Background/aimThe most common method to study the use and attitudes of mouth and face guards is a limited number of preprepared questions. This approach, however, risks information restriction and lowers the general value of the study. The aim of this study was therefore to present a phenomenographic approach to capture the use and attitudes towards mouth and face guards in two Swedish ice hockey clubs. less thanbrgreater than less thanbrgreater thanMaterials and methodThe phenomenographic study was set up as 12 focus group interviews: six interviews with one elite and six interviews with one division 3 ice hockey club in Sweden. A number of categories were identified, which became the basis for how the results are presented. less thanbrgreater than less thanbrgreater thanResultsThe participants inspired each other to speak freely, which allowed for much wider and deeper discussions than was expected. In comparison with the use of a preprepared questionnaire with a limited number of questions sent home by post, this method included comments from the participants and revealed new angles of approach in 12 identified categories. less thanbrgreater than less thanbrgreater thanConclusionsUsing a phenomenographic research method, more variations and different apprehensions could be revealed than what would be possible with a set of preprepared questions sent by post or used in individual interviews.

Aim and objective.  To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission.

Background.  Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder.

Design.  A randomised controlled trial. Methods.  A total of 106 women, ≥20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire.

Results.  Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality.

Conclusions.  Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time.

Relevance to clinical practice. Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years.

Despite living with a gluten-free diet Swedish women with celiac disease report a higher rate of gastrointestinal symptoms than women without the disease. This study was designed to assess the impact of active patient education on gastrointestinal symptoms in women with a gluten-free diet. A total of 106 Swedish women, > 20 years, with celiac disease on a gluten free diet for minimum five years took part in a randomized, controlled trial. The intervention group (n=54) underwent a ten-session educational program “Celiac School”, based on problem-based learning. Controls (n=52) were sent information regarding celiac disease at home. Outcome measure was gastrointestinal symptoms at ten weeks and six months after intervention, assessed with the Gastrointestinal Symptom Rating Scale. After ten weeks “Celiac school” (p=0.013) the participating women reported significant improvements that remained six months later (p=0.029). The controls did not improve significantly. A comparison of the development of scores, from baseline to 10 weeks, could not demonstrate a significant difference in the overall index between the two groups but showed a significant improvement concerning one of its components, namely the index reflecting Abdominal Pain (p= 0.007). Intervention methods should be refined in order to reach an even more pronounced effect.

The aim of this study was to describe perceptions of parenthood education among midwives and obstetricians in charge of antenatal care in Sweden. Focus group interviews of 25 obstetricians and midwives were conducted. Data were analyzed with a phenomenographic approach. Five main categories emerged: aim of the parenthood education, content and expectations, implementation, support to group leaders, and strategies for the future. There is a strong belief in parenthood education, and the overall aim was considered to be support in the transition to parenthood. Contents should focus on awareness of the expected child, confidence in the biological processes, and the changes of roles. Pedagogies training, cost effectiveness, development, and the need to reach target groups were emphasized.

Readjustment after an event of coronary heart disease (CHD) is defined to comprise cognitive, instrumental and affective components. The cognitive dimension refers to understanding of the disease. Twenty-three patients (<60 years) with CHD were interviewed about the nature of their disease and encouraged to use their own words. The study was conducted 1 year after the event of myocardial infarction (MI) and some patients had also been revascularized. The interviews were transcribed in extenso and analysed according to the phenomenographic approach. The main finding was the great variation of conceptions revealed. Six different conceptions were found concerning CHD. Some patients comprehended MI by involving (A) blood and vessels, (B) either blood or vessel or referred to (C) risk factors/symptoms. Angina pectoris was expressed as (A) insufficient heart capacity, (B) atherosclerosis/contracted vessel or as (C) symptoms. Several patients found it difficult to expand their answers and some expressed misconceptions about the course of events. Patients' pre-existing knowledge and their way of reasoning about central phenomena related to their disease should be taken into consideration in patient education and is also applicable in individual encounters with patients.

Twenty-three patients with an acute event of coronary heart disease (CHD) received routine care including information about medication and lifestyle changes. They were interviewed after 1 year about their conceptions concerning drug treatment and lifestyle changes. The interviews were taped, transcribed and analysed using the phenomenographic approach. Conceptions were hierarchically categorised with regard to level of understanding. The results showed that the patients’ understanding of the effects and health benefits of their treatment was superficial as judged on an informed layman level. The knowledge was fragmentary and mechanistic. Several misconceptions were revealed. Few answers related to prognostic benefits. However, a conception about effects of stopping drug intake was risk of relapse. Some patients considered fate and heredity as the main causes of CHD. Thus, our patients had not achieved an adequate understanding of CHD treatment. The level of knowledge was lower than anticipated.

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