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  • 1.
    Edelbring, Samuel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Allvin, Renée
    Universitetssjukhuset Örebro, Sweden.
    Karlsson, Katarina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelmqvist, Hans
    Karolinska Universitetssjukhuset, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Brandt, Jonathan
    Aleris specialistvård Motala, Sweden.
    Tamás, Éva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Interprofessionell simulering är engagerande och relevant [Interprofessional simulation: an engaging and relevant technique for teamwork practice]2019Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Studenter behöver träna på teamarbete och utveckla interprofessionell kompetens för att rustas för framtidens hälso- och sjukvård.

    Utbildning för interprofessionell samverkan kan ske genom simulering där läkar- och sjuksköterskestudenter möts och agerar tillsammans i patientscenarier. 

    Interprofessionell simulering upplevdes som relevant och engagerande av studenter på två lärosäten. Studenter från den andra professionen bidrog till lärandet. Det finns dock utrymme att ytterligare förbättra det pedagogiska genomförandet, och professionsperspektiven kan balanseras bättre. 

  • 2.
    Pettersson, Sara
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hadziabdic, Emina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Medicinska fakulteten. Linnaeus Univ, Sweden.
    Marklund, Helén
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Urologiska kliniken i Östergötland.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Lower knowledge about diabetes among foreign-born compared to Swedish-born persons with diabetes: A descriptive study2019Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 2, s. 367-376Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To compare foreign‐ and Swedish‐born persons, diagnosed with type 2 diabetes, to study whether there are dissimilarities in knowledge about diabetes and to study determinants of knowledge.

    Design

    A cross‐sectional descriptive study was conducted.

    Method

    Data were collected between September 2014 and March 2016, using the standardized Diabetes Knowledge Test (DKT), statistically analysed.

    Results

    The results showed dissimilarities in knowledge between foreign‐ and Swedish‐born persons, supporting the hypothesis that foreign‐born persons had lower knowledge about diabetes than Swedish‐born persons. There was a relationship between poor knowledge and country of birth, marital status and employment status. Country of birth was the strongest independent determinant of knowledge about diabetes. The risk of poor knowledge was ten times higher among persons born in the Middle East or in another country outside Europe compared with Swedish‐born persons. Other influencing factors for poor knowledge about diabetes were being not gainfully employed and living alone.

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  • 3.
    Linderholm, Märit
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Medicinska fakulteten. Primary Hlth Care Ctr Valdemarsvik, Sweden.
    Törnvall, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Ledningsstab Region Östergötland, Övrig enhet.
    Yngman Uhlin, Pia
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Ledningsstab Region Östergötland, Enheten för forskningsstöd. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Self-rated health, lifestyle habits and risk assessment in 75-year-old persons attending preventive clinic visits with a nurse in primary health care: a cross-sectional study2019Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 20, artikel-id UNSP e88Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim:

    To describe self-rated health in relation to lifestyle and illnesses and to identify risk factors for ill health such as pressure ulcers, falls and malnutrition among 75-year-old participants in a new clinical routine involving health assessment followed by tailored one-to-one health promotion at preventive clinic visits to a nurse at primary health care centres (PHCC).

    Background:

    There is a rapidly growing ageing population worldwide. It is central to health policy to promote active and healthy ageing. Preventive clinic visits to a nurse in primary health care were introduced as a new clinical intervention in a region in Sweden to improve the quality of health for the older adults.

    Design:

    A quantitative cross-sectional population-based study.

    Methods:

    The sample consisted of 306 individuals in six primary health care centres in Sweden aged 75 years who attended preventive clinic visits to a nurse. Data were collected from March 2014 to May 2015 during structured conversations with a nurse based on self-administered questionnaires, clinical examinations, risk assessments and after the clinic visit existing register data were collected by the researcher.

    Findings:

    Participants experienced good self-rated health despite being overweight and having chronic illnesses. Daily exercise such as walking and housework was more common than aerobic physical training. The majority had no problems with mobility but reported anxiety, pain and discomfort and had increased risk of falls.

    Conclusion:

    It is important to encourage the older adults to live actively and independently for as long as possible. The healthy older adults may benefit from the clinical intervention described here to support the individual’s ability to maintain control over their health. Such supportive assessments might help the healthy older adult to achieve active ageing, reducing morbidity and preventing functional decline.

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  • 4.
    Hadziabdic, Emina
    et al.
    Faculty of Health and Life Sciences Department of Health and Caring Sciences Linnaeus University Växjö Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
    Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study2018Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 5, nr 2, s. 210-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden.

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  • 5.
    Lundin, Christina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland.
    Hadziabdic, Emina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Medicinska fakulteten. Linnaeus Univ, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare2018Ingår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, artikel-id 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: With an increasing migrant population globally the need to organize interpreting service arises in emergency healthcare to deliver equitable high-quality care. The aims of this study were to describe interpretation practices in multilingual emergency health service institutions and to explore the impact of the organizational and institutional context and possible consequences of different approaches to interpretation. No previous studies on these issues in multilingual emergency care have been found. Methods: A qualitative descriptive study was used. Forty-six healthcare professionals were purposively recruited from different organizational levels in ambulance service and psychiatric and somatic emergency care units. Data were collected between December 2014 and April 2015 through focus-group and individual interviews, and analyzed by qualitative content analysis. Results: Organization of interpreters was based on patients health status, context of emergency care, and access to interpreter service. Differences existed between workplaces regarding the use of interpreters: in somatic emergency care bilingual healthcare staff and family members were used to a limited extent; in psychiatric emergency care the norm was to use professional interpreters on the spot; and in ambulance service persons available at the time, e.g. family and friends were used. Similarities were found in: procuring a professional interpreter, mainly based on informal workplace routines, sometimes on formal guidelines and national laws, but knowledge of existing laws was limited; the ideal was a linguistically competent interpreter with a professional attitude, and organizational aspects such as appropriate time, technical and social environment; and wishes for development of better procedures for prompt access to professional interpreters at the workplace, regardless of organizational context, and education of interpreters and users. Conclusion: Use of interpreters was determined by health professionals, based on the patients health status, striving to deliver as fast and individualized care as possible based on humanistic values. Defects in organizational routines need to be rectified and transcultural awareness is needed to achieve the aim of person-centered and equal healthcare. Clear formal guidelines for the use of interpreters in emergency healthcare need to be developed and it is important to fulfill health professionals wishes for future development of prompt access to interpreters and education of interpreters and users.

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  • 6.
    Mufunda, Esther
    et al.
    Department of Health Sciences, Zimbabwe Open University, Harare, Zimbabwe.
    Ernersson, Åsa
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Limited knowledge of diabetes in patients attending an outpatient diabetes clinic at a referral hospital in Zimbabwe: a cross-sectional study2018Ingår i: Pan African Medical Journal, E-ISSN 1937-8688, Vol. 29, artikel-id 144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person?s knowledge of diabetes. The present study aimed to assess patients diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital.

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  • 7.
    Ring Jacobsson, Lisa
    et al.
    Karolinska Institute, Sweden.
    Milberg, Anna
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH Öst. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Experiences and own management regarding residual symptoms among people with coeliac disease2017Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 35, s. 53-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context: Between 7% and 30% of people with treated coeliac disease suffer from residual symptoms, and there is a knowledge gap about their own management of these symptoms. Aim: To explore experiences and management concerning residual symptoms despite a gluten-free diet in people with coeliac disease. Methods: A qualitative explorative design with semi-structured interviews with 22 adults with coeliac disease in Sweden. Data were analysed using qualitative content analysis. Results: The informants had, at diagnosis, thought that their symptoms would disappear if they followed a gluten free diet, but the disease was continuing to have a substantial impact on their lives, despite several years of treatment. They experienced cognitive, somatic as well as mental symptoms, including impact on personality (e.g. having a shorter fuse, being more miserable or tired). However, only a few informants had sought medical care for persistent symptoms. Instead they tried to manage these by themselves, e.g. abstaining from food during periods of more intense symptom, or using distraction. The management of persistent symptoms resembled thorough detective work. To prevent problems related to residual symptoms the informants used withdrawal of social contact as well as acceptance of their situation. Conclusion: People with treated coeliac disease may experience residual symptoms of both a physical and psychological nature, causing major negative impacts on their lives in different ways. In the light of this, healthcare staff should change their practices regarding the follow-up of these people, and in addition to medical care should provide guidance on management strategies to facilitate the daily life. Furthermore, information to newly diagnosed persons should make them aware of the possibility to experience continued symptoms, despite treatment. (C) 2017 Elsevier Inc. All rights reserved.

  • 8.
    Aho, Anna Carin
    et al.
    Linnaeus University, Sweden.
    Hultsjö, Sally
    Psychiat Clin, Sweden; Jönköping University, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Experiences of being parents of young adults living with recessive limb-girdle muscular dystrophy from a salutogenic perspective2017Ingår i: Neuromuscular Disorders, ISSN 0960-8966, E-ISSN 1873-2364, Vol. 27, nr 6, s. 585-595Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Recessive limb-girdle muscular dystrophies (LGMD2) involve progressive muscle weakness. Parental support is important for young adults living with LGMD2, but no study has been identified focusing on the parents experiences. The salutogenic perspective concentrates on how daily life is comprehended, managed and found meaningful, i.e. the persons sense of coherence. The aim of this study was to describe, from a salutogenic perspective, experiences of being parents of young adults living with LGMD2. Nineteen participants were included. Data were collected by semi-structured interviews and the self-administrated 13-item sense of coherence questionnaire. Interview data were analysed with content analysis and related to self-rated sense of coherence. The result shows experiences of being influenced, not only by thoughts and emotions connected to the disease but also by caregiving duties and the young adults well-being. Simultaneously, difficulty in fully grasping the disease was expressed and uncertainty about progression created worries about future management. Trying their best to support their young adults to experience well-being and to live fulfilled lives, the importance of having a social network, support from concerned professionals and eventually access to personal assistance was emphasized. The need to have meaningful pursuits of ones own was also described. The median sense of coherence score was 68 (range 53-86). Those who scored high (amp;gt;= 68) described satisfaction with social network, external support provided, work and leisure activities to a greater extent than those who scored low (amp;lt;68). The result shows that the young adults disease has a major impact on the parents lives. Assessment of how the parents comprehend, manage and find meaning in everyday life may highlight support needed to promote their health. (C) 2017 Elsevier B.V. All rights reserved.

  • 9.
    Atwine, Fortunate
    et al.
    School of Health and Caring Science, Linnaeus University, Vaxjo, Sweden; Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Health professionals’ knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in ugandans with diabetes: A cross-sectional survey2017Ingår i: Pan African Medical Journal, E-ISSN 1937-8688, Vol. 28, artikel-id 256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals’ perspective. The aim of the study was to describe healthcare professionals’ knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes. Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda. Nurses, midwives or nurse assistants 72.2%, physicians 12% and clinical officers 10% volunteered to participate in the study with a total 108 (93% response rate) response rate. Descriptive statistics were used to analyse data with frequencies, percentages and summarized in tables. Results: Most of the healthcare providers perceived more uneducated people to be at risk of developing complications related to diabetes (66.7%) and that most of the patients with diabetes were not knowledgeable about signs and symptoms of diabetes before being diagnosed (75.9%). The main reasons inducing persons with diabetes to seek care outside the health care sector were reported to be seeking a cure for the condition, influence from the popular sector, the accessibility of the place and signs of complications of diabetes related to poor glycaemic control. Healthcare providers had relatively positive attitudes towards using complementary and alternative medicine. Conclusion: Insufficient knowledge about diabetes, compromised healthcare-seeking practices including drug procurement for diabetes seem to be barriers to diabetes management. Patients were thus reported to be burdened with co-morbidities of complications of diabetes related to poor glycaemic control. © Fortunate Atwine et al.

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  • 10.
    Pihl Lesnovska, Katarina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Hjortswang, Henrik
    Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Börjeson, Sussanne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Healthcare as perceived by persons with inflammatory bowel disease – a focus group study2017Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 26, nr 21-22, s. 3677-3687Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The quality of care plays an important role in the life of persons with a chronic disease. In order to define what persons with inflammatory bowel disease perceive as high quality care, greater focus must be placed on the individual’s own perspective of living with the condition. Design: A qualitative exploratory study was conducted based on focus groups. Methods: Five focus groups were conducted with adult persons living with inflammatory bowel disease, fourteen men and twelve women aged 19-76 years. The interviews were performed between January and June 2014. Results: The perceptions of healthcare from the perspective of persons living with inflammatory bowel disease were summarized in two categories: “Professional attitudes of healthcare staff” and “Structure of the healthcare organization”. Persons with Inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision-making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organization comprises access to care, accommodation, continuity of care, as well as the pros and cons of specialized care. Conclusion: The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs – but there is room for improvement in terms of quality of care. Relevance to clinical practice: A person-centred approach, which place the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high quality healthcare organization for patients with IBD.

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  • 11.
    Andersson, Frieda
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Patient safety in nursing homes in Sweden: nurses´views on safety and their role2017Ingår i: Journal of Health Services Research and Policy, ISSN 1355-8196, E-ISSN 1758-1060, Vol. 22, nr 4, s. 204-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method: Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results: Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment. Barriers to patient safety were described as lack of sufficient resources; lack of communication and negative attitudes to incident reporting. To a great extent, nurses' work for patient safety consists of efforts to compensate for defects and ensure good health care in their daily work, since work with patient safety is not a management priority. Conclusion: Patient safety needs to be clarified and prioritized in nursing homes, and there is a need to understand nurses' role among other care givers and the need for shared routines among care givers

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  • 12.
    Ge, Li
    et al.
    Linnaeus University, Växjö, Sweden; Nursing College of Fujian University of Traditional Chinese Medicine, Fuzhou, China.
    Albin, Björn
    Linnaeus University, Växjö, Sweden..
    Hadziabdic, Emina
    Linnaeus University, Växjö, Sweden..
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Rask, Mikael
    Linnaeus University, Växjö, Sweden..
    Beliefs about health and illness and health-related behavior among urban women with gestational diabetes mellitus in the south east of China.2016Ingår i: Journal of Transcultural Nursing, ISSN 1043-6596, E-ISSN 1552-7832, Vol. 27, nr 6, s. 593-602Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE:

    The incidence of gestational diabetes among Chinese women is 4.3%. No study has previously been conducted about beliefs and health-related behavior among urban Chinese women with this disease. This article aims to explore beliefs about health and illness and health-related behavior among women in this group in a Chinese sociocultural context.

    DESIGN:

    A qualitative exploratory study was conducted and semistructured individual interviews (n = 15) were processed by content analysis.

    RESULTS:

    Beliefs about health and illness among these women were foremost attributed to the individual, social, and natural worlds. They feared the negative influence of gestational diabetes, but some of them believed in "letting nature take its course" and "living in the present." Their care-seeking behavior varied between the professional, popular, and folk sectors. They sought a balance between following professionals' advice and avoiding practical difficulties.

    CONCLUSION:

    The beliefs and health-related behavior among them were influenced by Chinese culture, which can sometimes but not always reduce the effect of the disease.

  • 13.
    Eriksson, Helene
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Norrköping, Sweden.
    Milberg, Anna
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Region Östergötland, Närsjukvården i östra Östergötland, LAH Öst.
    Hjelm, Katarina
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Friedrichsen, Maria
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    End of Life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer2016Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 11, nr 2, s. e0147694-, artikel-id 26845149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Although stroke is a significant public health challenge and the need for palliative care has been emphasized for these patients, there is limited data on end-of-life care for patients dying from stroke.

    Objective

    To study the end-of-life care during the last week of life for patients who had died of stroke in terms of registered symptom, symptom management, and communication, in comparison with patients who had died of cancer.

    Design

    This study is a retrospective, comparative registry study.

    Methods

    A retrospective comparative registry study was performed using data from a Swedish national quality register for end-of-life care based on WHO`s definition of Palliative care. Data from 1626 patients who had died of stroke were compared with data from 1626 patients who had died of cancer. Binary logistic analyses were used to calculate odds ratios, with 95% CI.

    Results

    Compared to patients who was dying of cancer, the patients who was dying of stroke had a significantly higher prevalence of having death rattles registered, but a significantly lower prevalence of, nausea, confusion, dyspnea, anxiety, and pain. In addition, the stroke group had significantly lower odds ratios for health care staff not to know whether all these six symptoms were present or not. Patients who was dying of stroke had significantly lower odds ratio of having informative communication from a physician about the transition to end-of-life care and of their family members being offered bereavement follow-up.

    Conclusions

    The results indicate on differences in end-of-life care between patients dying of stroke and those dying from cancer. To improve the end-of-life care in clinical practice and ensure it has consistent quality, irrespective of diagnosis, education and implementation of palliative care principles are necessary.

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  • 14.
    Ring Jacobsson, Lisa
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Milberg, Anna
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Region Östergötland, Närsjukvården i östra Östergötland, LAH Öst.
    Hjelm, Katarina
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Friedrichsen, Maria
    Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Gaining perspective on own illness - The lived experiences of a patient education program for women with treated coeliac disease.2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 9-10, s. 1229-1237Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and Objectives

    To explore the lived experiences of women with coeliac disease after attending a patient education programme, to gain a broader perspective of its influence.

    Background

    Adults, particularly women, with coeliac disease report suffering from poor well-being and reduced quality of life in terms of health. Patient education programmes might support and encourage them in the search for possible improvements in lifestyle and in their approach to the disease.

    Design

    A qualitative phenomenological study.

    Methods

    Personal narrative interviews with 14 women suffering from coeliac disease who had participated in an educational programme. Data analysis in accordance with Giorgi was performed.

    Results

    The essential structure of women's lived experiences following their participation in the patient education programme was found to be an interaction with others with the same disease, which left the women feeling individually strengthened. The interaction enabled the participants to acquire a broader view of their life with coeliac disease. As a result, this realigned their sense of self in relation to their own disease.

    Conclusion

    In coping with coeliac disease, it seems that women need interaction with others with the disease to experience togetherness within a group, get the opportunity to compare themselves with others and to exchange knowledge. The interaction appears to result in that women acquire an overview of life with the disease, develop a greater confidence and dare to try new things in life.

    Relevance to clinical practice

    When designing a patient education programme it seems important to consider the needs of persons to meet others with the same disease, and to ask them about their need for knowledge, rather than simply assuming that health care professionals know what they need.

  • 15.
    Aho, Anna-Carin
    et al.
    Linnéuniversitetet, Växjö, Sweden.
    Hultsjö, Sally
    Ryhovs sjukhus, Landstinget i Jönköping, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Health perceptions of young adults living with recessive limb-girdle muscular dystrophy2016Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 8, s. 1915-1925Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    The aim of this study was to describe health perceptions related to sense of coherence among young adults living with recessive limb-girdle muscular dystrophy.

    BACKGROUND:

    Limb-girdle muscular dystrophy refers to a group of progressive muscular disorders that may manifest in physical disability. The focus in health care is to optimize health, which requires knowledge about the content of health as described by the individual.

    DESIGN:

    A descriptive study design with qualitative and quantitative data were used.

    METHOD:

    Interviews were conducted between June 2012-November 2013 with 14 participants aged 20-30 years. The participants also answered the 13-item sense of coherence questionnaire. Qualitative data were analysed with content analysis and related to self-rated sense of coherence.

    FINDINGS:

    Health was viewed as intertwined physical and mental well-being. As the disease progressed, well-being was perceived to be influenced not only by physical impairment and mental strain caused by the disease but also by external factors, such as accessibility to support and attitudes in society. Factors perceived to promote health were having a balanced lifestyle, social relations and meaningful daily activities. Self-rated sense of coherence varied. The median score was 56 (range 37-77). Those who scored ≥56 described to a greater extent satisfaction regarding support received, daily pursuits and social life compared with those who scored <56.

    CONCLUSION:

    Care should be person-centred. Caregivers, with their knowledge, should strive to assess how the person comprehends, manages and finds meaning in daily life. Through dialogue, not only physical, psychological and social needs but also health-promoting solutions can be highlighted.

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  • 16.
    Atwine, Fortunate
    et al.
    Linnaeus University, Växjö, Sweden; Mbarara University of Science and Technology (MUST). Mbarara, Uganda.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Healthcare-seeking behaviour and management of type 2 diabetes: from Ugandan traditional healers’ perspective2016Ingår i: International Journal of Africa Nursing Sciences, E-ISSN 2214-1391, Vol. 5, s. 17-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    [Background] Healthcare-seeking behaviour has been investigated to a limited extent in persons with diabetes, and the way traditional healers manage diabetes still needs exploration. [Aim] To explore healthcare-seeking behaviour and management of type 2 diabetes from the perspective of traditional healers in the folk sector to understand how traditional medicine is integrated into the professional health sector. [Design] A qualitative descriptive study. [Method] A purposeful sample of 16 traditional healers known in the area. Data were collected by individual semi-structured interviews. [Findings] Healthcare was sought from the professional health sector, mainly from the public hospitals, before the patients switched to the traditional healers. Reasons for seeking help from traditional healers were mainly chronic conditions such as diabetes, high blood pressure and the perceived failure of western medicine to manage diabetes. The cost at the healers’ facilities also influenced healthcare seeking because it was perceived to be affordable as it was negotiable and accessible because it was always available. Traditional medicine therapies of patients with diabetes were herbal medicine, nutritional products and counselling, but many patients whose conditions were difficult to manage were told to return to the public hospitals in the professional health sector. [Conclusion] Healthcare seeking was inconsistent in character, with a switch between different healthcare providers. Living conditions including treatment costs, healthcare organization, patients’ health beliefs and general condition seemed to influence healthcare seeking practice.

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  • 17.
    Mehdiyar, Manijeh
    et al.
    Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
    Andersson, Rune
    Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Povlsen, Lene
    Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
    HIV-positive migrants’ encounters with the Swedish health care system2016Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, artikel-id 31753Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients.

    Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden.

    Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years.

    Results: ‘A hybrid of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated that participants experienced frustration and discrimination because they were required to provide sexual partners with information about their HIV status, which is compulsory under the Swedish Disease Act. The study also showed that the bias or fear regarding HIV infection among general health care professionals outside of the infectious diseases clinics limited the access to the general health care system for HIV-positive migrants.

    Conclusions: The HIV-positive migrants appreciated the free access to antiviral therapy, but wished to have more time for patient–physician communications. The participants of this study felt discrimination in health care settings outside of the infectious diseases clinics. There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group.

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  • 18.
    Rydé, Kerstin
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    How to support patients who are crying in palliative home care: an interview study from the nurses' perspective.2016Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 17, nr 5, s. 479-488Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.

    BACKGROUND: In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse's responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.

    METHODS: A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32-63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient's wishes. A few examples of the patients' need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.

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  • 19.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Apelqvist, J.
    Lund University, Sweden.
    Influence of beliefs about health and illness on self-care and care-seeking in foreign-born people with diabetic foot ulcers: dissimilarities related to origin2016Ingår i: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 25, nr 11, s. 602-616Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe beliefs about health and illness among foreign-born people with diabetic foot ulcers that might affect self-reported self-care and health-care seeking and to study whether there are dissimilarities related to origin. Method: Qualitative descriptive study. Semi-structured interviews with people aged 38-86 years; 13 born in European and 13 in non-European countries (all except one in the Middle East). All resident in Sweden for 7-60 years (median: 18.5years). Results: Most believed foot ulcers were unavoidable and difficult to detect. Foot problems were mainly believed to be due to internal factors (diabetes), sometimes combined with external factors (inappropriate footwear, hot water, or barefoot walking). Health was described as freedom from illness and health professionals were seen as important sources of information. Perceived health deteriorated after the onset of the foot problems due to immobility and pain. People from the Middle East differed from other respondents as they discussed the importance of adapting to the will of Allah, leading to even poorer quality of life and a more negative view of future health. They also described more foot problems and perceived religion (Islam) with ritual washing of the feet to be important for health. However, they were regularly monitored to a lesser extent than European migrants. Economy affected health, more so in Europeans, due to expenses for medications and shoes. Many described limited activity in self-care, few had sought help for their problems and then solely among professionals, and had limited knowledge about the influence of glycaemic control on diabetes and foot status. Conclusion: Foreign-born people felt unable to prevent the incidence of foot ulcers, experienced problems with detection, and had limited knowledge of self-care. Dissimilarities in beliefs related to origin negatively influenced self-care of the feet, so it is important to assess individual beliefs and plan care and education accordingly. Declaration of interest: None to declare.

  • 20.
    Hadziabdic, Emina
    et al.
    Department of Health and caring sciences, Faculty of Health and Life sciences, Linnaeus University, s weden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Perspectives of Professional Interpreters Regarding their Role and Attitude in the Healthcare Encounter2016Ingår i: Diversity and equality in health and care, ISSN 2049-5471, E-ISSN 2049-548X, Vol. 13, nr 3, s. 221-229Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to explore how professional interpreters experience their role in a healthcare encounter. An explorative study with semi-structured individual interviews and written descriptions was conducted with a purposeful sample of nine professional interpreters who represented the migrant population in Sweden. Qualitative content analysis was used to analyse data. The findings showed that the professional interpreters viewed their role as to transfer information accurately, to keep confidentiality, to remain impartial and to perform the duties related to their work assignments. However, the study also found a number of factors and challenges that influenced this role. These were: 1) the form of interpretation, 2) the interpretation environment, 3) the employment conditions and personal characteristics of the interpreters, and 4) the behaviour of the patient and healthcare staff during the interpretation session. The study found that professional interpreters experienced their role as aligning with the existing guidelines regarding an interpreter’s role and ethical attitude. Healthcare service providers, policymakers and interpreter agencies should focus on improving training and support and development opportunities in order to increase the impact of interpretation on equality and quality of healthcare.

  • 21.
    Hermansen, Anna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Kammerlind, Ann-Sofi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Futurum Region Jönköping County.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study2016Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 4, s. 352-358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Subjects: Fourteen women aged 39-62 years (median 52 years), were included 1.5 to 3 years after ACDF for cervical degenerative disc disease.

    Methods: Individual semi-structured interviews were analyzed by qualitative content analysis with an inductive approach.

    Results: The women described their experiences of daily life in five different ways; Experiences of recovery; Experiences of symptoms in daily life influence feelings and thoughts; Making daily life work; Importance of social  and occupational networks; Experiences of the influence of healthcare professionals and interventions on daily life.

    Conclusion: This interview study provides insight into women’s daily life after ACDF. While improved after surgery, informants also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge on aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after ACDF.

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  • 22.
    Hjelm, Katarina
    Institutionen för Hälso- och vårdvetenskap, Linnéuniversitetet, Växjö.
    Bemötande i vård och omsorg, transkulturellt perspektiv2015Bok (Övrigt vetenskapligt)
    Abstract [sv]

    Utgångspunkten för allt hälso- och sjukvårdsarbete är Hälso- och sjukvårdslagen som anger att vården ska vara individualiserad, genomföras i samråd med den enskilde, bygga på respekt för individens självbestämmande och integritet och meddelas på lika villkor oavsett ras, religion eller politisk åsikt. Tydligt framgår att alla individer är unika och därmed inte nödvändigtvis ska meddelas samma vård.

    Inom transkulturell omvårdnad studeras individens förutsättningar för hälsa, reaktioner på och upplevelser av sjukdom eller ohälsa samt effekter av vård och behandling hos individer med olika kulturell bakgrund. Man studerar skillnader och likheter, både mellan och inom olika kulturer, men också mellan olika generationer. Avsikten är att kunna vårda människan som döljs bakom kulturen. Både individens och vårdarens kultur påverkar vårdandet. Eftersom varje människa är unik blir mötet mellan två personer alltid transkulturellt i någon mån.

    Exemplen i Vårdhandboken belyser i huvudsak hur personer med olika ursprung uppfattar sjukdomen diabetes och dess hantering.

    Bemötande i vården ur transkulturellt perspektiv ska med utgångspunkt i Hälso- och sjukvårdslagen inriktas på att undvika etnocentrism där majoritetskulturens värderingar styr planeringen av insatser. Istället bör man sträva efter kulturrelativism med en transkulturell medvetenhet, vilket innebär att varje unika individs behov och önskemål fokuseras. Kulturellt kompetent vård är skräddarsydd vård.

  • 23.
    Hadziabdic, Emina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Linnaeus University, Sweden.
    Lundin, Christina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare2015Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 15, nr 458Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigations on interpreting practices in multilingual elderly healthcare from different healthcare professionals perspectives. This study examines issues concerning communication and healthcare through a particular focus on interpretation between health professionals and patients of different ethnic and linguistic backgrounds. The central aim of the project is to explore interpretation practices in multilingual elderly healthcare. Methods: A purposive sample of 33 healthcare professionals with experience of using interpreters in community multilingual elderly healthcare. Data were collected between October 2013 and March 2014 by 18 individual and four focus group interviews and analysed with qualitative content analysis. Results: The main results showed that interpreting practice in multilingual elderly healthcare was closely linked to institutional, interpersonal and individual levels. On the organizational level, however, guidelines for arranging the use of interpreters at workplaces were lacking. Professional interpreters were used on predictable occasions planned long in advance, and bilingual healthcare staff and family members acting as interpreters were used at short notice in everyday caring situations on unpredictable occasions. The professional interpreter was perceived as a person who should interpret spoken language word-for-word and who should translate written information. Furthermore, the use of a professional interpreter was not adapted to the context of multilingual elderly healthcare. Conclusion: This study found that interpreter practice in multilingual elderly healthcare is embedded in the organizational environment and closely related to the individuals language skills, cultural beliefs and socio-economic factors. In order to formulate interpreter practice in the context of multilingual elderly healthcare it is important to consider organizational framework and cultural competence, cultural health knowledge, beliefs and customs.

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  • 24.
    Atwine, Fortunate
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden; Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
    Hultsjö, Sally
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Albin, Björn
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews2015Ingår i: Pan African Medical Journal, E-ISSN 1937-8688, Vol. 20, nr 76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The purpose of the study was to describe health-care seeking behaviour and understand reasons for using therapies offered by traditional healers.

    Methods: descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

    Results: reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

    Conclusion: the pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.

  • 25.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Atwine, Fortunate
    Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
    Health-care seeking behaviour and use of traditional medicine in persons with diabetes in Uganda.2015Ingår i: Global Health Congress, Oxford 2015, Oxford University, 2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Health-care seeking behaviour is important as it determines acceptance of healthcare and outcomes of chronic conditions but has been investigated to a limited extent in persons with diabetes in developing countries.

    Qualitative study. Focus-group interviews.

    Reasons for seeking help from traditional healers were diabetessymptoms and failure of effect from western medicine. Help had been sought from different health facilities with the help of relatives and friends.

    Conclusion: A switch between healthcare providers influenced by popular and folk sectos was found. Despite beliefs of using different healthcare providers searching for complementary medicine, participants still experienced health problems related to diabetes.

  • 26.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Apelqvist, Jan
    Diabetes-och Endokrin kliniken, Universitetssjukhuset i Malmö, Lunds universitet.
    Migrants with diabetes believe diabetic foot ulcers being unavoidable and impossible to prevent.2015Ingår i: 50th annual meeting of the EUROPEAN DIABETES EPIDEMIOLOGY GROUP.25-28 April 2015. Les Fontaines, Gouvieux-Chantilly, France.Study group of the European Association for the Study of Diabetes (EASD), Paris, France.: EUROPEAN DIABETES EPIDEMIOLOGY GROUP - EDEG , 2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Since type 2 diabetes is developing into a pandemic, particularly affecting migrants in industrializing countries, the prevalence of diabetes complications is expected to increase. Diabetic foot disorders are the predominant source of complications and are serious and costly but highly preventable particularly by self-care. Health-related behavior, including self care and health care seeking, is guided by beliefs about health/illness but has not previously been studied in different migrant groups. We aim to describe beliefs about health/illness in foreign-born persons with diabetic foot ulcers that might affect self-care and health care seeking and to study whether there are dissimilarities related to origin. ‘

    Material and methods: Qualitative descriptive study. Semi-structured interviews with 26 persons, aged 38-86 years, whereof 13 born in European and 13 in non European countries, all except one in the Middle East, being residents in Sweden between 7-60 years (Md 18 yrs).

    Results: Most believed foot ulcers being unavoidable and problematic to detect, and mainly caused by internal factors such as diabetes, sometimes combined with external factors as inappropriate foot wear, hot water, or bare foot walking. Perceived health had deteriorated after onset of the foot problems due to immobility and pain. Middle Easterners differed as they discussed the importance to adapt to the will of Allah, leading to even poorer quality of life and view of future health. They described more foot problems and perceived religion (Muslim) with washing rituals of the feet being of importance for health. They were less often regularly monitored than European migrants. Economy affected health, more so in Europeans, due to expenses for medications and shoes. Many described limited activity in self-care, few had searched help for their foot problems and if so solely among professionals and had limited knowledge about the influence of glycaemic control on diabetes/foot status.

    Conclusions: Foreign-born persons perceived foot ulcers being impossible to prevent, experienced problems with detection, and had limited knowledge about self-care. Dissimilarities in beliefs related to origin were found that negatively affected self-care of the feet why it is important to assess individual beliefs and plan care and education accordingly. 

  • 27.
    Aho, Anna Carin
    et al.
    Linnaeus Univ, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Hultsjö, Sally
    Cty Hosp, Psychiat Clin, Jonkoping, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.2015Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 22, s. 2083-2091Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. Methods: A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Result: Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. Conclusion: In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Implications for Rehabilitation Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  • 28.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Arabic-speaking migrants' attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey2014Ingår i: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, nr 71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Good communication is an important prerequisite for equal treatment in a healthcare encounter. One way to overcome language barriers when patients and healthcare staff do not share the same language is to use a professional interpreter. Few previous studies have been found investigating the use of interpreters, and just one previous study from the perspective of European migrants, which showed that they perceived interpreters as a communication aid and a guide in the healthcare system as regards information and practical matters. No previous study has gathered quantitative information to focus on non-European migrants' attitudes to the use of interpreters in healthcare encounters. Thus, the aim of this study was to investigate Arabic-speaking individuals' attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare in order to: (i) understand how persons' expectations and concerns regarding interpreters may vary, both within and across cultural/linguistic populations; (ii) understand the consequences of diverse opinions/expectations for planning responsive services; and (iii) confirm findings from previous qualitative studies.

    METHOD: A postal cross-sectional study using a structured self-administered 51-item questionnaire was used to describe and document aspects of Arabic-speaking individuals' attitudes to the use of interpreters in healthcare. The sample of 53 Arabic-speaking migrants was recruited from three different places. Participants were mostly born in Iraq and had a high level of education and were almost equally divided between genders. Data were analysed with descriptive statistics.

    RESULTS: The main findings were that most of the participants perceived the interpreter's role as being a communication aid and a practical aid, interpreting literally and objectively. Trust in the professional interpreter was related to qualification as an interpreter and personal contact with face-to-face interaction. The qualities of the desired professional interpreter were: a good knowledge of languages and medical terminology, translation ability, and sharing the same origin, dialect and gender as the patient.

    CONCLUSION: This study confirmed previous qualitative findings from European migrant groups with a different cultural and linguistic background. The study supports the importance of planning a good interpretation situation in accordance with individuals' desire, irrespective of the migrant's linguistic and cultural background, and using interpreters who interpret literally and objectively, who are highly trained with language skills in medical terminology, and with a professional attitude to promote communication, thus increasing cost-effective, high-quality individualized healthcare.

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  • 29.
    Hadziabdic, Emina
    et al.
    Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden .
    Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study2014Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, nr 49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area.

    METHOD: A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.

    RESULTS: Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speaking participants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment.

    CONCLUSION: The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.

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  • 30.
    Albin, Björn
    et al.
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Elmståhl, Sölve
    Lund University, Universitetssjukhuset MAS, Malmö, Sweden.
    Comparison of Stroke Mortality in Finnish-Born Migrants Living in Sweden 1970-1999 and in Swedish-Born Individuals2014Ingår i: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, nr 1, s. 18-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A limited number of studies have been found on stroke mortality in migrants showing higher mortality for some groups. Influence of time of residence has been studied by a previous  research group. A previous study showed a significantly higher number of deaths in Diseases of the circulatory system in Finnish migrants compared to native Swedes. The aim was to test the hypothesis of a higher mortality in and a decrease in mortality over time in stroke among Finnish migrants in Sweden. The study was based on National Population registry data. The study population included 321,407 Swedish and 307,174 foreign born persons living in Sweden 1987-1999. Mean age was lower at time for death for Finnish migrants than native Swedes, men 5.1 years difference and women 2.3 years. The dissimilarity decreased over time. The risk of death by stroke was higher for migrants with short time of residence in Sweden than with long time (≤10 years, OR 1.61-1.36 vs ≥11 year, OR 1.18). Migrants with short time of residence in Sweden died 9.8-5.3 years earlier than native Swedes. The hypothesis was confirmed and an indication of adjustment to life in the new host country was found. International studies show similar results for other migrant groups but further studies are needed to verify if a similar pattern can be found in other migrant groups living in Sweden and to be able to generalise the findings.

  • 31.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Dissimilarities in Social Support as  Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden2014Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 3, s. 211-222Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Diabetes (DM) requires self-care that is demanding and may cause stress. Social support canbuffer effects of stress. No previous study has been found comparing perceptions of foreign-bornpersons with DM, concerning the content of and need for social support with a population of origin.The aim was to compare the meaning of support and its impact on the life situation in Swedishandforeign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74persons; 34 foreign- and 40 Swedish-born, aged 32 - 80 years, diagnosed with type 2 DM, was included.The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixedmethods were used and data were collected by qualitative interviews and quantitative data collectedby the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured byNSSQ, no significant differences were found according to gender but foreign-born men scoredlower than Swedish, especially in emotional support and aid. The main findings showed that respondents,irrespective of origin, described the meaning of the concept of support mainly as informationsupport in learning to manage DM. However, foreign-born persons also focused onmedical support with regular follow-ups while Swedes emphasized the need for emotional support.Foreign- and Swedish-born persons are in general more similar than dissimilar in describingthe meaning, need and impact of support. Irrespective of origin they want to learn to manage theirdisease and thus desire and need regular follow-up and information immediately from being diagnosed.Further studies are needed as the study is based on a limited sample.

  • 32.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Albin, Björn
    Linnaeus University, Växjö, Sweden.
    Limited focus on the use of health care by elderly migrants - A litterature review2014Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 6, s. 465-473Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

  • 33.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Linnaeus University, Växjö, Sweden.
    Bard, Karin
    Linnaeus University, Växjö, Sweden.
    Beliefs about health and illness in Latin-American migrants with diabetes living in Sweden2013Ingår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, s. 57-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to explore beliefs about health and illness in Latin American migrants diagnosed with diabetes mellitus (DM) living in Sweden, and investigated also the influence on self-care and care-seeking behavior. Migrants are particularly affected in the diabetes pandemia. Beliefs about health and illness guide health-related behaviour and health but no studies have been identified on Latin American migrants with DM. An explorative study design with focus-group interviews of nine persons aged 36-77 years from a diabetes clinic was used. Health was described from a pathogenetic or a salutogenetic perspective: 'freedom from disease or feeling of well-being', and being autonomous and able to work. Economic hardship due to high costs for medications and food for DM affected health. Individual factors such as diet, exercise and compliance with given advice, and social factors with good social relations and avoidance of stress, often caused by having experienced severe events related to migrational experiences, were considered of importance for maintaining health and could cause DM. Disturbed relations to others (social factors), punishment by Fate or God (supernatural factors), intake of drugs (diuretics) and imbalance between warmth and cold (natural factors) were also perceived as causes. A mixture of biomedical and traditional explanations and active self-care behaviour with frequent use of herbs was identified. It is important to assess the individual's beliefs, and healthcare staff, particularly nurses, should incorporate discussions of alternative treatments and other components of explanatory models and co-operate with social workers to consider the influence of economic resources and migrational experiences on health.

     

     

  • 34.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Växjö, Sweden .
    Heikkilä, Kristiina
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease2013Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 2, s. 140-150Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To describe conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease (COPD) in different stages of the disease.

    BACKGROUND: A chronic disease like COPD affects not only the person living with the illness, but also the spouse. Significant tasks and demands are placed on husbands. COPD has for a long time been considered more a man's disease than a woman's disease, but according to new evidence COPD is a vast problem in women, which requires support from their spouses. The literature review did not reveal any previous studies concerning conceptions of daily life in men living with women suffering from COPD in different stages.

    METHODS: A phenomenographic study was conducted. Data were collected from October 2008 to October 2009 through semi-structured interviews with 19 men living with a woman suffering from COPD.

    FINDINGS: Two main descriptive categories were found: (1) unchanged life situation where no support was needed; (2) changed life situation related to severity of COPD, where support was needed. The categories were described from the perspective 'ME and my spouse'. Even in their caregiving situation, the men continued with their own life and activities and did not put themselves in second place. No support was needed from healthcare or municipality when the women had mild COPD, but this changed when the COPD progressed. The men felt that daily life was burdened, restricted and the partner relationship was affected, even if the disease had not reached the final stage. The COPD forced them gradually into a caregiving role, and their daily life changed. They become more of a caregiver than a spouse. The men experienced lack of knowledge and support, and they felt that health professionals and municipality did not care about them.

  • 35.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Heikkilä, Kristiina
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease2013Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 1, s. 40-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To describe conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease (COPD) in different stages.

    Background

    The spouse is often the primary caregiver to someone with COPD, and thus also affected by the consequences of the disease. No previous studies have been found focusing on conceptions of daily life in women living with a man suffering from COPD in different stages.

    Methods

    A phenomenographic study was conducted. Data were collected in 2008–2009 through semi-structured interviews with 21 women living with men suffering from COPD in different stages.

    Findings

    Four main descriptive categories were found: unchanged life situation where no support was needed; socially restricted life and changed roles; changes in health; and changes in the couple's relationship where support was needed. The categories are described in relation to the woman herself, in relation to the man, and in relation to others. No support was needed from society or health care when the men had mild COPD and the women experienced no change in their daily life. As the disease progressed, the women's responsibilities increased and their role changed from being a spouse to being an informal carer. Social contacts became limited, and they began to feel isolated. The women prioritized their spouse's health and well-being and compromised their own health. They experienced lack of support from health professionals and from the municipality.

  • 36.
    Noor Abdulhadi, Nadia M.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Al-Shafaee, Mohammed Ali
    Sultan Qaboos University, Muscat, Oman .
    Wahlström, Rolf
    Karolinska Institutet, Stockholm, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman2013Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 3, s. 258-269Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care.

    BACKGROUND: Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the health-care system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels.

    METHOD: Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings Organizational barriers and barriers related to patients and health-care providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.

  • 37.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Heikkilä, Kristiina
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Family members' experiences of the use of interpreters in healthcare2013Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, nr 2, s. 156-169Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    The aim was to explore adults’ experiences of their family members’ use of interpreters in health-care encounters.

    Background

    Language barriers are a major hindrance for migrants to receive appropriate healthcare. In a foreign country, family members often need support in care of migrant patients. No previous studies focusing on adult family members’ experiences of the use of interpreters in healthcare have been found.

    Method

    A purposive sample of 10 adult family members with experiences of the use of interpreters in health-care encounters. Data were collected between May and September 2009 by focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.

    Findings

    Three categories emerged from the analysis: (1) Experiences of the use of professional interpreters, (2) Experiences of being used as an interpreter and (3) Experiences of what needs to be improved when using interpreters. The main findings showed no agreement in family members’ experiences; interpretation should be individually and situationally adapted. However, when family members acted as interpreters, their role was to give both practical and emotional support, and this led to both positive and negative emotions. Use of simple language, better collaboration in the health-care organization and developing the interpreters’ professional attitude could improve the use of professional interpreters. The type of interpreter, mode of interpretation and patient's preferences should be considered in the interpretation situation. In order to achieve high-quality healthcare, health-care professionals need to organize a good interpretation situation case-by-case, choose the appropriate interpreters with the patient in focus and cooperate with members of the patient's social network.

     

     

  • 38.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Linnaeus University, Växjö, Sweden .
    Beebwa, Esther
    Mbarara University of Science and Technology (MUST), Uganda.
    The influence of beliefs about health and illness on foot care in ugandan persons with diabetic foot ulcers2013Ingår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, s. 123-132Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Diabetes mellitus is developing into a pandemic, mainly affecting Sub-Saharan Africa, and the prevalence of complications is increasing. Diabetic foot disorders are a major source of disability and morbidity. Delay in the health care process due to patients' beliefs might have deleterious consequences for life and limb in persons with diabetic foot ulcers. No previous studies of beliefs about health and illness in persons with diabetic foot ulcers living in Africa have been identified. The aim of the study was to explore beliefs about health and illness among Ugandans with diabetic foot ulcers that might affect health-related behaviour including self-care and care seeking. An explorative study was implemented with consecutive sample and semi-structured interviews were held with 14 Ugandan men and women, aged 40-79, with diabetic foot ulcers. The main findings showed that knowledge was limited about causes, management and prevention of diabetic foot ulcers. Foot ulcers were often detected as painful, believed to heal or improve, and led to stress and social isolationbecause of smell and reduced mobility. Most lacked awareness of the importance of complete daily foot care and seldom practised self-care. Health was described as absence of disease and pain. Many feared future health which was related to contact with nurses in the professional sector from whom they sought information, help with blood tests and wound dressings and desired better organised diabetes clinics providing health education and more opening hours. Many have an underutilised potential for self-care and need education urgently, delivered in well-organised clinics aimed to raise awareness of the threat and prevent foot ulcers.

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  • 39.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Working with interpreters: practical advice for use of an interpreter in healthcare2013Ingår i: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 11, nr 1, s. 69-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim is to improve communication in healthcare when an interpreter is used by providing practical advice to healthcare professionals when considering using interpreters. This descriptive commentary considered the issues of planning, preparation and implementation of interpretation sessions to reveal the complexities and dilemmas of an effective healthcare encounter when using interpreters. Using the design of a discursive paper, this work seeks to explore and position of what is published in the literature on the topic and based on previous studies to provide practical advice on the use of interpreters. The results  showed that the interpreter should be used not only as a communication aid but also as a practical and informative guide through the healthcare system. In planning and preparing the interpretation session, it is important to consider the type (trained professional interpreter, family member or bilingual healthcare staff as interpreters) and mode (face to face and telephone) of interpreting. Furthermore, it is important to consider the interpreter's ethnic and religious background, gender, language or dialect, social group, appearance, clothes and attitude. During the healthcare encounter, the interpreter should follow the recommendations given in guidelines for interpreters. Healthcare professionals should choose an appropriate room and be aware of their own attitude, behaviour and appearance during the healthcare encounter. Good planning is needed, with careful consideration of choices regarding the right kind of interpreter, mode of interpretation and individual preferences for the interpretation in order to deliver high-quality and cost-effective healthcare. Depending on the nature of the healthcare encounter, healthcare professionals need to plan interpretation carefully and in accordance with the individuals' wishes and choose the type of interpreter and mode of interpreting that best suits the present need in the healthcare situation in order to deliver healthcare high in quality.

  • 40.
    Hjelm, Katarina
    et al.
    Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Berntorp, Kerstin
    Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
    Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden2012Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 9-10, s. 1374-1386Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: This paper is a report on a study exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. A further aim is to study the influence of beliefs on self-care and care seeking.

    BACKGROUND: Extensive global migration leading to multicultural societies implies challenges to health care. Health/illness beliefs are culturally related and determine health-related behaviour, including self-care, which is crucial in management of gestational diabetes. The risk of developing gestational diabetes is increased in migrants, particularly of African origin, when residing in Western countries. No previous studies, except one, have been found comparing health/illness beliefs in women with gestational diabetes of different origin.

    DESIGN: Exploratory descriptive study.

    METHODS: Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied.

    RESULTS: Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting.

    CONCLUSIONS: Health/illness beliefs differed and affected self-care and care seeking. Lower risk awareness in African-born women was related to limited knowledge about the body and gestational diabetes, which was further amplified by healthcare professionals informing them about gestational diabetes being transient.

    RELEVANCE TO CLINICAL PRACTICE: Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.

  • 41.
    Hultsjö, Sally
    et al.
    Psychiatric Clinic, County Hospital, Ryhov, Jönköping, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: an interview study with health staff2012Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, nr 5, s. 480-489Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.

  • 42.
    Albin, Björn
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Ekberg, Jan
    Department of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden.
    Elmståhl, Sölve
    Centre of Labour Market Policy Research (CAFO), School of Business and Economics, Linnaeus University, Växjö, Sweden.
    County Differences in Mortality among Foreign-Born Compared to Native Swedes 1970-19992012Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, s. art.id 136581-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970-1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0-4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations.

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  • 43.
    Mufunda, Esther
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Albin, Björn
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Differences in health and illness beliefs in zimbabwean men and women with diabetes2012Ingår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 6, s. 117-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study explored beliefs about health and illness that might affect self-care and health-seeking behaviours in Zimbabwean men and women with diabetes. Gender differences were indicated in a previous study but their extent has not been studied. The present study used a qualitative descriptive design with semi-structured interviews to gain a deeper understanding of the phenomena. The sample consisted of 21 participants, 11 females aged 19-61 years (Median 44 years) and 10 males aged 22-65 years (Median 52 years). Qualitative content analysis was used. Health was described as freedom from diseases and enjoying well-being. Both males and females displayed limited knowledge about diabetes and dissimilarities in health-seeking behaviours. Women, in contrast to men, were more active in self-care and used various measures besides drugs as they related to a higher extent the cause of diabetes to supernatural factors like gods and witches. They sought information from self-help groups and help from outside the professional health sector like healers in the folk sector. Prolonged economic disruption also had negative effects towards maintenance of healthy life-styles as both men and women struggled to get money for food and drugs. Thus, the study highlighted that knowledge about diabetes and its management are important for self-care. There is therefore need to develop acceptable and affordable gender- sensitive diabetes care programmes that enhance patient participation, empowerment and promotion of health.

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  • 44.
    Hjelm, Katarina
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Bard, Karin
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University Hospital, University of Lund, Lund, Sweden.
    Gestational diabetes: prospective interview-study of the developing beliefs about health, illness and health care in migrant women.2012Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 21-22, s. 3244-3256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the development over time of beliefs about health, illness and health care in migrant women with gestational diabetes mellitus born in the Middle East and living in Sweden and to study the influence on self-care and care seeking.

    BACKGROUND: With today's extensive global migration, contact with the new society/health care confronts the migrant's culture of origin with the culture of the host country. The question is whether immigrants' patterns of beliefs about health, illness and health-related behaviour change over time, as no previous studies have been found on this topic.

    DESIGN: A qualitative prospective exploratory study.

    METHODS: Semi-structured interviews, with 14 women (28-44 years), on three occasions: during pregnancy in gestational weeks 34-38 and three and 14 months after delivery.

    RESULTS:   There was a U-shaped development of beliefs, from focusing on worries about the baby's health during pregnancy and trying to comply with advice from health professionals, particularly a healthy diet, through regression to dietary habits (more sugar, less fibre) and lifestyle held before being diagnosed with gestational diabetes mellitus three months after delivery, back to a healthy diet/lifestyle and worries 14 months after delivery but then focusing on their own risk, as mothers, of developing type 2 diabetes and being unable to care for the child. Over time, the number of persons perceiving gestational diabetes mellitus as a transient condition decreased. Respondents lacked information about gestational diabetes mellitus, diet and follow-ups.

    CONCLUSION: Beliefs changed over time and influenced health-related behaviour. Beliefs about the seriousness of gestational diabetes mellitus among healthcare staff/care organisation influence the development of patients' beliefs and need to be considered in planning care.

    RELEVANCE TO CLINICAL PRACTICE: Pregnancy should be used as an opportunity to provide complete information about gestational diabetes mellitus and future health risks. This should continue after delivery and wishes for regular follow-ups should be met.

  • 45.
    Mufunda, Esther
    et al.
    Linnaeus University, Växjö, Sweden.
    Wikby, Kerstin
    Linnaeus University, Växjö, Sweden.
    Albin, Björn
    Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Linnaeus University, Växjö, Sweden.
    Level and determinants of diabetes knowledge in patients with diabetes in Zimbabwe: a cross-sectional study2012Ingår i: Pan African Medical Journal, E-ISSN 1937-8688, Vol. 13, s. 78-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION:

    A previous study of beliefs about health and illness in Zimbabweans with diabetes mellitus indicated limited knowledge about diabetes and the body, affecting self-care and health-care seeking behaviour. The aim of this study was to assess the level of diabetes knowledge in Zimbabwean adults with diabetes mellitus, to determine the main gaps in knowledge and identify the socio-demographic and diabetes-related determinants that predict diabetes awareness and self-care practices.

    METHODS:

    A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents, 32 women and 26 men. Results were analysed with descriptive and analytic statistical methods.

    RESULTS:

    The majority of the respondents scored average knowledge on all three sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1 ± 14, 2%. Major knowledge gaps were in areas related to diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the diabetes knowledge sub-scales when comparisons were made of mean knowledge scores in relation to socio-demographic and diabetes-related characteristics. However, diabetes-related complications were significantly associated with lower total and general diabetes knowledge, and female gender was an independent determinant of low general knowledge.

    CONCLUSION:

    Knowledge gaps were evident in areas regarding insulin use, diet and glycaemic control. Low diabetes knowledge was associated with female gender and could be a risk factor for development of diabetes-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of diabetes-related complications.

  • 46.
    Hjelm, Katarina
    et al.
    Linnaeus University, Växjö, Sweden.
    Albin, Björn
    Linnaeus University, Växjö, Sweden.
    Benato, Rosa
    City University London, UK.
    Sourtzi, Panayota
    University of Athens, Greece.
    Migration and health2012Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, s. 621914-Artikel i tidskrift (Övrigt vetenskapligt)
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  • 47.
    Hultsjö, S M
    et al.
    Department of Psychiatry, Ryhov County Hospital, Jönköping.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, nr 10, s. 891-902Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.

  • 48.
    Hultsjö, Sally
    et al.
    Ryhov County Hospital, Jönköping, Sweden; Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, nr 10, s. 891-902Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow‐ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self‐care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow‐ups of glycaemic control.

  • 49.
    Albin, Björn
    et al.
    Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Ekberg, Jan
    Linnaeus University, Växjö, Sweden.
    Elmståhl, Sölve
    Lund University, Sweden.
    Utilization of In-Hospital Care among Foreign-Born Compared to Native Swedes 1987-19992012Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, s. 713249-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987-1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970-1999, was used. Persons were selected if they were admitted to hospital during 1987-1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care.

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  • 50.
    Hjelm, Katarina
    Linnéuniversitetet, Växjö.
    Bemötande i vård och omsorg, transkulturellt perspektiv2011Ingår i: Vårdhandboken, Inera AB , 2011Kapitel i bok, del av antologi (Refereegranskat)
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