markus
    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.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season2005In: British Journal of Sports Medicine, ISSN 0306-3674, Vol. 39, no 8, p. 542-546Article in journal (Refereed)
    Abstract [en]

    Background: No previous study on adult football involving severaldifferent countries has investigated the incidence and patternof injuries at the highest club competitive level.

    Objective: To investigate the risk exposure, risk of injury,and injury pattern of footballers involved in UEFA ChampionsLeague and international matches during a full football season.

    Method: Eleven top clubs (266 players) in five European countrieswere followed prospectively throughout the season of 2001–2002.Time-lost injuries and individual exposure times were recordedduring all club and national team training sessions and matches.

    Results: A total of 658 injuries were recorded. The mean (SD)injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5(11.0) injuries per 1000 match hours and 5.8 (2.1) injuriesper 1000 training hours). The risk of match injury was significantlyhigher in the English and Dutch teams than in the teams fromFrance, Italy, and Spain (41.8 (3.3) v 24.0 (7.9) injuries per1000 hours; p = 0.008). Major injuries (absence >4 weeks)constituted 15% of all injuries, and the risk of major injurywas also significantly higher among the English and Dutch teams(p = 0.04). National team players had a higher match exposure,with a tendency towards a lower training injury incidence thanthe rest of the players (p = 0.051). Thigh strain was themost common injury (16%), with posterior strains being significantlymore common than anterior ones (67 v 36; p<0.0001).

    Conclusions: The risk of injury in European professional footballis high. The most common injury is the thigh strain typicallyinvolving the hamstrings. The results suggest that regionaldifferences may influence injury epidemiology and traumatology,but the factors involved are unclear. National team playershave a higher match exposure, but no higher risk of injury thanother top level players.

  • 418.
    Waldén, Markus
    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.
    Hägglund, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Physiotherapy.
    Magnusson, Henrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Physiotherapy.
    Ekstrand, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Sports Medicine .
    Anterior cruciate ligament injury in elite football: a prospective three-cohort study.2011In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 19, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    Anterior cruciate ligament (ACL) injury causes long lay-off time and is often complicated with subsequent new knee injury and osteoarthritis. Female gender is associated with an increased ACL injury risk, but few studies have adjusted for gender-related differences in age although female players are often younger when sustaining their ACL injury. The objective of this three-cohort study was to describe ACL injury characteristics in teams from the Swedish men's and women's first leagues and from several European men's professional first leagues. Over a varying number of seasons from 2001 to 2009, 57 clubs (2,329 players) were followed prospectively and during this period 78 ACL injuries occurred (five partial). Mean age at ACL injury was lower in women compared to men (20.6 ± 2.2 vs. 25.2 ± 4.5 years, P = 0.0002). Using a Cox regression, the female-to-male hazard ratio (HR) was 2.6 (95% CI 1.4-4.6) in all three cohorts studied and 2.6 (95% CI 1.3-5.3) in the Swedish cohorts; adjusted for age, the HR was reduced to 2.4 (95% CI 1.3-4.2) and 2.1 (95% CI 1.0-4.2), respectively. Match play was associated with a higher ACL injury risk with a match-to-training ratio of 20.8 (95% CI 12.4-34.8) and 45 ACL injuries (58%) occurred due to non-contact mechanisms. Hamstrings grafts were used more often in Sweden than in Europe (67 vs. 34%, P = 0.028), and there were no differences in time to return to play after ACL reconstruction between the cohorts or different grafts. In conclusion, this study showed that the ACL injury incidence in female elite footballers was more than doubled compared to their male counterparts, but also that they were significantly younger at ACL injury than males. These findings suggest that future preventive research primarily should address the young female football player.

  • 419.
    Waldén, Markus
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Orchard, J
    University of Sydney, Australia.
    Kristenson, Karolina
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Regional differences in injury incidence in European professional football2013In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 23, no 4, p. 424-430Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate regional differences in injury incidence in men's professional football in Europe. A nine-season prospective cohort study was carried out between 2001–2002 and 2009–2010 involving 1357 players in 25 teams from nine countries. Teams were categorized into different regions according to the Köppen–Geiger climate classification system. Teams from the northern parts of Europe (n = 20) had higher incidences of injury overall [rate ratio 1.12, 95% confidence interval (CI) 1.06 to 1.20], training injury (rate ratio 1.16, 95% CI 1.05 to 1.27), and severe injury (rate ratio 1.29, 95% CI 1.10 to 1.52), all statistically significant, compared to teams from more southern parts (n  = 5). In contrast, the anterior cruciate ligament injury incidence was lower in the northern European teams with a statistically significant difference (rate ratio 0.43, 95% CI 0.25 to 0.77), especially for noncontact anterior cruciate ligament injury (rate ratio 0.19, 95% CI 0.09 to 0.39). In conclusion, this study suggests that there are regional differences in injury incidence of European professional football. However, further studies are needed to identify the underlying causes.

  • 420.
    Waldén, Markus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science.
    Hägglund, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Physiotherapy.
    Werner, Jonas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Sports Medicine.
    The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective.2011In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 19, no 1, p. 3-10Article, review/survey (Refereed)
    Abstract [en]

    Football (soccer), the most popular sport worldwide, is associated with a high injury risk, and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on gender-related differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2-3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males, and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.

  • 421.
    Wallinius, Marta
    et al.
    Skane University Hospital.
    Johansson, Peter
    University Orebro.
    Larden, Martin
    Swedish Prison and Probat Service.
    Dernevik, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    SELF-SERVING COGNITIVE DISTORTIONS AND ANTISOCIAL BEHAVIOR AMONG ADULTS AND ADOLESCENTS2011In: CRIMINAL JUSTICE AND BEHAVIOR, ISSN 0093-8548, Vol. 38, no 3, p. 286-301Article in journal (Refereed)
    Abstract [en]

    The reliability and validity of the self-report questionnaire How I Think (HIT), designed to assess self-serving cognitive distortions related to antisocial behavior, was tested among Swedish offender and nonoffender adults and adolescents (N = 364). The results showed self-serving distortions to be more common among offenders and to predict self-reported antisocial behavior when tested among adults. Confirmatory factor analysis revealed, in contrast to earlier findings, that the underlying structure of the HIT was best explained by a three-factor solution with one major cognitive factor, referred to as "criminal mind." It was concluded that the HIT, after further examination of its structural and divergent validity, could be used as a measure of criminal thinking in adults as well as in adolescents.

  • 422.
    Wang, S
    et al.
    School of Public Health, Fudan University, Shanghai, China.
    Zou, J
    School of Public Health, Fudan University, Shanghai, China.
    Yin, M
    School of Public Health, Fudan University, Shanghai, China.
    Yuan, D
    School of Public Health, Fudan University, Shanghai, China.
    Dalal, Koustuv
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Injury Epidemiology in a Safe Community Health Service Center in Shanghai, China2011In: HEALTHMED, ISSN 1840-2291, Vol. 5, no 3, p. 479-485Article in journal (Refereed)
    Abstract [en]

    The current study has investigated the injury epidemiology in a community health service center (CHSC) under a Safe Community in Shanghai, China. It was a cross sectional study with data generated from hospital records and Injury Report Card (IRC). Open wounds constituted 571 (50.8%) injuries. Majority of the injuries (99.64%) did not need any hospitalization. Among the injured victims, 59.16% were floating population and occupied in the manufacturing or transportation sector (31.49% of the injury), commercial services and farms. Finger, toes, head and face were most affected part of the body due to injuries. Mechanical objects and falls constituted nearly 95% causes of injuries. During start of working hours (9am) and during Wednesday and Thursday the frequencies of injuries were highest. In a WHO Safe Community program, injury epidemiology has great emphasize as it dwelled with proper scientific evidences of the injury etiologies. The study had identified some important issues within its objected framework. Education and supervision of the floating workers can be effective for reducing injuries.

  • 423.
    Welén, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Faresjö, Åshild
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Functional Dyspepsia Affects Woman More Than Men in Daily Life: A Case-Control Study in Primary Care2008In: Gender Medicine, Vol. 5, no 1, p. 62-73Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about possible gender differences among patients with functional dyspepsia (FD). Few studies have measured health-related quality of life (HRQoL) in patients with FD using a population-based control group as a reference.

    Objective: This study aimed to determine the degree of HRQoL impairment among patients with FD, assess the self-reported health impact resulting from the disease, and analyze any gender differences.

    Methods: A questionnaire that included the HRQoL Short Form 36 (SF-36) Health Survey, the HAD Scale and other measurements was mailed to FD patients identified from medical records and control group randomly selected from the general population in the same geographical area. Responses to the SF-36 were transferred to a standard scale ranging from 0 (the worst possible score) to 100 (the best possible score).

    Results: A total of 176 patients with FD and 688 controls responded to the questionnaire. Responders were assigned to 2 gender-specific subgroups of 88 patients with FD and 344 randomly matched controls, all aged 18 to 65 years. HRQoL of the patients with FD was impaired in all SF-36 dimensions except one—role limitations caused by emotional problems compared with the controls. Female patients with FD had a significantly lower SF-36 score in the physical functioning dimension than did male patients (82.4 vs 90.5, respectively; P < 0.01). Both groups of patients with FD had impaired HRQoL compared with their respective control group in the dimensions of bodily pain (women: 69.3 vs 80.6; P < 0.001; and men: 75.8 vs 84.8; P < 0.001) and general health (women: 62.0 vs 75.6; P < 0.001; and men: 70.6 vs 78.6; P < 0.001). Additionally, women with FD had significant impairment compared with their respective control group in the dimensions of physical function (82.4 vs 89.3; P < 0.01) and physical role function (72.1 vs 85.9; P < 0.001). Depression was significantly more common among male patients with FD than among male controls (6.8% vs 2.0%, respectively; P < 0.05). More gastrointestinal comorbidity was reported among patients of both sexes compared with controls.

    Conclusions: This population-based case-control study reported HRQoL impairment overall among patients with FD. This impairment was more apparent among female patients compared with female controls. Females with FD tend to be more negatively affected in their daily life compared with their male counterparts. These gender differences should be investigated further in future studies.

  • 424.
    Wenemark, 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. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    The respondent’s perspective in health-related surveys2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Declining response rates are threatening the usefulness of and confidence in survey data. Survey practitioners have therefore studied why nonrespondents refuse to respond and have tried to counter the declining response rates by intensified follow-up methods. Such efforts sometimes yield negative reactions among respondents. This thesis focuses on the respondent’s perspective in self-administered health-related surveys. The aim was to investigate positive and negative aspects that respondents experience when participating in surveys, to study factors that could increase motivation and to study possibilities to increase response rates in a way that promotes data quality as well as positive experiences among respondents. Self-Determination Theory is a motivation theory that was used as a theoretical framework.

    Paper I is a study regarding two self-administered health questionnaires among patients in 20 intervention groups in 18 Swedish hospitals. Paper II is a qualitative analysis of data from telephone interviews with respondents to a self-administered health-related survey of the population in the county of Östergötland. Paper III is a randomized experiment in a self-administered survey of a random sample of parents in the municipality of Stockholm. Paper IV is an experimental study concerning a self-administered health questionnaire in a random sample of the general adult population in the county of Östergötland.

    The results from paper I show that questionnaire length and ease of response were not crucial arguments in choosing between two health questionnaires for use in routine health care. Instead, the most common motives for the choice concerned aspects of the questions’ comprehensiveness and ability to describe the health condition. Respondent satisfaction as described by respondents in paper II includes being able to give correct and truthful information as well as reflection and new insights from the questions. Respondent burden includes experiences of being manipulated or controlled by the researcher as well as worry, anxiety or sadness caused by the questions. Experiences of satisfaction and burden differed depending on the respondents’ primary motive for participating in surveys. The findings of paper III illustrate that the use of lottery tickets as incentives to parents may be less valuable or even harmful as a means of increasing response rates. In paper IV a survey design inspired by Self-Determination Theory yielded higher satisfaction among respondents and improved response rates with similar or better data quality compared with a standard design.

    Focusing on the respondents’ perspective provided important new knowledge. The results show a broad spectrum of positive as well as negative aspects of survey participation. The results support Self-Determination Theory as a useful theoretical framework for studying motivation in survey research and an interesting additional source to provide ideas on how to design surveys with the potential to motivate respondents. The results suggest that it is possible to improve response rates in a way that promotes data quality as well as positive experiences among the respondents.

    List of papers
    1. Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
    Open this publication in new window or tab >>Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
    2007 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 16, no 10, p. 1647-1654Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate respondent satisfaction regarding SF-36 and EQ-5D and patients' perspectives concerning health outcome assessment within routine health care. Methods: Eighteen Swedish hospitals participated in the study which included 30 patient intervention groups (e.g. education groups for patients with ischemic heart disease or chronic obstructive pulmonary disease). Patients responded to SF-36 and EQ-5D before and after ordinary interventions (n = 463), and then completed an evaluation form. Results: Regarding respondent satisfaction, most patients found both questionnaires easy to understand (70% vs. 75% for SF-36 and EQ-5D respectively), easy to respond to (54% vs. 60%), and that they gave the ability of describing their health in a comprehensive way (68% for both). Health outcome assessment in routine health care was perceived as valuable by 57% of the patients, while 4% disapproved. Most patients (68%) considered both questionnaires equally suitable, 25% preferred SF-36 and 8% EQ-5D. Among those who were more satisfied with a short questionnaire (EQ-5D), several still preferred a longer and more comprehensive questionnaire (SF-36). Conclusion: Health outcome assessment within routine health care seems to be acceptable, and even appreciated, by patients. Questionnaire length and ease of response were not found to be crucial arguments in choosing between SF-36 and EQ-5D. © 2007 Springer Science+Business Media B.V.

    Keywords
    outcome assessment, SF-36, EQ-5D, patient perspective, respondent satisfaction
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-39617 (URN)10.1007/s11136-007-9263-8 (DOI)50285 (Local ID)50285 (Archive number)50285 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
    2. Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey
    Open this publication in new window or tab >>Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey
    2010 (English)In: Field Methods, ISSN 1525-822X, E-ISSN 1552-3969, Vol. 22, no 4, p. 378-390Article in journal (Refereed) Published
    Abstract [en]

    Response rates in surveys have declined in many countries over the last decade. Reasons for refusal by nonrespondents have been discussed in many studies, but less attention has been paid to motivation among respondents who do take part. One theoretical framework for studying motivation is self-determination theory, which distinguishes between extrinsic and intrinsic motivation. This article describes respondents' experiences of participating in a self-administered health-related survey. Qualitative content analysis was used to analyze data from semistructured telephone interviews with 30 Swedish respondents aged 45–64 years. The results show a broad spectrum of positive as well as negative aspects of survey participation.

    Place, publisher, year, edition, pages
    Sage, 2010
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-60180 (URN)10.1177/1525822X10376704 (DOI)000283656600005 ()
    Note
    The final, definitive version of this paper has been published in: Field Methods, (22), 4, 378-390, 2010. Marika Wenemark, Gunilla Hollman Frisman, Tommy Svensson and Margareta Kristenson, Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey http://dx.doi.org/10.1177/1525822X10376704 by SAGE Publications Ltd, All rights reserved. http://www.uk.sagepub.com/ Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12
    3. Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?
    Open this publication in new window or tab >>Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?
    2010 (English)In: EUROPEAN JOURNAL OF EPIDEMIOLOGY, ISSN 0393-2990, Vol. 25, no 4, p. 231-235Article in journal (Refereed) Published
    Abstract [en]

    Response rates to surveys are decreasing. The purpose of this study was to evaluate the use of lottery tickets as incentives in an epidemiologic control group. A self-administered questionnaire was sent to parents in the municipality of Stockholm, Sweden, who were to be used as a control group in a study addressing stress in parents of children with cancer. A stratified random sample of 450 parents were randomized into three incentive groups: (a) no incentive; (b) a promised incentive of one lottery ticket to be received upon reply; (c) a promised incentive of one lottery ticket to be received upon reply and an additional lottery ticket upon reply within 1 week. The overall response rate across the three groups was 65.3%. The response rate was highest in the no incentive group (69.3%) and lowest in the one plus one lottery ticket group (62.0%). In a survival analysis, the difference between the two response curves was significant by the log-rank test (P = 0.04), with the no incentive group having a shorter time to response than the incentive group. Our findings suggest that the use of lottery tickets as incentives to increase participation in a mail questionnaire among parents may be less valuable or even harmful. Incentives may undermine motivation in studies in which the intrinsic motivation of the respondents is already high.

    Place, publisher, year, edition, pages
    Springer Science Business Media, 2010
    Keywords
    Data collection, Incentives, Participation, Response rate, Self-administered questionnaire, Survey
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-55054 (URN)10.1007/s10654-010-9434-8 (DOI)000276478800003 ()
    Note
    The original publication is available at www.springerlink.com: Marika Wenemark, Åsa Vernby and Annika Lindahl Norberg, Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?, 2010, EUROPEAN JOURNAL OF EPIDEMIOLOGY, (25), 4, 231-235. http://dx.doi.org/10.1007/s10654-010-9434-8 Copyright: Springer Science Business Media http://www.springerlink.com/ Available from: 2010-04-28 Created: 2010-04-28 Last updated: 2013-10-09
    4. Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey
    Open this publication in new window or tab >>Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey
    Show others...
    2011 (English)In: Journal of Official Statistics, ISSN 0282-423X, E-ISSN 2001-7367, Vol. 27, no 2, p. 393-414Article in journal (Refereed) Published
    Abstract [en]

    Response rates to surveys are declining in most countries. Attempts to persuade or pressure respondents to increase response might be counterproductive in the long-term because they can negatively affect attitudes towards future surveys. Targeting respondents’ own motivation to participate in surveys is an alternative approach to achieve higher response rates. Self-determination theory provides a theoretical framework for how intrinsic motivation can be stimulated. We used self-determination theory as inspiration to re-design a self-administered health-related survey. Two versions of the questionnaire and two data collection methods were used in an experimental design. Effects were measured in terms of respondent satisfaction, response rate, and data quality. The results suggest that it is possible to improve response rates in a way that also promotes data quality and positive experiences for the respondents.

    Place, publisher, year, edition, pages
    Almqvist & Wiksell International / Statistics Sweden, 2011
    Keywords
    Survey design; respondent motivation; self-determination theory; intrinsic motivation; questionnaire
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-60182 (URN)000292708100013 ()
    Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12
  • 425.
    Wenemark, Marika
    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 Public Health Sciences.
    Hollman Frisman, Gunilla
    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, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Kristenson, Margareta
    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.
    Respondent Satisfaction and Respondent Burden among Differently Motivated Participants in a Health-Related Survey2010In: Field Methods, ISSN 1525-822X, E-ISSN 1552-3969, Vol. 22, no 4, p. 378-390Article in journal (Refereed)
    Abstract [en]

    Response rates in surveys have declined in many countries over the last decade. Reasons for refusal by nonrespondents have been discussed in many studies, but less attention has been paid to motivation among respondents who do take part. One theoretical framework for studying motivation is self-determination theory, which distinguishes between extrinsic and intrinsic motivation. This article describes respondents' experiences of participating in a self-administered health-related survey. Qualitative content analysis was used to analyze data from semistructured telephone interviews with 30 Swedish respondents aged 45–64 years. The results show a broad spectrum of positive as well as negative aspects of survey participation.

  • 426.
    Wenemark, Marika
    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.
    Persson, Andreas
    Statistics Sweden, Örebro, Sweden.
    Noorlind Brage, Helle
    Östergötlands Läns Landsting, Centre for Health and Developmental Care, Centre for Public Health.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Kristenson, Margareta
    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.
    Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey2011In: Journal of Official Statistics, ISSN 0282-423X, E-ISSN 2001-7367, Vol. 27, no 2, p. 393-414Article in journal (Refereed)
    Abstract [en]

    Response rates to surveys are declining in most countries. Attempts to persuade or pressure respondents to increase response might be counterproductive in the long-term because they can negatively affect attitudes towards future surveys. Targeting respondents’ own motivation to participate in surveys is an alternative approach to achieve higher response rates. Self-determination theory provides a theoretical framework for how intrinsic motivation can be stimulated. We used self-determination theory as inspiration to re-design a self-administered health-related survey. Two versions of the questionnaire and two data collection methods were used in an experimental design. Effects were measured in terms of respondent satisfaction, response rate, and data quality. The results suggest that it is possible to improve response rates in a way that also promotes data quality and positive experiences for the respondents.

  • 427.
    Wenemark, Marika
    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. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Vernby, Asa
    Karolinska Institute.
    Lindahl Norberg, Annika
    Karolinska Institute.
    Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?2010In: EUROPEAN JOURNAL OF EPIDEMIOLOGY, ISSN 0393-2990, Vol. 25, no 4, p. 231-235Article in journal (Refereed)
    Abstract [en]

    Response rates to surveys are decreasing. The purpose of this study was to evaluate the use of lottery tickets as incentives in an epidemiologic control group. A self-administered questionnaire was sent to parents in the municipality of Stockholm, Sweden, who were to be used as a control group in a study addressing stress in parents of children with cancer. A stratified random sample of 450 parents were randomized into three incentive groups: (a) no incentive; (b) a promised incentive of one lottery ticket to be received upon reply; (c) a promised incentive of one lottery ticket to be received upon reply and an additional lottery ticket upon reply within 1 week. The overall response rate across the three groups was 65.3%. The response rate was highest in the no incentive group (69.3%) and lowest in the one plus one lottery ticket group (62.0%). In a survival analysis, the difference between the two response curves was significant by the log-rank test (P = 0.04), with the no incentive group having a shorter time to response than the incentive group. Our findings suggest that the use of lottery tickets as incentives to increase participation in a mail questionnaire among parents may be less valuable or even harmful. Incentives may undermine motivation in studies in which the intrinsic motivation of the respondents is already high.

  • 428.
    Werner, J
    et al.
    Ortopedkliniken ViN.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Waldén, Markus
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekstrand, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science.
    UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons.2009In: British journal of sports medicine, ISSN 1473-0480, Vol. 43, no 13, p. 1036-40Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Groin injury is a common injury in football and a complicated area when it comes to diagnosis and therapy. There is a lack of comprehensive epidemiological data on groin injuries in professional football. OBJECTIVE: To investigate the incidence, pattern and severity of hip and groin injuries in professional footballers over seven consecutive seasons. STUDY DESIGN: Prospective cohort study. SETTING: European professional football. METHODS: During the 2001/2 to 2007/8 seasons, between nine and 17 clubs per season (23 clubs in total) were investigated, accounting for 88 club seasons in total. Time loss injuries and individual exposure during club and national team training sessions and matches were recorded. MAIN OUTCOME MEASURE: Injury incidence. RESULTS: A total of 628 hip/groin injuries were recorded, accounting for 12-16% of all injuries per season. The total injury incidence was 1.1/1000 h (3.5/1000 match hours vs 0.6/1000 training hours, p<0.001) and was consistent over the seasons studied. Eighteen different diagnostic entities were registered, adductor (n = 399) and iliopsoas (n = 52) related injuries being the most common. More than half of the injuries (53%) were classified as moderate or severe (absence of more than a week), the mean absence per injury being 15 days. Reinjuries accounted for 15% of all registered injuries. In the 2005/6 to 2007/8 seasons, 41% of all diagnoses relied solely on clinical examination. CONCLUSIONS: Hip/groin injuries are common in professional football, and the incidence over consecutive seasons is consistent. Hip/groin injuries are associated with long absences. Many hip/groin diagnoses are based only on clinical examination.

  • 429.
    Westerling, Ragnar
    et al.
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet och Akademiska sjukhuset, Uppsala.
    Burström, Bo
    Institutionen för folkhälsovetenskap, avdelningen för socialmedicin, Karolinska Institutet, Samhällsmedicinska kliniken, Karolinska universitetssjukhuset.
    Kristenson, Margareta
    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.
    Säkerställ den socialmedicinska kompetensen!2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 32-33, p. 1948-9Article in journal (Other academic)
    Abstract [sv]

    För att säkra folkhälsokompetensen på europeisk nivå i svensk hälso- och sjukvård och kvaliteten i specialistutbildningen är det angeläget att landstingen inrättar socialmedicinska tjänster med tydliga uppdrag inom organisationen samt specialisttjänster och ST-tjänster inom socialmedicin.

  • 430.
    Wilhelmsson, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ponzer, Sari
    Karolinska Institute, Stockholm.
    Dahlgren, Lars-Ove
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational 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.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare?2011In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 11, no 15Article in journal (Refereed)
    Abstract [en]

    Background: Interprofessional Education (IPE) is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions. Methods: Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS). Totally, 955 students were invited and 70.2% (n = 670) participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors) for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player". Results: Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs. Conclusions: The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the students personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.

  • 431.
    Wilhelmsson, Margareta
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Svensson, Annemie
    Linköping University, Department of Medical and Health Sciences, Nursing 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.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Nurses views of interprofessional education and collaboration: A comparative study of recent graduates from three universities2013In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 27, no 2, p. 155-160Article in journal (Refereed)
    Abstract [en]

    Today interprofessional education (IPE) is spread throughout the world. In Sweden only one of the existing nursing programs has an IPE curriculum on several levels during the training. The aim of this study was to examine how nurses who recently graduated from universities with IPE or non-IPE curricula perceive the importance of different educational goals and whether they found themselves prepared for their profession, and especially for collaboration with other professions. Three universities with different commitments to IPE were studied. We used a survey with eight different targets: communication skills, cooperation with other professions, problem-solving capability, self-directed learning skills, whether their education has prepared them to work professionally, to perform research, to take care of acutely ill patients, to work preventively and working as a nurse. The participants were asked whether their undergraduate education had prepared them for these targets and whether they perceived that the targets were important goals for their education. A main result in this study was that nurses who had recently graduated from the IPE university perceived to a greater extent that their undergraduate training had prepared them to work together with other professions in comparison with nursing students from non-IPE universities.

  • 432.
    Wilhelmsson, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svensson, Annemie
    Linköping University, Department of Medical and Health Sciences, Nursing 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.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Nurses with IPE curricula during training think they are better prepared to work with other health professionsManuscript (preprint) (Other academic)
    Abstract [en]

    Today interprofessional education is spread throughout the world. In  Sweden only one of the existing nursing programmes has an IPE curriculum on several levels during the training.

    The aim of this study was to examine how nurses who recently graduated from universities with IPE or non-IPE curricula perceive the importance of different educational goals and whether they found themselves prepared for their profession, and especially for collaboration with other professions.

    Three universities with different commitments to interprofessional education were studied. We used a survey with eight different targets: communication skills, co-operation with other professions, problem solving capability, self-directed learning skills, whether their education has prepared them to work professionally, to perform research, to take care of acute ill patients, to work preventively and working as a nurse. The participants were asked if their undergraduate education had prepared them for these targets and if they perceived that the targets were important goals for their education.

    A main result in this study was that nurses who had recently graduated from the IPEuniversity perceived to a greater extent that their undergraduate training had prepared them to work together with other professions in comparison with nursing students from non-IPE universities.

  • 433.
    Wiréhn, Ann-Britt
    et al.
    Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Andersson, Agneta
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Östgren, Carl Johan
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Primary Health Care Centres.
    Carstensen, John
    Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Age-specific direct health care costs attributable to diabetesin a Swedish population: a register-based analysis2008In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 25, no 6, p. 732-737Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this population-based study was to explore the age-specific additional direct healthcare cost for patients with diabetes compared with the non-diabetic population.

    Methods: In 1999-2005, patients with diabetes in the Swedish county of Östergötland (n = 20 876) were identified from an administrative database. Cost data on the healthcare expenditure in primary healthcare, out-patient hospital care and in-patient care for the entire county population (n = ∼415 000) in 2005 were extracted from a cost per patient (CPP) database, which includes information on all utilized healthcare resources in the county. Data on drug sales were obtained from the Swedish Prescribed Drug Register.

    Results: The cost per person was 1.8 times higher in patients with diabetes than in the non-diabetic population, 7.7 times higher in children and 1.3 times higher in subjects aged > 75 years. The additional cost per person for diabetes was €1971; €3930 and €1367, respectively, for children and subjects aged > 75 years. The proportion of total additional diabetes costs attributable to in-patient care increased with age from 25 to 50%; in-patient care was the most expensive component at all ages except in children, for whom visiting a specialist was most expensive. The diabetes-related segment of the total healthcare cost was 6.6%, increasing from 2.0% in children to 10.3% in the age group 65-74 years, declining to 6.2% in the oldest age group.

    Conclusions: The direct medical cost of diabetes varies considerably by age. Knowledge about the influence of age on healthcare costs to society will be important in future planning of diabetes management.

  • 434.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Security.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Patientsäkerhetsdialog: lärande och kunskapsspridning för förbättrad säkerhetskultur2010In: Implementering: teori och tillämpning inom hälso- och sjukvård / [ed] Per Nilsen, Lund: Studentlitteratur , 2010, 1, p. 263-Chapter in book (Other academic)
    Abstract [sv]

    Frågor kring implementering av forskningsbaserad kunskap i hälso- och sjukvårdens verksamhet får allt större uppmärksamhet. Det så kallade gapet mellan produktion av forskningsresultat och vad som nyttiggörs i vården diskuteras i dag som ett stort problem, såväl för samhället som för de individer som inte erbjuds bästa möjliga vård. Denna bok utgör en introduktion till teoribildning och forskningsrön inom flera kunskapsområden som har relevans för frågor kring implementering inom hälso- och sjukvården. Samtliga författare är verksamma som forskare vid den tvärvetenskapliga institutionen för medicin och hälsa vid Linköpings universitet. Boken vänder sig till studenter, lärare och forskare som intresserar sig för implementeringsfrågor samt till dem som arbetar praktiskt med implementerings- och förändringsarbete inom hälso- och sjukvård. Läs mer om redaktören Läs mer om doktorandkursen IMPLEMENTERING ht 2011 Linköpings Universitet

  • 435.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Olai, Anders
    Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Spinal Surgery.
    Rutberg, Hans
    Östergötlands Läns Landsting, Patient Security. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. 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.
    Tropp, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Adverse events in spine surgery in Sweden: A comparison of patient claims data and national quality register (Swespine) data2011In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, no 6, p. 727-731Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine).

    Methods: We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 2005. The medical records of the patients filing these claims were reviewed and compared with Swespine data for the same period.

    Results: Two-thirds (119/182, 65%) of patients who claimed economic compensation from the insurance company were registered in Swespine. Of the 210 complications associated with these 182 claims, only 74 were listed in Swespine. The most common causes of compensated injuries (n = 139) were dural lesions (n = 40) and wound infections (n = 30). Clinical outcome based on global assessment, leg pain, disability, and quality of health was worse for patients who claimed economic compensation than for the total group of Swespine patients.

    Interpretation: We found considerable under-reporting of complications in Swespine. Dural lesions and infections were not well recorded, although they were important reasons for problems and contributed to high levels of disability. By analyzing data from more than one source, we obtained a better understanding of the patterns of adverse events and outcomes after spine surgery.

  • 436.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Rutberg, Hans
    Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Patient safety dialogue: evaluation of an intervention aimed at achieving an improved patient safety culture2011In: Journal of patient safety, ISSN 1549-8425, Vol. 7, no 4, p. 185-92Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Patient Safety Dialogue, a local intervention inspired by walk round-style approaches, was implemented in 2005 in a Swedish county council to achieve a positive patient safety culture in health care. This paper evaluates the results and changes after 5 years of the Patient Safety Dialogue in 50 departments (37 medical and 13 psychiatric) in 3 hospitals.

    METHODS: The patient safety culture maturity was rated on 5 levels that correspond with the Manchester Patient Safety Assessment Framework. The assessment was based on information supplied by the departments and discussions between clinical leaders and staff members with special patient safety assignments and representatives from a patient safety unit. Three patient safety areas were assessed: hospital-acquired infections, outcome measurements, and general patient safety. Each department was assessed 3 times: at baseline and at follow-ups at 18 and 36 months. Average scores were calculated for each of the 3 safety areas on all occasions. The departments were classified into 3 types of trajectories on the basis of the development of their scores over time.

    RESULTS: More than two-thirds of the departments attained higher scores in round 3 than in round 1. Seventy-eight percent of the departments in the general patient safety area were categorized as continuously improving or developing, compared with 68% for outcome measurement and 50% for hospital-acquired infection. Approximately one-third was categorized as nonimproving, with scores in round 3 lower than or equal to the scores in round 1. The medical departments had higher scores than the psychiatric departments in all rounds.

    CONCLUSIONS: Most of the 50 departments were evaluated to have improved their patient safety culture during the 5 years of the Patient Safety Dialogue, suggesting that the intervention is effective in supporting an improved patient safety culture. However, one-third of the departments did not improve during the 5-year study period.

  • 437.
    Ölvingson, Christina
    et al.
    Linköping University, Department of Computer and Information Science, EISLAB - Economic Information Systems. Linköping University, The Institute of Technology.
    Hallberg, Niklas
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    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.
    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.
    Ethical issues in public health projects: Implications of geographic information resolution2002In: Alvarez I:, Ward Bynum T., Àlvaro de Assis Lopes J., and Rogerson S. Proceedings of the sixth international conference: The transformation of organisations in the information Age: Social and ethical implications. ETHICOMP 2002, 2002Conference paper (Refereed)
  • 438.
    Östlund, Gunnel
    et al.
    Linköping University, Department of Social and Welfare Studies, Society, Diversity, Identity . Linköping University, Faculty of Arts and Sciences.
    Borg, Karin
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Wide, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Hensing, Gunnel
    Department of Social Medicine, Sahlgrenska Academy, University of Göteborg, Sweden.
    Alexandersson, Kristina
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Client’s perceptions of contacts with professionals within health care and social insurance offices2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no 4, p. 275-282Article in journal (Refereed)
    Abstract [en]

    Aims: An increasing number of people interact with professionals within healthcare and social insurance offices during periods of sick leave due to musculoskeletal disorders. Knowledge of clients' perceptions of such contact is scarce. This study analysed clients' perceptions of their contact with professionals within healthcare and social insurance offices.

    Methods: A cohort study was conducted in the municipality of Linköping, Sweden. Participants were all citizens who in 1985 were aged 25 - 34 years and had at least one new sick-leave spell due to back, neck, or shoulder diagnoses exceeding 28 days (n=213). In 1996, 11 years after inclusion, a questionnaire about perception of contact with professionals, self-perceived health, and mental health was administered. Register data on sickness absence and disability pension from 1985 - 96 were also obtained.

    Results: Factor analysis indicated the existence of three dimensions of contact with professionals: supportive treatment, distant treatment, and empowering treatment. Women perceived their contact with both social insurance officers and healthcare professionals as more supportive than did the men. Respondents with disability pensions perceived their contact with social insurance officers as more supportive and empowering than persons without disability pensions. Respondents with mental health problems perceived their contact with both types of professionals as more distant. Respondents with neck/shoulder diagnoses perceived their contact with healthcare professionals as more empowering than respondents with low back diagnoses.

    Conclusion: There was a relationship between clients' perceptions of contact with professionals and the sex, disability pension, diagnosis, and mental health of clients.

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