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  • 1. Baxter, Rebecca
    et al.
    Jemberie, Wossenseged Birhane
    Li, Xia
    Naseer, Mahwish
    Dalarna University, School of Health and Welfare, Social Work.
    Pauelsen, Mascha
    Shebehe, Jacques
    Viklund, Emilia
    Xia, Xin
    Elena Zulka, Linn
    Badache, Andreea
    COVID-19: Opportunities for interdisciplinary research to improve care for older people in Sweden2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 1, p. 29-32Article in journal (Refereed)
    Abstract [en]

    The emergence of COVID-19 has changed the world as we know it, arguably none more so than for older people. In Sweden, the majority of COVID-19-related fatalities have been among people aged ⩾70 years, many of whom were receiving health and social care services. The pandemic has illuminated aspects within the care continuum requiring evaluative research, such as decision-making processes, the structure and organisation of care, and interventions within the complex public-health system. This short communication highlights several key areas for future interdisciplinary and multi-sectorial collaboration to improve health and social care services in Sweden. It also underlines that a valid, reliable and experiential evidence base is the sine qua non for evaluative research and effective public-health systems.

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  • 2. Brehmer, Lovisa
    et al.
    Alexanderson, Kristina
    Schytt, Erica
    Days of sick leave and inpatient care at the time of pregnancy and childbirth in relation to maternal age2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 3, p. 222-229Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore whether older women differ from younger women with respect to sick leave and inpatient care at the time around their first pregnancy and delivery.

    METHODS: This was a descriptive population-based cohort study. The study population included all 236,176 nulliparous women registered as living in Sweden who gave birth to their first singleton infant in 2006-2010. Data from nationwide Swedish registers were used. Maternal age was categorized in five-year intervals. Time was calculated in years with the delivery date as the starting point, from two years before and up to three years after delivery. Descriptive statistics were used to calculate mean values and ANOVA tables were used to obtain the 95% confidence intervals of the means. Restriction was used to reduce potential confounding.

    RESULTS: Women aged ⩾35 years had a higher annual mean number of sick leave days from two years before to one year after their delivery date compared with younger women. The range for all age categories in the year before the delivery date, including pregnancy, was 15.3-37.4 mean sick leave days. The mean number of inpatient days increased with each age category during the year after the date of delivery in the range 1.4-4.3 days.

    CONCLUSIONS: This first explorative study indicates the need for more knowledge on morbidity among older primiparous women. They had a higher number of days with sick leave and hospitalization in the year before and after their delivery date. This might reflect higher health risks during pregnancy and childbirth among older women; however, social factors and reverse causation might also be influential.

  • 3.
    Flacking, Renée
    et al.
    Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden; Center for Clinical Research Dalarna, SE-791 82 Falun, Sweden; Department of Paediatrics, Falun Hospital, SE-791 82 Falun Sweden.
    Dykes, Fiona
    Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Public Health and Clinical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
    Ewald, Uwe
    Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
    The influence of fathers’ socioeconomic status and paternity leave on breastfeeding duration: a population based cohort study2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, p. 337-343Article in journal (Refereed)
    Abstract [en]

    Aim: The propensity to breastfeed is a matter of public concern because of the favourable effects for infants. However, very few studies have described the influence of paternal variables upon duration of breastfeeding. The aim of this study was to describe the effects of fathers’ socioeconomic status and their use of paternity leave on breastfeeding duration for infants up to 1 year of age. Methods: A prospective population-based cohort study was undertaken. Data on breastfeeding, registered in databases in two Swedish counties for 1993—2001, were matched with data on socioeconomic status and paternity leave obtained from Statistics Sweden. Fathers of 51,671 infants were identified and included. Results: Infants whose fathers had a lower level of education, were receiving unemployment benefit and/or had a lower equivalent disposable household income were significantly less likely to be breastfed at 2, 4, 6, 9, and 12 months of age. Infants whose fathers did not take paternity leave during the infant’s first year were significantly less likely to be breastfed at 2 (p < 0.001), 4 (p < 0.001), and 6 months (p < 0.001). Conclusions: This paper shows that an enabling of an increased involvement from fathers during the infants’ first year of life, such as by paid paternity leave, may have beneficial effects on breastfeeding up to 6 months of age. A more systematic approach to supporting fathers’ involvement may be particularly valuable to those infants whose fathers have a lower socioeconomic status.

  • 4. Frieberg, Otto-Patrik
    et al.
    Millqvist, Eva
    Nilsson, Jan
    From, Ingrid
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Development and validation of the self-administered Falun health instrument (SAFHI) using data from health promoted workplaces in Sweden2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 7, p. 735-743Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to develop and to validate the self-administered Falun health instrument. An additional aim was to test its applicability in measuring people's lifestyles linked to health.

    METHODS: In 2002, an instrument was constructed containing questions regarding the hazardous use of alcohol, tobacco, unhealthy diets and insufficient physical activity. A pilot study using the instrument was assessed between 2002 and 2006. In Sweden, it was further expanded and tested during the years 2004-2014 among a total of 1295 people.

    RESULTS: Face validity was evaluated among colleagues and experts for clarity and completeness resulting in minor adjustments of some questions. With the test-retest method, the self-administered Falun health questionnaire showed a positive and high reproducibility and high compliance. Cronbach's alpha showed a high level of consistency (average 0.86). Factor analysis demonstrated the choice of questions correlated highly to the measured lifestyle.

    CONCLUSIONS: This study showed that the self-administered Falun health questionnaire is a valid and reliable instrument, useful for detecting individuals at risk of developing diseases that are related to individual choice of lifestyle.

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  • 5.
    Jerdén, Lars
    et al.
    Umeå universitet, Epidemiologi och folkhälsovetenskap.
    Bildt-Ström, Pia
    Burell, Gunilla
    Weinehall, Lars
    Umeå universitet, Epidemiologi och folkhälsovetenskap.
    Bergström, Erik
    Umeå universitet, Epidemiologi och global hälsa.
    Personal health documents in school health education: a feasibility study2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 6, p. 662-665Article in journal (Refereed)
    Abstract [en]

    Aims: To examine the feasibility of a school intervention using a personal health document adapted for adolescents. Methods: The health document was developed in close cooperation with groups of adolescents and tested among seventh-grade students at two junior high schools (n=339). The document was presented to the students by their regular teachers. For evaluation, an adolescent questionnaire was used at baseline and after one year. Results: After one year, 87% of adolescents reported having written in the health document, and 77% reported having had classes with discussions on subjects in the document. The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a non-smoker, and having a positive school experience. Conclusions: Implementation of a personal health document in junior high-school health education was feasible and well accepted.

  • 6. Johansson, Fred
    et al.
    Côté, Pierre
    Hogg-Johnson, Sheilah
    Rudman, Ann
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Karolinska Institutet, Stockholm.
    Holm, Lena W
    Grotle, Margreth
    Jensen, Irene
    Sundberg, Tobias
    Edlund, Klara
    Skillgate, Eva
    Depression, anxiety and stress among Swedish university students before and during six months of the COVID-19 pandemic: A cohort study.2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 7, p. 741-749, article id 14034948211015814Article in journal (Refereed)
    Abstract [en]

    AIMS: The COVID-19 pandemic has had a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety and stress symptoms during the COVID-19 outbreak compared to before the outbreak, and to determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems.

    METHODS: We conducted a cohort study with 1836 Swedish university students entering the study before 13 March 2020, the onset of the pandemic, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications.

    RESULTS: We found small differences in mean levels of the depression, anxiety and stress scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to -0.45) at FU1 and decreased by 0.75/21 (95% CI:-0.97 to -0.53) at FU2. Anxiety decreased from baseline to FU1 by 0.09/21 (95% CI: -0.24 to -0.07) and by 0.77/21 (95% CI: -0.93 to -0.61) to FU2. Stress decreased from baseline to FU1 by 0.30/21 (95% CI: -0.52 to -0.09) and by 1.32/21 (95% CI: -1.55 to -1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality or pre-pandemic mental health problems did not have worse trajectories of mean mental health symptoms.

    CONCLUSIONS: Symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.

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  • 7. Johansson-Pajala, Rose-Marie
    et al.
    Alam, Moudud
    Dalarna University, School of Information and Engineering, Statistics.
    K Gusdal, Annelie
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Mälardalen University.
    Boström, Anne-Marie
    Trust and easy access to home care staff are associated with older adults' sense of security: a Swedish longitudinal study2024In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, p. 36830-, article id 14034948241236830Article in journal (Refereed)
    Abstract [en]

    AIM: Older adults are increasingly encouraged to continue living in their own homes with support from home care services. However, few studies have focused on older adults' safety in home care. This study explored associations between the sense of security and factors related to demographic characteristics and home care services.

    METHODS: The mixed longitudinal design was based on a retrospective national survey. The study population consisted of individuals in Sweden (aged 65+ years) granted home care services at any time between 2016 and 2020 (n=82,834-94,714). Multiple ordinal logistic regression models were fitted using the generalised estimation equation method to assess the strength of relationship between the dependent (sense of security) and independent (demographics, health and care-related factors) variables.

    RESULTS: The sense of security tended to increase between 2016 and 2020, and was significantly associated with being a woman, living outside big cities, being granted more home care services hours or being diagnosed/treated for depression (cumulative odds ratio 2-9% higher). Anxiety, poor health and living alone were most strongly associated with insecurity (cumulative odds ratio 17-64% lower). Aside from overall satisfaction with home care services, accessibility and confidence in staff influenced the sense of security most.

    CONCLUSIONS: We stress the need to promote older adults' sense of security for safe ageing in place, as mandated by Swedish law. Home care services profoundly influence older adults' sense of security. Therefore, it is vital to prioritise continuity in care, establish trust and build relationships with older adults. Given the increasing shortage of staff, integrating complementary measures, such as welfare technologies, is crucial to promoting this sense of security.

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  • 8. Khe, ND
    et al.
    Eriksson, B
    Phuong, DN
    Höjer, Bengt
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Diwan, V
    Faces of poverty: sensitivity and specificity of economic classification in rural Vietnam2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31(Suppl. 62), p. 70-75Article in journal (Refereed)
  • 9.
    Klingberg-Allvin, Marie
    et al.
    Karolinska institutet.
    Thu Nga, Nguyen
    Rangsjö-Arvidson, Anna-Berit
    Johansson, Annika
    Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam.2006In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 34, no 4, p. 414-421Article in journal (Refereed)
    Abstract [en]

    Background: Vietnam has one of the highest abortion rates in the world and adolescent abortions are thought to constitute at least one third of all cases. Lack of balanced reproductive health information and services to adolescents and negative social attitudes towards adolescent sexuality are contributing factors to the high abortion rates. Health providers are important in guiding and counselling adolescents on how to protect their reproductive health. There is a lack of studies on health providers’ perspectives on their work in adolescent reproductive health care. Aim: To explore the perspectives of midwives and doctors on adolescent sexuality and abortion, and what they considered to be quality abortion care for adolescents and the barriers to it, as well as to their own training needs. Methods: Observations of care in abortion clinics and focus group discussions (FGD) were used to collect data. Doctors and midwives from three health care facilities in Quang Ninh province in Northern Vietnam participated in a total of eight FGDs. Data were analysed using latent content analysis.

    Findings: Major barriers identified for quality abortion care were of technical and managerial nature. Participants considered that counselling unmarried clients in connection with abortion should focus on warning against the risks and dangers of abortion and pre-marital sexual relations, which they strongly disapproved of. However, they also expressed a pragmatic and caring attitude towards the unmarried girls and couples coming for abortion. Adolescent sexuality and abortion are morally sensitive issues in the Vietnamese culture. The contradictions between cultural norms and the reality facing health providers while counselling the unmarried adolescents need to be addressed in education and training programmes.

  • 10.
    Mankell, Anna
    et al.
    Marie Cederschiöld University, Centre for Civil Society Research.
    Abdelzadeh, Ali
    Dalarna University, School of Culture and Society, Political Science. Marie Cederschiöld University, Centre for Civil Society Research.
    The role of community trust for compliance with the Swedish COVID-19 immunisation programme2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, p. 704-710Article in journal (Refereed)
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  • 11.
    Onell, Clara
    et al.
    Sophiahemmet Univ, Dept Hlth Promot Sci, Musculoskeletal & Sports Injury Epidemiol Ctr, Stockholm, Sweden..
    Holm, Lena W.
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Solna, Sweden..
    Bohman, Tony
    Dalarna University, School of Health and Welfare, Medical Science. Karolinska Institutet.
    Magnusson, Cecilia
    Karolinska Inst, Dept Global Publ Hlth, Solna, Sweden..
    Lekander, Mats
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.;Stockholm Univ, Stress Res Inst, Dept Psychol, Stockholm, Sweden..
    Skillgate, Eva
    Sophiahemmet Univ, Dept Hlth Promot Sci, Musculoskeletal & Sports Injury Epidemiol Ctr, Stockholm, Sweden.;Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Solna, Sweden..
    Work ability and psychological distress in a working population: results from the Stockholm Public Health Cohort2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, no 4, p. 595-601, article id 14034948211033692Article in journal (Refereed)
    Abstract [en]

    Aims: Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population. Methods: Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18-60 years, with no or mild psychological distress at baseline (n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals. Results: At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6-2.0). Conclusions: Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.

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  • 12.
    Sundberg, Tobias
    et al.
    Sophiahemmet University.
    Skillgate, Eva
    Sophiahemmet University; Karolinska Institutet.
    Gustavsson, Petter
    Karolinska Institutet.
    Rudman, Ann
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Karolinska Institutet.
    Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 52, no 4, p. 427-433, article id 14034948231151992Article in journal (Refereed)
    Abstract [en]

    AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

    METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

    RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

    CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

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