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Lundgren, A.-M., Öhrn, K. & Jönsson, B. (2016). Do adolescents who are night owls have a higher risk of dental caries?: A case-control study. International Journal of Dental Hygiene, 14(3), 220-225
Open this publication in new window or tab >>Do adolescents who are night owls have a higher risk of dental caries?: A case-control study
2016 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 14, no 3, p. 220-225Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits.

METHODS: A group of 196 adolescents (15 and 16 years old) were divided into two equal groups based on caries risk (case = high risk; and control = low risk). Before their dental examinations, they were asked to complete a questionnaire. The questionnaire included questions on circadian rhythm, dietary and oral self-care habits, and demographic variables. The participants were divided into three circadian types: evening types who are alert in the evening and tired in the morning; morning types who are the opposite; and neutral types who are neither particularly alert in the evening nor extremely tired in the morning.

RESULTS: The most common sleep-cycle group type was neutral (50%). After this came evening types (37%) and finally morning types (13%). Morning and neutral types reported more frequently than evening types that they had breakfast every morning and brushed their teeth twice a day. More evening types were categorized as at high risk of caries. Circadian rhythm, breakfast habits and toothbrushing frequency were associated with a high risk of caries. The predicted probability of being at high risk of caries was almost four times higher for evening types than for morning types (OR 3.8; 95% CI 1.3-10.9).

CONCLUSION: Adolescents who belonged to the evening circadian rhythm group brushed their teeth more seldom, ate breakfast less regularly and had a higher risk of caries than morning types. A patient's circadian rhythm should be considered when planning oral health education for adolescents with a high risk of caries.

Keywords
circadian rhythm; diet habits; Morningness–eveningness; oral hygiene
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-19834 (URN)10.1111/idh.12165 (DOI)000379948100009 ()26198407 (PubMedID)
Available from: 2015-10-28 Created: 2015-10-28 Last updated: 2017-10-27Bibliographically approved
Elf, M., Eldh, A. C., Öhrn, K. & von Koch, L. (2016). Using modeling as a co-design approach in the planning process of new care environments. In: Nordic Conference in Nursing Research 2016: SSF. Paper presented at Nordic Conference in Nursing Research 2016. Methods and Networks for the future. 15-17 June, 2016 Stockholm.
Open this publication in new window or tab >>Using modeling as a co-design approach in the planning process of new care environments
2016 (English)In: Nordic Conference in Nursing Research 2016: SSF, 2016Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Current research shows a relationship between healthcare architecture and patient-related Outcomes. The planning and designing of new healthcare environments is a complex process; the needs of the various end-users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modelling utilizing system dynamics in the pre-design phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction, and then interviewed them about their experience. An explorative and qualitative design was used to describe participants’ experiences of participating in the group modelling projects. Participants (n=20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analysed by qualitative content analysis. Two themes were formed, representing the experiences in the group modeling process: ‘Partaking in the G-M created knowledge and empowerment’and ‘Partaking in the G-M was different from what was expected and required time and skills’. The method can support participants in design teams to focus more on their healthcare organization, their care activities and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.

Keywords
Design quality, Design process, group-modelling, co-design
National Category
Health Sciences
Research subject
Health and Welfare, Designa hållbara vårdmiljöer för framtiden
Identifiers
urn:nbn:se:du-22709 (URN)
Conference
Nordic Conference in Nursing Research 2016. Methods and Networks for the future. 15-17 June, 2016 Stockholm
Funder
Swedish Research Council Formas
Available from: 2016-08-16 Created: 2016-08-16 Last updated: 2016-11-17Bibliographically approved
Elf, M., Eldh, A. C., Malmqvist, I., Öhrn, K. & von Koch, L. (2016). Using of group-modeling in pre-design phase of new healthcare environments: stakeholders experiences. Health Environments Research & Design Journal, 9(2), 69-81
Open this publication in new window or tab >>Using of group-modeling in pre-design phase of new healthcare environments: stakeholders experiences
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2016 (English)In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 9, no 2, p. 69-81Article in journal (Refereed) Published
Abstract [en]

Background: Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process; the needs of the various end-users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modeling utilizing system dynamics in the pre-design phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction, and then interviewed them about their experience.

Methods: An explorative and qualitative design was used to describe participants’ experiences of participating in the group modeling projects. Participants (n=20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analyzed by qualitative content analysis.

Results: Two themes were formed, representing the experiences in the group modeling process: ‘Participation in the group modeling generated knowledge and was empowering’ and ‘Participation in the group modeling differed from what was expected and required the dedication of time and skills”.

Conclusions: The method can support participants in design teams to focus more on their healthcare organization, their care activities and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.

Keywords
design development; design methodology; environments of care; participatory design; quality improvements; codesign; system thinking; group modeling
National Category
Health Sciences
Research subject
Health and Welfare, Designa hållbara vårdmiljöer för framtiden
Identifiers
urn:nbn:se:du-19075 (URN)10.1177/1937586715599650 (DOI)000367438100007 ()26297717 (PubMedID)
Projects
Designa hållbara vårdmiljöer för framtiden
Funder
Swedish Research Council Formas
Available from: 2015-08-21 Created: 2015-08-21 Last updated: 2017-12-04Bibliographically approved
Svanberg, A., Öhrn, K. & Birgegård, G. (2015). Caphosol® mouthwash gives no additional protection against oral mucositis compared to cryotherapy alone in stem cell transplantation: a pilot study. European Journal of Oncology Nursing, 19(1), 50-53
Open this publication in new window or tab >>Caphosol® mouthwash gives no additional protection against oral mucositis compared to cryotherapy alone in stem cell transplantation: a pilot study
2015 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, no 1, p. 50-53Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2015
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-15522 (URN)10.1016/j.ejon.2014.07.011 (DOI)000350074400009 ()
Available from: 2014-09-12 Created: 2014-09-12 Last updated: 2017-12-05Bibliographically approved
Edman, K., Öhrn, K., Nordström, B., Holmlund, A. & Hellberg, D. (2015). Trends over 30 years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors: based on epidemiological surveys in Sweden 1983-2013. International Journal of Dental Hygiene, 13(4), 283-291
Open this publication in new window or tab >>Trends over 30 years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio-economic factors: based on epidemiological surveys in Sweden 1983-2013
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2015 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 4, p. 283-291Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Epidemiological studies of the prevalence of periodontitis over an extended time using the same methodology to investigate and classify periodontitis are sparse in the literature. Smoking and socio-economic factors have been proven to increase the risk for periodontal disease. The objective of this study was to investigate 30-year time trends, using the same methodology to classify the prevalence and severity in alveolar bone loss (ABL) and to investigate the influence of tobacco and socio-economic factors.

METHODS: Four cross-sectional epidemiological studies in an adult population were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008 and 2013. Random samples of 787-1133 individuals aged 35-85 who answered a questionnaire about tobacco use and socio-economic factors were radiographically and clinically examined. A number of teeth, ABL and calculus visible on radiographs were registered. The severity of ABL as detected on radiographs was classified into no bone loss, moderate or severe.

RESULTS: The prevalence of moderate ABL decreased from 45% in 1983 to 16% in 2008, but increased to 33% in 2013 (P < 0.05). The prevalence of severe ABL remained the same from 1983 (7%) to 2013 (6%). Calculus visible on radiographs increased from 22% in 2008 to 32% in 2013 (P < 0.05). Socio-economic factors had limited impact on the severity of ABL.

CONCLUSION: Moderate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.

Keywords
Nursing models, policy, simulation models, stroke care, designing of new spaces
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-19833 (URN)10.1111/idh.12164 (DOI)000362736400009 ()26215672 (PubMedID)
Available from: 2015-10-28 Created: 2015-10-28 Last updated: 2017-12-01Bibliographically approved
Jönsson, B. & Öhrn, K. (2014). Evaluation of the effect of nonsurgical periodontal treatment on oral health-related quality of life: estimation of minimal important differences 1 year after treatment. Journal of Clinical Periodontology, 41(3), 275-282
Open this publication in new window or tab >>Evaluation of the effect of nonsurgical periodontal treatment on oral health-related quality of life: estimation of minimal important differences 1 year after treatment
2014 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, no 3, p. 275-282Article in journal (Refereed) Published
Abstract [en]

Aim: To evaluate an individually tailored oral health educational programme on patient-reported outcome compared with a standard oral health educational programme, assess change over time and determine minimal important differences (MID) in change scores for two different oral health related quality of life (OHRQoL) instrument after non-surgical periodontal treatment (NSPT).

Materials and Methods: In a randomized controlled trial evaluating two educational programmes, patients (n=87) with chronic periodontitis completed a questionnaire at baseline and after 12months. OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI) and the UK oral health-related quality-of-life measure (OHQoL-UK). In addition, patients' global rating of oral health and socio-demographic variables were recorded. The MID was estimated with anchor-based and distributions-based methods.

Results: There were no differences between the two educational groups. The OHRQoL was significantly improved after treatment. The MID was approximately five for OHQoL-UK with a moderate ES, and three for GOHAI with a Small ES, and 46-50% of the patients showed improvements beyond the MID.

Conclusion: Both oral health educational groups reported higher scores in OHRQoL after NSPT resulting in more positive well-being (OHQoL-UK) and less frequent oral problems (GOHAI). OHQoL-UK gave a greater effect size and mean change scores but both instruments were associated with the participants' self-rated change in oral health. The changes were meaningful for the patients supported by the estimated MID.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
clinical relevance, cognitive behaviour strategies, individually tailored programme, oral hygiene behaviour, patient-reported outcome, periodontitis
National Category
Dentistry Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-13869 (URN)10.1111/jcpe.12202 (DOI)000330577300008 ()24372439 (PubMedID)
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2017-12-05Bibliographically approved
Öhrn, K. & Edman, K. (2014). Oral Impact on Daily Performance: association with clinical variables.. In: : . Paper presented at IADR/PER Congress 2104, Dubrovnik, Croatia, September 10-13 2014.
Open this publication in new window or tab >>Oral Impact on Daily Performance: association with clinical variables.
2014 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-16293 (URN)
Conference
IADR/PER Congress 2104, Dubrovnik, Croatia, September 10-13 2014
Available from: 2014-11-11 Created: 2014-11-11 Last updated: 2015-10-28Bibliographically approved
Elf, M., Malmqvist, I., Öhrn, K. & von Koch, L. (2013). Designing patient-centered healthcare spaces. In: : . Paper presented at ICN 25th Quadrennial Congress: Equity and Access to Health Care, 18-23 May 2013, Melbourne, Australia.
Open this publication in new window or tab >>Designing patient-centered healthcare spaces
2013 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

The architecture can promote patients health. Accessibility, safety and care quality can be built into the design of healthcare environments. The current planning process has been criticized to be guided by technical solutions rather than the users’ needs and a lack of correspondence between the goal of the organization and the planning process. We used the system dynamics (SD) modeling method to facilitate the pre-planning process (before architectural design details are presented) of new healthcare environments. SD is an interactive computer-based method that is suitable for use with a group-modeling approach with a focus on learning, which is facilitated through the construction of simple models of the system that help the user to experiment with and study the behavior of these models. The aim of using SD was to strengthen the understanding of the healthcare organization and its care processes, enhance the integration of scientific knowledge related to care processes and architecture. A case study design was used in five different healthcare settings. The participants built the model in collaboration through a reflective and iterative process of learning about their organization/system to contribute to the planning process. The preliminary results show that we succeeded in turning the discussions toward the work and related care processes as a basis for further planning of the building.

Keywords
System dynamics, healthcare environment, quality work
National Category
Medical and Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-13311 (URN)
Conference
ICN 25th Quadrennial Congress: Equity and Access to Health Care, 18-23 May 2013, Melbourne, Australia
Available from: 2013-11-23 Created: 2013-11-23 Last updated: 2015-10-28Bibliographically approved
Jönsson, B. & Öhrn, K. (2013). Stage of Change for Interdental Cleaning in Patients with Peridontitis. Paper presented at 91st General Session & Exhibition of the IADR, Seattle, Washington, USA, 20-23 March 2013.
Open this publication in new window or tab >>Stage of Change for Interdental Cleaning in Patients with Peridontitis
2013 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Objective: In the Transtheoretical model, behavioral change processes through a series of stages (Precontemplation, Contemplation, Preparation, Action and Maintenance). The purpose of the study was to determine if there were an association between decisional balance, self-efficacy and stage of change. A further aim was to assess stage of change for interdental cleaning before and after two different oral hygiene interventions.

Method: A randomized (n = 104), evaluator-masked, clinical trial, with two different active oral hygiene behavior interventions, was analyzed with respect to stage of change at baseline and 12 months after non-surgical treatment. An individually tailored oral health educational program [ITOHEP] based on social cognitive principles were compared with a standard oral hygiene education program [ST]. A questionnaire consisting of Stage of Change instrument, Decisional balance instrument, and Self-efficacy instrument was used.

Result: Nearly 36 % was in maintenance stage and 47% in the preparation stage. Individuals in the maintenance stage had significant higher self-efficacy than those in contemplation stage (p<0.001). There were no association between stage of change and decisional balance. Significantly more individuals was in the maintenance stage after treatment than before (p<0.001). At baseline there were no differences between groups. At the 12 month follow-up significantly more individuals in the ITOHEP group was in the maintenance stage (p< 0.05) and significantly more individuals in the ST group was in the preparation stage (p<0.05).

Conclusion: Individuals with higher self-efficacy were to a greater extent in maintenance stage. Oral hygiene behavior interventions influence patients to move on to the maintenance stage. Patients receiving an individually tailored program were more successful in movement towards maintenance stage compared to patients receiving standard health education.

Keywords
Oral hygiene, Periodontal disease, Preventive dentistry and Psychology
National Category
Medical and Health Sciences
Research subject
Hälsa och välfärd
Identifiers
urn:nbn:se:du-12191 (URN)
Conference
91st General Session & Exhibition of the IADR, Seattle, Washington, USA, 20-23 March 2013
Available from: 2013-05-06 Created: 2013-05-06 Last updated: 2015-10-28Bibliographically approved
Peterson, D. E., Öhrn, K., Bowen, J., Fliedner, M., Lees, J., Loprinzi, C., . . . Lalla, R. V. (2013). Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Supportive Care in Cancer, 21(1), 327-332
Open this publication in new window or tab >>Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy
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2013 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 21, no 1, p. 327-332Article in journal (Refereed) Published
Abstract [en]

PURPOSE: This systematic review analyzed the strength of the literature and defined clinical practice guidelines for the use of oral cryotherapy for the prevention and/or treatment of oral mucositis caused by cancer therapy.

METHODS: A systematic review on relevant oral cryotherapy studies indexed prior to 31 December 2010 was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using OVID/MEDLINE, with publications selected for review based on defined inclusion and exclusion criteria. Findings from the reviewed studies were integrated into guidelines based on the overall level of evidence for each intervention. Guidelines were classified into three types: recommendation, suggestion, or no guideline possible.

RESULTS: Twenty-two clinical studies and two meta-analyses were analyzed. Results were compared with the MASCC/ISOO guidelines published in 2007. The recommendation for the use of oral cryotherapy to prevent oral mucositis in patients receiving bolus fluorouracil (5-FU) was maintained, in agreement with the 2007 guidelines. A suggestion for use of oral cryotherapy to prevent oral mucositis in patients receiving high-dose melphalan as conditioning regimen with or without total body irradiation for HCST was revised from the 2007 guidelines. No guideline was possible for any other intervention, due to insufficient evidence.

CONCLUSIONS: The evidence continues to support the use of oral cryotherapy for prevention of oral mucositis in patients receiving bolus 5-FU chemotherapy or high-dose melphalan. This intervention is consistent with the MASCC/ISOO guidelines published in 2007. The literature is limited by the fact that utilization of a double-blind study design is not feasible. Future studies that compare efficacy of oral cryotherapy with other mucositis agents in patients receiving chemotherapy with relatively short plasma half-lives would be useful.

Place, publisher, year, edition, pages
Springer, 2013
National Category
Dentistry
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-11400 (URN)10.1007/s00520-012-1562-0 (DOI)000312088900040 ()
Available from: 2012-12-06 Created: 2012-12-06 Last updated: 2017-12-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7972-1470

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