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  1. Article ; Online: Hypertension treatment in the oldest-old

    Marjo Berkhout / Kristina Bengtsson Boström / Anna-Lena Östberg

    Scandinavian Journal of Primary Health Care, Pp 1-

    focus group interviews with Swedish general practitioners

    2022  Volume 10

    Abstract: Objective This study explored the considerations and experiences of Swedish General Practitioners (GPs) of hypertension treatment in patients 80 years and above.Design Qualitative design with focus group interviews. Data were analysed by qualitative ... ...

    Abstract Objective This study explored the considerations and experiences of Swedish General Practitioners (GPs) of hypertension treatment in patients 80 years and above.Design Qualitative design with focus group interviews. Data were analysed by qualitative content analysis.Setting Primary health care centres (PHCCs), both rural and urban, in the Region of Västra Götaland, Sweden.Subjects GPs and GP trainees working at PHCCs in 2019 and 2020. Five focus group interviews with 24 physicians were performed.Main outcome measures Considerations and experiences of hypertension treatment in the oldest-old.Results Eighteen GPs and six GP trainees participated in the study. The latent content was formulated in a theme: ‘The physician’s decision-making in the treatment of hypertension in the oldest-old implies the inclusion of both medical and humanistic considerations.’ The manifest content constituted three main categories: ‘The patient characteristics’ included medical condition, behavioural factors and daily life. ‘The physician’s role’ described the GP as a professional and her/his experienced support. ‘The treatment decision’ considered these categories and involved risk-benefit balancing and communication. For the future, the participants proposed better guidelines for the oldest-old multimorbid patients, increased teamwork, continuous cooperation with nurses and better cooperation with hospital physicians.Conclusion Hypertension care for the oldest-old was experienced as complicated by GPs, due to the need of balancing medical and humanistic considerations. The GP’s clinical experience and the received support were of importance when making the treatment decision based on risk-benefit balancing and communication with the patient.Key pointsGPs experienced the task of caring for the oldest-old patients with hypertension as complicated.Patient factors like multimorbidity, polypharmacy, behavioural factors and the patient’s condition of daily life were identified.Clinical experience and the experienced support at the PHCC ...
    Keywords Focus group interviews ; general practitioners ; hypertension ; oldest-old ; physicians ; primary health care ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Primary care physicians’ concerned voices on sickness certification after a period of reorganization. Focus group interviews in Sweden

    Kristina Bengtsson Boström / Karin Starzmann / Anna-Lena Östberg

    Scandinavian Journal of Primary Health Care, Vol 38, Iss 2, Pp 146-

    2020  Volume 155

    Abstract: Objective: This study explored the views of primary health care (PHC) physicians on sickness certification after reforms in 2005 prompted by the Swedish government to increase the quality and decrease the inequalities, and costs of sickness certification. ...

    Abstract Objective: This study explored the views of primary health care (PHC) physicians on sickness certification after reforms in 2005 prompted by the Swedish government to increase the quality and decrease the inequalities, and costs of sickness certification. Design: Qualitative design with focus group interviews. Data were analysed using qualitative content analysis. Setting: Urban and rural PHC centres in Region Västra Götaland, Sweden. Subjects: GPs, interns, GP trainees and locums working in PHC centres 2015. Six focus group interviews with 28 physicians were performed. Main outcome measures: Experiences and reflections about the sickness certification system. Results: The latent content was formulated in a theme: ‘The physicians perceived the sickness certification process as emotive and a challenge to master with differing demands and expectations from authorities, management and patients’. Sickness certification could be easy in clear-cut situations or difficult when other factors besides the pure medical were ruling the decisions. The physicians’ coping strategies for the task included both active measures (cooperation with health care staff and social insurance officers) and passive adaptation (giving in or not caring too much) to the circumstances. Proposals for the future were to transfer lengthy sickness certifications and rehabilitation to specialized teams and increase cooperation with rehabilitation coordinators and social insurance officers. Conclusions: Political decisions on laws and regulations for sickness certification impacted the primary health care making the physicians’ work difficult and burdensome. Their views and suggestions should be carefully considered in future organization of primary care. KEY POINTS In 2005 Swedish government introduced reforms to decrease the inequalities and costs of sickness certification and facilitate the physicians’ work. Focus group interviews with Swedish primary care physicians revealed that sickness certification was challenging due to differing demands from authorities, management and patients. Coping strategies for the sick-listing task included both active measures and passive adaptation to the circumstances. A proposal for future better working conditions for physicians was to transfer lengthy sickness certifications and rehabilitation to specialized teams.
    Keywords focus group interviews ; physicians ; primary health care ; qualitative research ; sick leave ; sickness certification ; Public aspects of medicine ; RA1-1270
    Subject code 300
    Language English
    Publishing date 2020-04-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Oral health-related quality of life in Swedish young adults

    Gunvi Johansson / Anna-Lena Östberg

    International Journal of Qualitative Studies on Health & Well-Being, Vol 10, Iss 0, Pp 1-

    2015  Volume 12

    Abstract: The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased ... ...

    Abstract The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21–29 years, were interviewed. The findings from the interviews were summarized under the theme “Young adults reflected on their OHRQoL in a time perspective” consisting of three categories: “Past experiences, Present situation, and Future prospects.” The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up.
    Keywords Oral health ; quality of life ; young adults ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2015-06-01T00:00:00Z
    Publisher Taylor & Francis Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Socio-economic and demographic determinants affecting participation in the Swedish cervical screening program

    Gudrun Broberg / Jiangrong Wang / Anna-Lena Östberg / Annsofie Adolfsson / Szilard Nemes / Pär Sparén / Björn Strander

    PLoS ONE, Vol 13, Iss 1, p e

    A population-based case-control study.

    2018  Volume 0190171

    Abstract: Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure.Identify socio-economic and demographic determinants for non-attendance in cervical screening.Design: Population-based case-control ... ...

    Abstract Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure.Identify socio-economic and demographic determinants for non-attendance in cervical screening.Design: Population-based case-control study. Setting: Sweden. Population: Source population was all women eligible for screening. Based on complete screening records, two groups of women aged 30-60 were compared. The case group, non-attending women, (N = 314,302) had no smear registered for 6-8 years. The control group (N = 266,706) attended within 90 days of invitation. Main outcome measures: Risk of non-attendance by 9 groups of socioeconomic and demographic variables. Analysis: Unadjusted odds ratios (OR) and OR after adjustment for all variables in logistic regression models were calculated.Women with low disposable family income (adjOR 2.06; 95% confidence interval (CI) 2.01-2.11), with low education (adjOR 1.77; CI 1.73-1.81) and not cohabiting (adjOR 1.47; CI 1.45-1.50) were more likely to not attend cervical screening. Other important factors for non-attendance were being outside the labour force and receiving welfare benefits. Swedish counties are responsible for running screening programs; adjusted OR for non-participation in counties ranged from OR 4.21 (CI 4.06-4.35) to OR 0.54 (CI 0.52-0.57), compared to the reference county. Being born outside Sweden was a risk factor for non-attendance in the unadjusted analysis but this disappeared in certain large groups after adjustment for socioeconomic factors.County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance. This indicates considerable potential for improvement of cervical screening attendance in several areas if best practice of routines is adopted.
    Keywords Medicine ; R ; Science ; Q
    Subject code 331
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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