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  • 1. Abrahams, Jacobus
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    The dental hygienist, the key person in the future team?2003In: Swiss Dental Hygienists and Swiss Society of Periodontology Congress, St Gallen, Schweiz, 2003Conference paper (Other academic)
  • 2. Abrahamsson, K
    et al.
    Almståhl, A
    Andersson, P
    Johannsen, A
    Rolandsson, M
    Ståhlnacke, K
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Swedish Dental Hygienists and Oral Health Research2010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 3. Abrahamsson, Kajsa
    et al.
    Stenman, Jane
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hakeberg, Magnus
    Attitudes to dental hygienists: Evaluation of The Dental Hygienist Beliefs Survey in a Swedish population of patients and students2007In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 5, 95-102 p.Article in journal (Refereed)
  • 4. Abrahamsson, Kajsa
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hakeberg, Magnus
    Dental beliefs: factor structure of the revised dental beliefs survey in a group of regular dental patients2009In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 117, no 6, 720-727 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.

  • 5. Abrahamsson, KH
    et al.
    Hakeberg, M
    Stenman, J
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Dental beliefs: evaluation of the Swedish version of the revised Dental Beliefs Survey in different patient groups and in a non-clinical student sample2006In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 114, 209-215 p.Article in journal (Refereed)
  • 6. Dahl, K
    et al.
    Wang, N
    Skau, I
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life and associated factors in Norwegian adults2010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 7. Dahl, Kari E
    et al.
    Wang, Nina
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life among older adults in Norway2009In: 44th meeting of the IADR-Continental European Division with the Scandinavian Division and Israeli Division, Munchen, 2009Conference paper (Refereed)
  • 8. Dahl, Kari Elisabeth
    et al.
    Wang, Nina J.
    Skau, Irene
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life and associated factors in Norwegian adults2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 4, 208-214 p.Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians.

    Material and methods. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed.

    Results. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [ odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses.

    Conclusion. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.

  • 9. Dahl, KE
    et al.
    Wang, N
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Does oral health matter in people’s daily life?: Oral health-related quality of life in adults 35–47 years of age in Norway2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, 15-21 p.Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health.

    Material and methods: A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used.

    Results: Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P = 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales.

    Conclusions: This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life.

  • 10. Dahl, KE
    et al.
    Wang, NJ
    Holst, D
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life among adults 68-77 years old in Nord-Tröndelag, Norway2011In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 9, no 1, 87-92 p.Article in journal (Refereed)
    Abstract [en]

    Dental health has mostly been measured by dental staff disregarding patient’s experiences. However, clinical conditions alone do not fully indicate how people feel affected by their oral status. The aim of this study was to investigate how clinical recorded dental health, self-rated dental health, satisfaction with dental health were related to oral health-related quality of life (OHRQoL) assessed by Oral Health Impact Profile (OHIP-14) in 68–77 years old. A total of 151 individuals completed a questionnaire on self-rated dental health, satisfaction with dental health and the short form of OHIP-14. Clinical examination was performed registering number of teeth and dental caries. In total 63% of the individuals rated their dental health as good, and 59% were satisfied with their dental health. Using the OHIP-14 42% reported no problems or oral discomfort at all. The proportion of individuals reporting problems or discomfort varied between 13% and 43% according to the dimensions of OHIP-14. The most frequently reported problems were physical pain (43%), psychological discomfort (28%) and psychological disability (28%). Individuals who rated their dental health as poor and those who were dissatisfied with their dental health had significantly lower OHRQoL than other individuals. The study showed relationship between self-evaluations of dental health and OHRQoL in 68–77 years old. Individuals with few teeth reported lower OHRQoL than others, but no association between clinical caries status and OHRQoL could be found.

  • 11. Edman, K
    et al.
    Nordström, B
    Hellberg, D
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health in an adult population aged 35-85 in the County of Dalarna, Sweden in 1983 and 20082010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 12. Edman, K
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Nordström, B
    Holmlund, A
    Hellberg, D
    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 1983-20132015In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 4, 283-291 p.Article in journal (Refereed)
    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.

  • 13. Edman, Kristina
    et al.
    Nordström, Birgitta
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hellberg, Dan
    Oral health among womenaged 35-75 in the county of Dalarna, Sweden2012Conference paper (Refereed)
  • 14. Edman, Kristina
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Caries prevalence among children with dental hygienist as primary care provider2004In: The 16th International Symposium on Dental Hygiene, Madrid, 2004Conference paper (Refereed)
  • 15. Edman, Kristina
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Holmlund, Anders
    Nordström, Birgitta
    Hedin, Måns
    Hellberg, Dan
    Comparison of oral status in an adult population 35 - 75 year of age in the county of Dalarna, Sweden in 1983 - 20082012In: Swedish Dental Journal, ISSN 0347-9994, no 2, 61-70 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50,65 and 75 answered a questionnaire and were also clinically and radiographically examined. The number of edentulous individuals decreased from 15% in 1983 to 3 % in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15 % in 1983 to 2 % in 2008. Individuals with moderate periodontitis decreased from 45 % in 1983 to 16 % in 2008. 

    Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated. This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

  • 16. Edman, Kristina
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Holmlund, Anders
    Nordström, Birgitta
    Hellberg, Dan
    Peridontal status and influenceof socioeconomic factors among adults in Dalarna County, Sweden, A cross-sectionalstudy in 20082012Conference paper (Refereed)
  • 17.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Malmqvist, Inga
    Chalmers.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Karolinska institutet.
    Using of group-modeling in pre-design phase of new healthcare environments: stakeholders experiences2016In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 9, no 2, 69-81 p.Article in journal (Refereed)
    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.

  • 18.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Karolinska Institutet.
    Using modeling as a co-design approach in the planning process of new care environments2016In: Nordic Conference in Nursing Research 2016: SSF, 2016Conference paper (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.

  • 19.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Holmström, Paul
    Göteborgs Universitet .
    Malmqvist, Inga
    Chalmers Tekniska Högskola .
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Karolinska Institutet Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Facilitating designing of a new dementia care environment through group modeling2012Conference paper (Refereed)
  • 20. Elf, Marie
    et al.
    Malmqvist, Inga
    von Koch, Lena
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Designing Sustainable Health Care Spaces2008In: The Natural Step´s Sustainability Leadership Challenge, Stockholm, 2008Conference paper (Refereed)
  • 21.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers tekniska högskola, Karolinska Institutet.
    Malmqvist, Inga
    Chalmers University of Technology,, Architecture, Göteborg.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Karolinska Institutet Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Designing patient-centered healthcare spaces2013Conference paper (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.

  • 22.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Malmqvist, Inga
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Designing sustainable healthcare environments2011In: 19th International Conference on Health Promoting Hospitals and Health Services, Turku, Finland, 2011Conference paper (Refereed)
  • 23.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Poutilova, M
    von Koch, L
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Using system dynamics for collaborative design: a case study2007In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 7, no 123Article in journal (Refereed)
    Abstract [en]

    Background 

    In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group.

    Aim

    To explore to which extent and how the use of system dynamics contributed to the collaborative design process.

    Method

    A case study was conducted using several data sources.

    Results

    SD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care.

    Conclusion

    SD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.

  • 24.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Poutilova, Maria
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    A dynamic conceptual model of care planning2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 4, 530-538 p.Article in journal (Refereed)
    Abstract [en]

    This article presents a conceptual model of the care planning process developed to identify the hypothetical links between structural, process and outcome factors important to the quality of the process. Based on existing literature, it was hypothesized that a thorough assessment of patients' health needs is an important prerequisite when making a rigorous diagnosis and preparing plans for various care interventions. Other important variables that are assumed to influence the quality of the process are the care culture and professional knowledge. The conceptual model was developed as a system dynamics causal loop diagram as a first essential step towards a computed model. System dynamics offers the potential to describe processes in a nonlinear, dynamic way and is suitable for exploring, comprehending, learning and communicating complex ideas about care processes.

  • 25.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Putilova, Maria
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Developing a model of a stroke care process2009In: On-line journal of Nursing Informatics, ISSN 1089-9758, E-ISSN 1089-9758, Vol. 13, no 3, 3-34 p.Article in journal (Refereed)
    Abstract [en]

    Aim. The paper presents the development and structure of a generic stroke care simulation model, used in designing of a stroke unit in Sweden. Background and rationale. Designing new health care spaces is a multifaceted process; requiring multi-professional (nurses, other healthcare professionals, building planners and architects) involvement. To secure that the patients’ interest are in focus the different stakeholders need to analyze and develop a common understanding of the care processes that are to take place in the new space. Modeling and simulation is one significant method, making it possible to depict the dynamic structure of the system and experiment with the model, asking “what – ifs” questions. Methods. System dynamics, a modeling method was used to develop the model. The iterative and group-modeling process included development of a quantified model (with a multi-professional design team, based on evidence from the literature, and a survey from stroke care experts), and validation of the model. Results. The dynamic care model developed included variables that are essential in modern care, such as patient-participation, care-planning, and teamwork. Conclusion. The presented generic model provides a framework for exploring, comprehending, and communicating complex ideas about stroke care.

  • 26.
    Eriksson, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Förändringsstadier, för- och nackdelar samt självtillit till approximal rengöring, hos patienter med kronisk parodontit - en kvantitativ studie2010Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    För att förhindra eller kontrollera parodontit är det viktigt med en god och effektiv egenvård och då är speciellt approximal rengöring viktigt. En modell som beskriver olika förändringsstadier för hälsobeteenden är den transteoretiska modellen. Syftet med studien var att testa ett instrument för att fastställa olika förändringsstadier för approximal rengöring och att studera hur värdering av fördelar och nackdelar till att använda approximalt hjälpmedel samt självtillit är associerade med olika förändringsstadier. Etthundratretton individer (60 kvinnor och 53 män) med diagnosen moderat till grav parodontit som remitterats till specialistkliniken för parodontologi utgjorde urvalet. Studien var en beskrivande och jämförande studie med kvantitativ ansats. Individerna fyllde i en enkät i hemmet innehållande frågor om frekvens för approximal rengöring, fördelar och nackdelar med att rengöra tänderna approximalt och självtillit till daglig rengöring av tänderna approximalt så väl som bakgrunds variabler. Flest individer befann sig i förberedelse/beredd stadiet och vidmakthållande stadiet vid studiens start. Självtilliten till att utföra daglig approximal rengöring var högre i vidmakthållande stadiet jämfört med intresserad/osäker samt förberedelse/beredd stadierna. Inga skillnader noterades mellan de olika förändringsstadierna och för- och nackdelar med daglig approximal rengöring. Konklusion: Individer i vidmakthållande stadiet har större självtillit till att utföra daglig approximal rengöring jämfört med individer i intresserad/osäker stadiet eller förberedelse/beredd stadiet.

  • 27.
    Frykberg, Jonna
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Forsling, Anna
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Tandvårdsrädsla och attityder till tandhygienist bland patienter med kronisk parodontit - en kvantitativ studie2010Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med studien var att beskriva och jämföra tandvårdsrädsla och attityder till tandhygienist vid studiens start samt 3 månader efter icke kirurgisk parodontalbehandling hos patienter med kronisk parodontit samt att beskriva hur olika bakgrundsfaktorer påverkar tandvårdsrädsla och attityder till tandhygienist. Ett ytterligare syfte var att studera sambandet mellan attityder till tandhygienist och tandvårdsrädsla. Studien var en jämförande studie med kvantitativ ansats och en del i en större experimentell studie med två aktiva interventioner för att påverka munhygienbeteende. Studien innefattade 109 studiedeltagare, 57 kvinnor och 52 män i åldrarna 25-65 år som var remitterade till specialistklinik för parodontologi. Frågeformuläret som användes gällande tandvårdsrädsla var Dental Anxiety Scale (DAS) med 4 påståenden avseende upplevelser för att besöka tandhygienist. För att fastställa attityder till tandhygienist användes Dental Hygiene Belief Survey (DHBS) som innehöll 8 påståenden rörande kommunikation. Resultatet visade att studiedeltagarna 3 månader efter behandling hade en lägre grad av tandvårdsrädsla samt en mer positiv attityd till tandhygienist jämfört med vid studiens start. Ingen skillnad mellan interventionerna kunde ses med avseende på tandvårdsrädsla samt attityder till tandhygienist. Samband mellan ålder, kön och tandvårdsrädsla kunde endast ses vid studiens start. Konklusionen visar att icke-kirurgisk parodontalbehandling utförd av tandhygienist minskar graden av tandvårdrädsla och att attityder till tandhygienist förbättras efter denna behandling.

  • 28. Fundak, A
    et al.
    Suvan, J
    Hovius, M
    Ramseier, C
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Globat, N
    Winkel, E
    Knevel, R
    Dental Hygiene Debate2006In: Europerio 5, Madrid, 2006Conference paper (Other academic)
  • 29.
    Grahn, Helena
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Adolfsson, Pernilla
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Behovet av nödvändig tandvård i Ludvika kommun 2003-2008: En beskrivande, retrospektiv journalstudie2009Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Munvården är ofta ett eftersatt område inom vården och omsorgen vilket återspeglar sig på munhälsan hos de boende. Syftet med denna studie var att undersöka om behovet av nödvändig tandvård har förändrats i Ludvika kommun under åren 2003-2008, samt att studera om de vårdtagare som var i behov av nödvändig tandvård fick densamma. Metoden var en beskrivande, retrospektiv journalstudie. Studien baseras på 2010 st screeningjournaler från år 2003 - 2008. Dessa screeningjournaler plus listor på vilka som fått nödvändig tandvård under de här åren har studerats och analyserats. Samtliga uppgifter inhämtades från beställarenheten för tandvård i Säter. Någon skillnad i antalet tänder kunde inte påvisas med avseende på olika år. Antal vårdtagare med helprotes har blivit färre. Prevalensen av synlig karies har ökat. En ökning av antal personer som får hjälp med den dagliga munvården kunde påvisas. Behovet av nödvändig tandvård har varierat över tid. Vårdtagarna har ett betydande behov av nödvändig tandvård som har varit relativt konstant över tid. De personer som var i behov av nödvändig tandvård har fått densamma i stor utsträckning, även om en del sjukdomssymptom kvarstår. Munhygienen är inte tillfredsställande trots att de som är i behov av hjälp med munvård får sådan i tillräcklig utsträckning.

  • 30.
    Granér, Inger
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Förändringsstadier, för- och nackdelar samt självtillit till rengöring mellan tänderna hos patienter med kronisk parodontit tolv månader efter behandling hos tandhygienist2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att beskriva och jämföra individers olika förändringsstadier för rengöring mellan tänderna före och tolv månader efter icke-kirurgisk parodontalbehandling utförd av tandhygienist. Ytterligare syften var att studera om olika förändringsstadier var associerat med vilken patientundervisningsmodell patienten erhålliit samt tilltro till egenförmågan till att rengöra mellan tändernadagligen, balansen mellan för- och nackdelartill daglig rengöring mellan tänderna samt kön och utbildning 12 månader efter behandling. Studien var en jämförande och beskrivande studie. All data kommer från en randomiserad och kontrollerad studie där deltagarna var remitterade till specialistklinik för parodontologi.

    Studien innefattade 104 individer, 56 kvinnor och 48 män där en grupp erhöll ett individuellt utformat munhälsoutbildningsprogram baserat på beteendemedicinska principer och en grupp erhöll standardiserad munhälsoutbildning. Instrumenten som användes var tre frågeformulär som berörde frekvens av approximal rengöring och förändringsstadier, för- och nackdelar med regelbunden approximal rengöring samt självtillit till att utföra daglig rengöring mellan tänderna. Resultaten visade att det totalt skedde en förflyttning mellan de olika förändringsstadierna och fler individer befann sig i vidmakthållande stadiet vid 12-månaderskontrollen jämfört med studiens start. Ingen skillnad förelåg mellan de olika förändringsstadierna och kön respektive utbildning. En signifikant skillnad förelåg mellan de olika förändringsstadierna och självtillit till daglig rengöring mellan tänderna där de i vidmakthållandestadiet hade högre självtillit jämfört med de andra grupperna. Det förelåg en signifikant skillnad mellan de som fanns i förberedande/beredd-stadiet och de i vidmakthållandestadiet i avseende mellan för- och nackdelar.

    Konklusionen av denna studie visade att det skedde en förflyttning mellan de olika förändringsstadiernamellan behandlingsstart och 12-månaderskontrollen och fler individer befann sig i vidmakthållandestadiet. I den beteendemedicinska gruppen var det signifikant fler som befann sig i vidmakthållandestadiet jämfört med standardgruppen. De i vidmakthållandestadiet hade en högre självtillit till daglig rengöring mellan tänderna jämfört med de andra grupperna och ett samband förelåg mellan de olika förändringsstadierna och för- och nackdelar.

  • 31.
    Hellqvist, Lena
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Tobaksbruk och tandvårdsvanor bland 15-70 åringar ur ett 20-års perspektiv (1983 - 2003)2007Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [sv]

    Det tobakspreventiva arbetet är en av samhällets största utmaningar. Syftet med studien var att beskriva tobaksbruket och dess förändring över tid (1983-2003) i ett slumpmässigt urval av individer 15-70 år i Jönköpings kommun. Den specifika målsättningen var att analysera tobaksvanorna i relation till socioekonomiska förhållanden, personlighet, tandvård och tandvårdsvanor. Studien utgjordes av tre epidemiologiska tvärsnittsstudier utförda åren 1983, 1993 och 2003. En klinisk och röntgenologisk undersökning utfördes av mun och tänder. Individerna fick även besvara ett frågeformulär. Resultaten visade en statistiskt signifikant minskning av tobaksbruket från 31 % tobaksbrukare 1983 till 24 % såväl 1993 som 2003. Detta gällde samtliga åldersgrupper utom åldersgruppen 40-åringar. I första hand minskade andelen rökare. Samtidigt ökade snusarna i samtliga åldersgrupper 20-60 år innebärande ett i stort sett oförändrat tobaksbruk 1993 och 2003. Det förelåg ingen statistisk signifikant skillnad vid de tre undersökningsåren mellan tobaksbrukare och icke/brukare med avseende på inkomst-, utbildningsnivå, civilstånd, och KASAM poäng. År 2003 förelåg en statistisk signifikant skillnad mellan brukare och icke brukare med avseende på frekvens av tandvårdsbesök, där tobaksbrukarna i större utsträckning än icke brukaren, inte besökte tandvården eller besökte tandvården oregelbundet. Icke brukarna borstade tänderna statistiskt signifikant oftare än tobaksbrukarna år 1993 och icke brukarna använde tandstickor statistiskt signifikant oftare än tobaksbrukarna år 1983 och 2003.

  • 32. Hovan, AJ
    et al.
    Williams, PM
    Stevensen-Moore, P
    Wahlin, YB
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Elting, LS
    Spijkervet, FK
    Brennan, MT
    A systematic review of dysgeusia induced by cancer therapies2010In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 18, no 8, 1081-1087 p.Article in journal (Refereed)
    Abstract [en]

    Purpose. The purpose was to review relevant scientific papers written since 1989 which focused on the prevalence and management of dysgeusia as an oral side effect of cancer treatment.

    Methods. Our literature search was limited to English language papers published between 1990 and 2008. A total of 30 papers were reviewed; the results of 26 of these papers were included in the present systematic review. A structured assessment form was used by two reviewers for each paper. Studies were weighted as to the quality of the study design, and treatment recommendations were based on the relative strength of each paper.

    Results. A wide range in reported prevalence of dysgeusia was identified with the weighted prevalence from 56–76%, depending on the type of cancer treatment. Attempts to prevent dysgeusia through the prophylactic use of zinc sulfate or amifostine have been of limited benefit. Nutritional counseling may be helpful to some patients in minimizing the symptoms of dysgeusia.

  • 33.
    Häggström, Malin
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Selin, Matti
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Evidensbaserad munvård för att förebygga ventilatorassocierad pneumoni hos ventilatorbehandlande patienter: en systematisk litteraturstudie2008Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Utgångspunkten för denna litteraturstudie är att ventilatorassocierad pneumoni (VAP) går att förebygga. Syftet med detta arbete var att kartlägga olika evidensbaserade munvårdsmetoder som används av intensivvårdssjuksköterskor för att förebygga VAP hos ventilatorbehandlade patienter. Syftet var också att belysa vilka faktorer som påverkar intensivvårdssjuksköterskans utförande av evidensbaserad munvård till ventilatorbehandlade patienter. Studien utfördes som en systematisk litteraturstudie. Till resultatet användes 16 vetenskapliga artiklar. För att kunna bedöma artiklarnas vetenskapliga kvalitet granskades artiklarna utifrån en modifierad granskningsmall. Samtliga artiklar fick höga kvalitetspoäng, vilket innebär hög vetenskaplig relevans. Resultatet av litteraturstudien visar att i flera av de evidensbaserade munvårdsprotokoll som publicerats den senaste tiden finns några återkommande punkter. Dessa punkter är; bedömning av munhålans status, tandborstning med barntandborste, munsköljmedel och att munnen fuktas med ett intervall av två till sex timmar. Flera faktorer påverkar intensivvårdssjuksköterskans utförande av evidensbaserad munvård. Genom att införa ett evidensbaserat munvårdsprotokoll för ventilatorbehandlade intensivvårdspatienter och ge personalen utbildning i munvård kan incidensen av VAP minska. Resultatet visar också att generellt sett är kunskapsnivån låg hos intensivvårdssjuksköterskor gällande förebyggande åtgärder för att förhindra VAP. Om sjuksköterskan anser att hon/han har tid att utföra munvård blir resultatet av högre kvalitet och hon/han upplever också åtgärden som mindre obehaglig. Detta innebär att försök att förbättra omvårdnaden och därmed minska antalet vårdrelaterade infektioner även är en organisatorisk fråga.

  • 34. Johnsson, P
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    International Profile of Dental Hygiene, 1987-2007: Twenty Years of Professional Growth and Evolvement2007In: 17th International symposium on Dental Hygiene, Toronto, Canada, 2007Conference paper (Refereed)
  • 35.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hälsosamt beteende2010Conference paper (Other (popular science, discussion, etc.))
  • 36.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Resultat från konsesuskonferens Beteendemedicinsk prevention och behandling2012Conference paper (Other (popular science, discussion, etc.))
  • 37.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Baker, S
    Lindberg, P
    Oscarson, N
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Factors influencing oral hygiene behaviour and gingival outcomes 3 and 12 months after initial periodontal treatment: an exploratory test of an extended Theory of Reasoned Action2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 2, 138-144 p.Article in journal (Refereed)
    Abstract [en]

    Aim. The aim was to empirically test the extended Theory of Reasoned Action (TRA) and the prospective direct and indirect role of attitudes, beliefs, subjective norms, self-efficacy, and a cognitive behavioural intervention in adult's oral hygiene behaviour and gingival outcomes at 3- and 12-month follow-up.

    Materials and Methods. Data were derived from an RCT evaluating the effectiveness of oral hygiene educational programs integrated in non-surgical periodontal treatment (n = 113). Before baseline examination, participants completed a self-report questionnaire. Structural equation modelling using maximum likelihood estimation with bootstrapping was used to test the direct and indirect (mediated) pathways within the extended TRA model.

    Results. The extended TRA model explained a large amount of variance in gingival outcome scores at 12 months (56%). A higher level of self-efficacy at baseline was associated with higher frequencies of oral hygiene behaviour at 3 months. Being female was linked to more normative beliefs that, in turn, related to greater behavioural beliefs and self-efficacy. Gender was also related to behavioural beliefs, attitudes and subjective norms. Both frequency of oral hygiene behaviour at 3 months and the cognitive behavioural intervention predicted gingival outcome at 12 months.

    Conclusions. The model demonstrated that self-efficacy, gender and a cognitive behavioural intervention were important predictors of oral hygiene behavioural change.

  • 38.
    Jönsson, Birgitta
    et al.
    Department of Public Health and Caring Services, Uppsala University, Uppsala, Sweden.
    Lindberg, Per
    Department of Public Health and Caring Services, Uppsala University, Uppsala, Sweden.
    Oscarsson, Nils
    Department of Periodontology, Public Dental Health Care, Uppsala, Sweden.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Improved compliance and self-care in patients with periodontitis: a randomized control trial2006In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 4, no 2, 77-83 p.Article in journal (Refereed)
  • 39.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Behavioural medicine perspective for change or oral hygiene behaviour in patients with periodontal disease2010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 40. Jönsson, Birgitta
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Compliance and self-care in patients with severe periodontitis - an experimental study2004In: The 16th Internatiional Symposium on Dental Hygiene, Madrid, 2004Conference paper (Refereed)
  • 41.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Dental anxiety before and after non-surgical periodontal treatment2010In: 88th General Session of the International Association for Dental Research and 5th General Session of the Pan European Region of the IADR, Barcelona, Spanien, 2010Conference paper (Refereed)
  • 42.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Competence Ctr Northern Norway TkNN, Publ Dent Hlth Serv, Tromso, Norway.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Evaluation of the effect of nonsurgical periodontal treatment on oral health-related quality of life: estimation of minimal important differences 1 year after treatment2014In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, no 3, 275-282 p.Article in journal (Refereed)
    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.

  • 43.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Factors influencing oral hygiene behaviour 12 month after dental hygiene treatment2011In: 2nd North American/Global Dental Hygiene Research Conference, Washington, DC, 2011Conference paper (Refereed)
  • 44. Jönsson, Birgitta
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Self-efficacy scale a useful tool for predicting oral hygiene behavior2009In: 44th meeting of the IADR-Continental European Division with the Scandinavian Division and Israeli Division, Munchen, Tyskland, 2009Conference paper (Refereed)
  • 45.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Stage of Change for Interdental Cleaning in Patients with Peridontitis2013Conference paper (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.

  • 46.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science. Uppsala University.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, P
    Oscarson, N
    Evaluation of an individually tailored oral health educational programme on periodontal health2010In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, no 10, 912-919 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate an individually tailored oral health educational programme (ITOHEP) on periodontal health compared with a standard oral health educational programme. A further aim was to evaluate whether both interventions had a clinically significant effect on non-surgical periodontal treatment at 12-month follow-up.

    Material and Method: A randomized, evaluator-blinded, controlled trial with 113 subjects (60 females and 53 males) randomly allocated into two different active treatments was used. ITOHEP was based on cognitive behavioural principles and motivational interviewing. The control condition was standard oral hygiene education (ST). The effect on bleeding on probing (BoP), periodontal pocket depth, “pocket closure” i.e. percentage of periodontal pocket >4 mm before treatment that were <5 mm after treatment, oral hygiene [plaque indices (PlI)], and participants' global rating of oral health was evaluated. Preset criteria for PlI, BoP, and “pocket closure” were used to describe clinically significant non-surgical periodontal treatment success.

    Results: The ITOHEP group had lower BoP scores 12-month post-treatment (95% confidence interval: 5–15, p<0.001) than the ST group. No difference between the two groups was observed for “pocket closure” and reduction of periodontal pocket depth. More individuals in the ITOHEP group reached a level of treatment success. Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success.

    Conclusions: ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment.

  • 47.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, Per
    Kognitiva beteendestrategier och motiverande samtal för att uppnå långsiktigt goda munhygienvanor vid kronisk parodontit. En randomiserad kontrollerad tvågruppsstudie2009In: Svenska Tandläkarsällskapets 45:e Odontologiska Riksstämma, Stockholm, 2009Conference paper (Refereed)
  • 48.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, Per
    Oscarson, Nils
    Cost-effectiveness of an individually tailored oral health educational programme based on cognitive behavioural strategies in non-surgical periodontal treatment2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 7, 659-665 p.Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this cost-effectiveness analysis (CEA), performed from a societal perspective, was to compare costs and consequences of an individually tailored oral health educational programme (ITOHEP) based on cognitive behavioural strategies integrated in non-surgical periodontal treatment compared with a standard treatment programme (ST).

    Material and Methods. A randomized (n = 113), evaluator-blinded, controlled trial, with two different active treatments, was analysed with respect to their costs and consequences 12 months after non-surgical treatment. Costs referred to both treatment costs and costs contributed by the patient. Consequences (outcome) were expressed as the proportion of individuals classified as having reached the pre-set criteria for treatment success after non-surgical treatment (“successful-NSPT”).

    Results. More individuals in the ITOHEP group reached the pre-set criteria for treatment success than individuals in the ST group did. The CEA revealed an incremental cost-effectiveness of SEK1724 [€191.09; SEK9.02 = €1 (January 2007)] per “successful-NSPT” case, of which treatment costs represented SEK1189 (€131.82), using the unit cost for a dental hygienist.

    Conclusion. The incremental costs per “successful-NSPT” case can be considered as low and strengthens the suggestion that an ITOHEP integrated into non-surgical periodontal treatment is preferable to a standardized education programme.

  • 49.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden and Dental health care administration in Uppsala County Council, Uppsala, Sweden.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oscarson, Nils
    National Board of Health and Welfare, Stockholm, Sweden.
    Lindberg, Per
    Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden and Department of Psychology, Uppsala University, Uppsala, Sweden.
    An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis2009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 3, 166-175 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis.

    Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse.

    Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period.

    Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

  • 50. Jönsson, Birgitta
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oscarson, Nils
    Lindberg, Per
    The effectiveness of an individual tailored ora health education programme on oral hygiene behaviour in patients with periodontal disease2009In: Europerio 6, Stockholm, 2009Conference paper (Refereed)
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