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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, p. 95-102Article 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, p. 720-727Article 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, p. 209-215Article 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, p. 208-214Article 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, p. 15-21Article 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, p. 87-92Article 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, p. 283-291Article 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, p. 61-70Article 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, p. 69-81Article 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.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Holmström, Paul
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Models of Care processes – Implications for the Design of New Health Care Environments2004In: EuroFM Conferences, Copenhagen, 2004Conference paper (Other academic)
  • 21. 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)
  • 22.
    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.

  • 23.
    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)
  • 24.
    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.

  • 25.
    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, p. 530-538Article 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.

  • 26.
    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, p. 3-34Article 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.

  • 27. 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)
  • 28. 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, p. 1081-1087Article 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.

  • 29. 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)
  • 30.
    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, p. 138-144Article 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.

  • 31.
    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, p. 77-83Article in journal (Refereed)
  • 32.
    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)
  • 33. 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)