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1.
  • Andersson, Ann-Christine, et al. (författare)
  • Five Types of Practice-Based ImprovementIdeas in Health Care Services: : An EmpiricallyDefined Typology
  • 2011
  • Ingår i: Quality Management in Health Care. - 1063-8628. ; 20:2, s. 122-130
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the health care sector. This study is based on a Swedish county council improvement program. Health care departments and primary health care centers in the Kalmar County Council were invited to apply for money to accomplish improvement projects. A qualitative content analysis was done of 183 proposed applications from various health care departments and primary health care centers. The following 5 types of improvement projects were identified: organizational process, evidence and quality, competence development, process technology, and proactive patient work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. These projects point to the various problems and experiences health care professionals encounter in their day-to-day work. To generalize beyond this improvement program and to validate the typology, we applied it to all articles found when searching for quality improvement projects in the journal Quality Management in Health Care during the last 2 years and found that all of them could be fitted into at least 1 of those 5 categories. This article provides valuable insights into the current state of improvemen  work in Swedish health care, and will serve as a foundation for further investigations in this quality improvement program.
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2.
  • Langius-Eklöf, Ann, et al. (författare)
  • Sense of coherence and psychiatric morbidity in terms of anxiety and depression in patients with major depression before and after electric convulsive treatment
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - Oxford : Wiley-Blackwell. - 0283-9318. ; 23:2, s. 375-379
  • Tidskriftsartikel (refereegranskat)abstract
    • The specific aim of this study was to explore if the Sense of Coherence (SOC) Scale reflects and overlaps with standardized psychiatric assessments of depression and anxiety leading to the main hypothesis that the degree of depression decreases while the SOC scores remain stable. Fifteen patients with a diagnosis of major depression according to Axis I in DSM-IV and planned electric convulsive treatment (ECT) participated in the study. The clinician-rated instruments, Montgomery Asberg Depression Rating Scale (MADRS) and Global Assessment of Function (GAF), and the self-assessment instruments such as SOC and the Comprehensive Psychopathological Rating Scale-Self Rating Scale for Affective Syndromes (CPRS-S-A) were used before and after the treatment. The patients showed statistically significant improvements in clinician-rated depression (p < 0.001) and functional status (p < 0.001), and in self-rated anxiety (p = 0.001) and depression (p = 0.003). There was no significant improvement in SOC (p = 0.213). No significant correlations were found between the SOC scores and any of the measures except for GAF after treatment (r = 0.57, p = 0.039); the lower the SOC scores the greater was the functional dysfunction. In conclusion, the SOC Scale seems not to be a measure of psychopathology in terms of depression or anxiety merely.
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3.
  • Tinghög, Petter, et al. (författare)
  • A phenomenological approach to the study of stress among immigrants : the case of Iraqi and Iranian women in Sweden
  • ????
  • Annan publikation (övrigt vetenskapligt)abstract
    • This study begins with the outlining of a general phenomenological theory of stress, which subsequently is applied to eleven Iraqi and Iranian migrant women’s own accounts of life in Sweden. The analysis of the interviews suggested that domestic disputes and intergenerational conflicts may become particularly stressful in that they are often amplified by incompatible Western and Non‐Western representations. The detected stressful experiences are analysed and structured to elucidate their character. Finally, a typology of stressful experiences in the new environment based on the distinctions between immigrant/minority‐specific and non‐immigrant/‐ minority‐specific stress, as well as between culturogenic and non‐culturogenic stress, is presented and defended.
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4.
  • Tinghög, Petter, 1973-, et al. (författare)
  • Cross‐cultural equivalence of HSCL‐25 and WHO (ten) Wellbeing Index : findings from a population‐based survey of immigrants and non‐immigrants in Sweden
  • 2010
  • Ingår i: Community mental health journal. - Springer-Verlag New York. - 0010-3853. ; 46:1, s. 65-76
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate whether the Hopkins Symptom Checklist (HSCL‐25) and the WHO (ten) Wellbeing Index are cross‐culturally equivalent by comparing Scandinavians with Middle Eastern immigrants in Sweden. The study population consisted of a stratified random sample of nativeborn Swedes and immigrants from Finland, Iraq and Iran. Both instruments loaded on a single factor in the respective populations. A few of the items did however not discriminate or predict equally well in the groups, nonetheless it was found to only marginally influenced the instruments’ total scores in both groups. The analyses also revealed that the groups had similar intercept and slope when the exogenous factor traumatic episodes was used to predict the measurement scores, supporting scalar equivalency. In conclusion, the results support the use of these instruments in population‐based surveys within multicultural Western societies.
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5.
  • Tinghög, Petter, 1973- (författare)
  • Migration, Stress and Mental Ill Health Post-migration Factors and Experiences in the Swedish Context
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Denna huvudsakligen empiriska avhandling behandlar hur socioekonomiska levnadsvillkor och invandrarspecifika faktorer kan kopplas till invandrares mentala hälsa. I avhandlingen undersöks även hur kulturella representationer kan påverka stressfulla upplevelser och huruvida mental ohälsa uttrycks annorlunda bland invandrare från Irak och Iran än bland nordbor. Vidare genomförs en begreppsanalys av stress skisserad utifrån ett fenomenologiskt perspektiv. Fokus ligger här på hur ett sådant perspektiv på stress kan relateras till kultur och migration.Det empiriska materialet består av elva djupintervjuer med invandrarkvinnor från Irak och Iran, samt två populationsbaserade enkätundersökningar.De huvudsakliga fynden i denna avhandling är följande: 1) Mental ohälsa bland utrikesfödda är vanligare än bland svenskfödda och detta kan till stor del ”förklaras” av ogynnsammare socioekonomiska levnadsvillkor. 2) Invandrares mentala ohälsa har ett direkt samband med olika typer av faktorer som traumatiska episoder, sociokulturell anpassningsnivå och socioekonomiska levnadsvillkor. 3) Självskattningsinstrumenten för mental hälsa, HSCL-25 och WHO (ten) Wellbeing Index, producerar värden som är jämförbara mellan nordbor och invandrare från Mellanöstern. 4) Icke-universella representationer som kan påvisas i Irak och Iran kan förstärka, eller till och med vara nödvändiga komponenter för vissa typer av stressfulla upplevelser bland invandrarkvinnor från dessa länder. 5) Distinktionerna mellan universell och icke-universell stress, och mellan invandrar/minoritets och icke-invandrar/icke-minoritets stress, tycks vara centrala för en adekvat förståelse av invandrares stressfulla upplevelser.
6.
  • Tinghög, Petter, et al. (författare)
  • To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?
  • 2007
  • Ingår i: Social Psychiatry and Psychiatric Epidemiology. - Springer Link. - 0933-7954. ; 42:12, s. 990-996
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden.Methods The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI).Results Immigrants’ excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants’ higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced.Conclusions The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.
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7.
  • Wettergren, Lena, et al. (författare)
  • Quality of life before and one year following stem cell transplantation using an individualized and a standardized instrument
  • 2008
  • Ingår i: Psycho-oncology. - New York, N.Y. : John Wiley & Sons. - 1099-1611. ; 17:4, s. 338-346
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim was to prospectively measure quality of life in patients with malignant blood disorders following stem cell transplantation (SCT) using an individualized and a standardized measure. METHODS: Twenty-two consecutive patients were assessed before and one year following SCT, using a generic and disease-related version of the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) and the EORTC QLQ-C30. Results of the QLQ-C30 were compared with Swedish norm values. RESULTS: A majority of the patients reported concerns related to health before as well as one year after SCT, recorded by both instruments. Mean scores produced by the SEIQoL-DW, and four scales of the EORTC QLQ-C30, showed a change over time, indicating improved quality of life one year after SCT. In comparison with Swedish norm values for the EORTC QLQ-C30, SCT recipients reported a worse functioning. CONCLUSIONS: In addition to well-known disease and treatment-related problems, areas not typically included in standardized instruments were nominated in the disease-related SEIQoL-DW. Such areas included positive aspects, e.g. a changed view of life and oneself. The results support the use of the generic and disease-related SEIQoL-DW to achieve a comprehensive picture of patient's clinical situation under treatment or when recovering from illness.
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8.
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9.
  • Östlund, Britt, 1956- (författare)
  • Gammal är äldst : En studie om teknik i äldre människors liv
  • 1995
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Avhandlingen består av en etnografisk studie där äldre människors användning av teknik relateras till deras vardagliga kontext och till deras livslånga vana av tekniskanvändning och teknisk förändring. Två i vardagen välintegrerade teknologier - telefonen och televisionen - och två teknologier de fått i hög ålder - trygghetslarmet och handla hemma terminal - fokuseras. Resultatet visar att äldre människor använder teknik i hög utsträckning, att den är inordnad i dagliga rutiner,att de bedömer nyttan av ny teknik i förhållande till tidigare erfarenheter och att de blir mer pragmatiska jämfört med tidigare i livet. En slutsats är att teknikens nytta kan bedömas enbart i förhållande till sitt sammanhang och i sin egenskap av social artefakt. En annan slutsats är att äldre människors syn på teknik och vilken nytta de tillskriver den skiljer sig från den man finner hos dem som tillhandahåller och utvecklar teknik för deras räkning. Exempel i avhandlingen visar på missförstånd och fördomar.
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