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  • 1.
    Abrahamsson, Agneta
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    A salutogenic perspective could be of practical relevance for the prevention of smoking amongst pregnant women2002In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 18, no 4, p. 323-331Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: to use empirical data to assess the theoretical relevance of using a salutogenic, instead of a pathogenic, perspective to prevent smoking during pregnancy. DESIGN: quantitative study, a questionnaire was completed during the first trimester of pregnancy and an interview was conducted after the baby was born. SETTING: a geographically defined area in the south-east of Sweden. PARTICIPANTS: all 395 women in the study area who were pregnant during the study period 1994-1995. FINDINGS: the women were categorised according to their smoking habits. A significant difference in the sense of coherence (SOC) score was shown between smoking and non-smoking women in indicators of bad health. Women who relapsed to smoking showed a lower level of SOC, particularly in the manageability component, than others. The SOC score was higher in the whole study group than in other comparable, non-pregnant populations. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a salutogenic perspective could be used in antenatal care as a basis for encouraging pregnant women to stop smoking. This could enhance the SOC by making smoking more understandable for the woman, by discussing smoking as a way of coping, and by encouraging the woman's own capacity and motivation to stop smoking. Starting a dialogue about smoking from the woman's point of view could do this, with the midwife and the woman exploring together the woman's thoughts about the smoking problem.

  • 2.
    Abrahamsson, Agneta
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Smoking patterns during pregnancy: differences in socio-economic and health-related varaiables2000In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 10, no 3, p. 208-213Article in journal (Refereed)
    Abstract [en]

    Background: The objective of this study was to assess different smoking patterns during and after pregnancy and relate these patterns to socioeconomic conditions and different health issues such as symptoms, drug consumption and health care use. Methods: The study group included 337 pregnant women from a district in south Sweden. A questionnaire was filled in during the first part of pregnancy and an interview was conducted after the baby was born. The women were categorised according to their smoking habits. Results: The categories defined were continuers, relapsers, decreasers, quitters and non-smokers. Among relapsers three symptoms, difficulty in relaxing (OR 4.48), restlessness (OR 9.59) and dysphoria (OR 3.98), were more common than among non-smokers. All three musculoskeletal symptoms were most common among continuers. Among quitters the OR for backache was 2.05, for numbness In the arms and legs 2.76 and for tearfulness 2.92. Educational level was relatively high among quitters and few had a smoking partner. Among smokers (decreasers, relapsers and continuers) 24% used drugs regularly, compared to 5% among non-smokers. Conclusions: To prevent smoking during pregnancy awareness of the relations between different smoking categories and symptoms could make it easier for hearth personnel to individualise support. A possible starting point is to discuss how to cope with different symptoms occurring during smoking cessation. Women with predictors for continued smoking during pregnancy, such as low education, unemployment, a smoking partner and multiparous, should be focused on more intensively and preventive strategies suitable for their special needs should be developed.

  • 3.
    Abrahamsson, Agneta
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Samhällsvetenskap. Kristianstad University, Forskningsmiljön Arbete i skolan (AiS).
    Samarasinghe, Kerstin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Arbete i skolan (AiS).
    Open pre-schools at integrated health services: a program theory2013In: International Journal for Integrated Care, ISSN 1568-4156, Vol. 13, p. e014-Article in journal (Refereed)
    Abstract [en]

    Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres.

    Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre.

    Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents.

    Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

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  • 4.
    Agosti, Madelaine
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Andersson, Ingemar
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Erlandsson, Lena-Karin
    Lunds universitet.
    Främjar metoden "Livspussla - hälsa i vardagen" personalens upplevelse av hälsa och balans i vardagen?2013Conference paper (Other academic)
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  • 5.
    Andersson, Ann-Christine
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Melander, Katarina
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Kvinnors upplevelse av att leva med diabetes typ 22013Report (Other academic)
    Abstract [sv]

    Bakgrund: Diabetes typ 2 är en kronisksjukdom som ökar på grund av förändrade kostvanor och minskad fysisk aktivitet. Det är en sjukdom som ställer stora krav på individen eftersom det är viktigt med välfungerande egenvård för att må bra. Att drabbas av en kronisk sjukdom upplevs oftast negativt samtidigt som det är viktigt att få ett namn på sjukdo- men. Det finns studier som tyder på att kvinnor verkar må psykiskt sämre och har sämre reglerad diabetes än män. För att kunna stödja kvinnorna i egenvården behövs kunskap om hur de upplever det att leva med diabetes. Syfte: Undersöka kvinnors upplevese av att leva med typ 2 diabetes. Metod: Litteraturstudie som bygger på nio kvalitativa artiklar. Resultat: Fyra teman hittades; besvikelse och svek, kluvenhet, skuld och skam samt oro för framtiden. Diskussion: Det är svårt att vara kvinna och leva med diabetes typ 2. Sjukdomen kräver daglig egenvård och kombinerat med andra roller som kvinnan har i sitt dagliga liv kan kraven upplevas som stressande för en del av kvinnorna. Många kvinnor med diabetes typ två upplevde att de var i behov av bättre stöd och information för att kunna leva med sin sjukdom. Slutsats: Vårdpersonal behöver mer utbildning och ha med ett genusperspektiv för att förstå kvinnornas behov. Diabetesutbildningen behöver utveckas till att omfatta hela familjen, men samtidigt måste den vara individanpassad.

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  • 6.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Folkhälsovetenskap: perspektiv och framtid2009In: Folkhälsa som tvärvetenskap: möten mellan ämnen / [ed] Andersson, Ingemar & Ejlertsson, Göran, Lund: Studentlitteratur , 2009, p. 367-375Chapter in book (Other academic)
  • 7.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Salutogenetic and pathogenetic factors of equal importance to predict mortality in a Swedish general population2008In: European Journal of Public Health, 18(Suppl. 1), 2008, Vol. 18, no Suppl. 1, p. 193-194Conference paper (Other academic)
    Abstract [en]

    Social support and physical exercise seem to be salutogenetic factors of importance for longterm survival to balance traditional risk factors such as smoking and defined diseases. The results support health promotion initiatives focused on salutogenetic factors and not only prevention in relation to traditional risk factors and diseases.

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    SUMMARY01
  • 8.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Sleep disturbances predict long-term mortality in men: a prospective Swedish study2007In: European Journal of Public Health, 17(Suppl. 2), 2007, Vol. 17, no Suppl. 2, p. 225-Conference paper (Other academic)
    Download (pdf)
    POPULARSUMMARY01
  • 9.
    Andersson, H. Ingemar
    et al.
    Department of Community Medicine, Lund University, Sweden.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Department of Medicine, Rheumatology section, Central Hospital, Kristianstad.
    Rosenberg, Claes
    Simrishamn Health Care Centre.
    Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization.1993In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 9, no 3, p. 174-182Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To establish basic epidemiological data on chronic pain (duration > 3 months) in a defined population. Relationships between age, gender, and social class were tested. DESIGN: A survey of pain symptoms, including location, intensity, duration, and functional capacity, was conducted by means of a mail questionnaire. SETTING: General populations in two Swedish primary health care districts. Medical care was provided in a state health system. SUBJECTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1,806). The response rate was 90%. OUTCOME MEASURES: Descriptive epidemiologic data in relation to objectives of the study. RESULTS: Without sex differences, 55% (95% confidence interval, 53-58%) of the population had perceived persistent pain for 3 months and 49% for 6 months. Among individuals with chronic pain, 90% localized their pain to the musculoskeletal system to a variable extent. Women experienced more multiple localizations of pain and had pain in the neck, shoulder, arm, and thigh to a greater extent than men. Prevalence of pain increased by age up to 50-59 years for both genders and then slowly decreased. The neck-shoulder area was the most common site of pain (30.2%), followed by the lower back (23.2%). Even in the youngest age groups more than one of four reported chronic pain. Blue-collar workers and employers (including farmers) reported chronic pain to a greater extent than other groups. In 13% of the population, manifest pain problems were associated with reduced functional capacity. CONCLUSION: Chronic pain symptoms are common but unevenly distributed in a general population. The results may influence planning and consultation in primary health care as well as warranting selective prevention activities.

  • 10.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Sektion för reumatologi, Medicinkliniken, Centralsjukhuset Kristianstad.
    Scherstén, Bengt
    Avdelningen för Samhällsmedicinska vetenskaper Lund/Dalby, Lunds Universitet.
    Impact of chronic pain on health care seeking, self care, and medication: results from a population-based Swedish study1999In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 53, no 8, p. 503-509Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p < 0.05) consulted a physician and 7.2% (compared with 1.2%, p < 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.

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    FULLTEXT01
  • 11.
    Andersson, H. Ingemar
    et al.
    Department of Community Medicine, Lund University.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Department of Medicine, Rheumatology section, Central Hospital, Kristianstad.
    Scherstén, Bengt
    Department of Community Medicine, Lund University.
    Musculoskeletal chronic pain in general practice: studies of health care utilisation in comparison with pain prevalence1999In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 17, no 2, p. 87-92Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses. DESIGN: A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC. SETTING: General population in a well-defined Swedish PHC district. SUBJECTS: A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre. MAIN OUTCOME MEASURES: Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996. RESULTS: Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache. CONCLUSION: Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.

  • 12.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Nilsson, P.
    Bringsén, Åsa
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Faculty of Health Science, Forskningsmiljön Man - Health - Society (MHS).
    Positive work experience factors relate to salutogenic health-a survey among Swedish hospital employees2012Conference paper (Refereed)
  • 13.
    Andersson, Ingemar
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Epidemiologi för vård- och hälsovetenskaperna: en fördjupning2013Book (Other academic)
    Abstract [sv]

    Epidemiologi för vård- och hälsovetenskaperna är avsedd som en fördjupning i epidemiologi för dem som tillägnat sig grunderna. Den vänder sig främst till universitets- och högskolestuderande inom vård- och hälsoområdet, d.v.s. till blivande folkhälsovetare, sjuksköterskor, läkare, apotekare, sjukgymnaster, socialarbetare och arbetsterapeuter. Den är också användbar för yrkesverksamma inom samma områden samt i forskningsmetodiska utbildningar.

  • 14.
    Andersson, Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Ejlertsson, GöranKristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Folkhälsa som tvärvetenskap: möten mellan ämnen2009Collection (editor) (Other academic)
    Abstract [sv]

    Folkhälsovetenskap är ett förhållandevis ungt ämne. Det har vuxit fram i samklang med en rad andra discipliner och behandlar olika aspekter av betydelse för befolkningens hälsa. Från att ha varit nästan obefintlig har folkhälsovetenskapen under några få decennier utvecklats till vad den är idag.

    Den här boken visar vilka relationer som finns mellan folkhälsovetenskap och andra ämnen. Med folkhälsovetenskap som bas görs i bokens olika kapitel kopplingar till biomedicin, vård- och omvårdnadsvetenskap, sociologi, statistik, epidemiologi, politik, psykologi, pedagogik, kultur, arbetsvetenskap, arbets- och miljömedicin, ekonomi och etik. Även en del definitioner tas upp, liksom en redovisning av folkhälsovetenskapens utveckling och möjliga framtid.

    Boken är skriven av specialister inom de respektive ämnena, som dessutom har bred kunskap inom folkhälsovetenskap. Till boken finns en webbplats med länkar och kompletteringar.

    Folkhälsa som tvärvetenskap är främst avsedd som en fördjupning i folkhälsovetenskap för dem som redan tillägnat sig grunderna. Den kan användas såväl i rent folkhälsovetenskapliga utbildningar som i andra utbildningar där hälsan är av betydelse. Blivande och färdiga folkhälsovetare, folkhälsopedagoger, sjuksköterskor, läkare, sjukgymnaster, arbetsterapeuter, lärare, samhällsvetare m.fl. bör i boken finna stimulans och kunskap som kan omsättas i praktiskt arbete för folkhälsan.

  • 15.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Kvalitatsindikatorer för munhälsa2013In: Kvalitatsindikatorer inom omvårdnad: Svensk sjuksköterskeförening / [ed] Ewa Idvall, Stockholm: Gothia Förlag AB, 2013, 6, p. 30-37Chapter in book (Other academic)
  • 16.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Munhälsa2013In: Ortopedisk vård och rehabilitering / [ed] Ami Hommel, Carina Bååth, Lund: Studentlitteratur, 2013, p. 113-125Chapter in book (Other academic)
  • 17.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Munhälsa2009In: Omvårdnadens grunder: hälsa och ohälsa / [ed] Edberg, Anna-Karin, Wijk, Helle, Lund: Studentlitteratur, 2009, p. 349-380Chapter in book (Other academic)
  • 18.
    Andersson, Pia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Hakeberg, Magnus
    Research Center, Public Dental Service, Region Västra Götaland.
    Abrahamsson, Kajsa H.
    Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg.
    Psychometric properties of the Dental Hygienist Anxiety Scale in a group of general dental patients2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 877-882Article in journal (Refereed)
    Abstract [en]

    Objective.  The aim of the present study was to evaluate the psychometric properties of the Dental Hygienist Anxiety Scale (DHAS) in a sample of adult general dental patients.  Materials and methods.  The DHAS is a questionnaire adapted to assess fear and anxiety of dental hygienist (DH) treatment. The DHAS contains four items and the sum of scores range from 4 (no anxiety) to 20 (extreme fear). A convenient sample of 80 patients in treatment at two DH programs in Sweden were consecutively included in the study. The DHAS was distributed together with questions regarding self-perceived oral health and experience of dental care at the first visit after a clinical examination performed by a DH. Re-test assessments of DHAS were conducted ∼ 2 weeks later in conjunction with the next visit to the DH before treatment (scaling session).  Results.  The results verified a significant positive correlation between the average DHAS sum of scores and global fear of DH and dentist treatment, perceived pain during the last DH treatment and female gender. The DHAS sum of scores had a high internal consistency, Cronbach's  coefficient of 0.89 and 0.87 at the first and at the second assessment, respectively. The test-re-test reliability of the DHAS sum of scores was acceptable, with an intra-class coefficient of 0.82 and Kappa coefficients between 0.49-0.78 for the four single items in the DHAS. Conclusions.  These results suggest that the DHAS has acceptable psychometric proprieties and is a valid and reliable scale to assess anxiety in DH treatment.

  • 19.
    Andersson, Pia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Johannsen, Annsofi
    Karolinska institutet.
    Tandhygienisters arbete med tobaksavvänjning2010Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Projektets syfte var att kartlägga tandhygienisters utövande av tobaksavvänjning i behandling av patienter som röker och/eller snusar, samt att undersöka deras inställning till tobaksavvänjning i förhållande till olika tillstånd i munhålan. Syftet var också att genom intervjuer beskriva yrkesgruppens uppfattningar om och erfarenheter av arbetet med tobaksavvänjning i patientbehandling. Målet med projektet har varit att implementera kunskaper om tobaksavvänjning i utbildningen till tandhygienist utifrån exempel från tandhygienistens verksamhet.

    Projektet har genomförts vid tandhygienistutbildningarna Högskolan Kristianstad och Karolinska institutet i Stockholm från hösten 2008 till och med 2010. En enkät som innehöll 25 frågor skickades till 400 tandhygienister som slumpmässigt valdes ut från medlemsregistret i Sveriges tandhygienistförening. Enkäten besvarades av 232 tandhygienister (58%). Tolv tandhygienister intervjuades och kvalitativ innehållsanalys användes som analysmetod. Dessutom har kursplaner granskats och innehållet av undervisningen om tobak utvärderats vid de båda lärosätena.

    Resultatet av enkäten visade att 45% av tandhygienisterna hade utbildning i tobaksavvänjning. I stort sett samtliga av dem tillfrågade patienter som rökte eller snusade om deras tobaksbruk, de informerade om tobakens skadliga effekter och frågade om motivationen till att sluta använda tobak. Sextiofyra procent av tandhygienisterna uppgav att de arbetade aktivt för att få patienterna att sluta röka eller snusa. Avsaknad av tid, otillräcklig kompetens och erfarenhet uppgavs vara hinder till att bedriva tobaksavvänjning. Skrivna riktlinjer för tobaksavvänjning och utbildning i detta område efterfrågades av 53% respektive 37%. Samtliga tandhygienister tyckte att det var viktigt att bedriva rökavvänjning på patienter som har tandlossning och tandimplantat, 58% uppgav att de utförde rökavvänjning på patienter som har tandlossning och 31% att de utförde det på patienter med tandimplantat.

    Resultatet av intervjuerna visade att tobaksavvänjning kan beskrivas som osynligt i munhälsoarbetet. Det integrerades i andra behandlingsåtgärder, eftersom det saknas debiteringskod i tandvårdens ekonomiska system för åtgärder mot tobaksbruk. Tandhygienisterna frågade sina patienter om deras tobaksbruk vid varje behandlingstillfälle och försökte få dem motiverade till att sluta. Deras förhållningssätt för att få sina patienter att upphöra med att röka eller snusa präglades av en helhetssyn. De hade fokus på etiska aspekter, som patientens självbestämmande och att deras egna handlingar skulle ha ett gott syfte för såväl patienten som för samhället. Flera av dem som intervjuades betonade att de var aktsamma för att inte förstöra sin goda relation till patienten. De tolkade patienterna utifrån hur motiverade de var till att sluta röka eller snusa och utgick från detta i sitt arbete. Kunskap om olika metoder för att få patienter att upphöra med sitt tobaksbruk upplevdes vara betydelsefullt för att bedriva ett bra arbete med tobaksavvänjning.

    Granskning av kursplaner och utvärderingar vid de båda lärosätena visade att utbildningens innehåll om tobaksavvänjning hade brister. Det framkom att det framförallt fanns brister i den praktiska tillämpningen och att denna del behövde få utökat utrymme i utbildningen.

    Projektet har lett till förändringar av tobaksinnehållet i kursplaner vid tandhygienistutbildningarna på respektive lärosätet för att förbättra undervisningen. Projektet har också resulterat i att de studerande kommer att få utbildning som kan erbjuda dem diplomering i tobaksavvänjning enligt standard hos Yrkesföreningar mot tobak. Därigenom stärks de för att i sin framtida yrkesroll kunna arbeta med att avvänja patienter från tobaksbruk. Ett hinder för att tandhygienister ska kunna utföra tobaksavvänjning är debiteringen, eftersom patienter får betala en högre avgift om avvänjningen sker inom tandvården, jämfört med inom hälso- och sjukvården för samma åtgärd. Detta kan innebära att patienter avböjer erbjudande som ges av tandhygienister. Det är därför angeläget att ekonomiska och organisatoriska förutsättningar ges, så att tobaksavvänjning kan bedrivas inom tandvården. Denna arena är betydelsefull för främjande av folkhälsan och åtgärden når en stor grupp människor eftersom en hög andel av befolkningen besöker tandvården regelbundet.

  • 20.
    Andersson, Pia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Johannsen, A.
    Division of Periodontology and Dental Hygiene, Department of Dental Medicine, Karolinska Institutet, Huddinge.
    The invisible work with tobacco cessation: strategies among dental hygienists2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, p. 54-60Article in journal (Refereed)
    Abstract [en]

    Objective:  This study elucidates dental hygienists’ experiences of work with tobacco cessation among patients who smoke or use snuff.

    Methods:  Data were obtained and categorized by interviewing 12 dental hygienists, who worked actively with tobacco cessation interventions. Qualitative content analysis was used for analysis.

    Results:  The latent content was formulated into the core category ‘the invisible oral health promotion work’. The informants thought that they had a responsibility to work with tobacco cessation. They perceived the financial system in which they perform the activity as frustrating, because tobacco cessation has no treatment code in the dental care insurance. This was one of several reasons why they had to integrate it in other treatment procedures. The results identified three categories: ‘balance in the meeting’, ‘possibilities and hindrance’ and ‘procedures’. In the narratives, both positive and negative aspects were displayed.

    Conclusions:  The financial conditions for tobacco cessation interventions need to be reformed and the activity has to be given a higher priority in the organization of dental care. Practical training in performing tobacco cessation interventions is important during the dental hygiene education; otherwise, tobacco cessation interventions will remain invisible in oral health promotion in the future.

  • 21.
    Andruskiene, Jurgita
    et al.
    Klaipeda Unversity, Lithuania.
    Kirveliene, Deimante
    Klaipeda Unversity, Lithuania.
    Martinkenas, Arvydas
    Klaipeda Unversity, Lithuania.
    Andersson, Ingemar
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Work experience and school worker's health evaluated by salutogenic health indicators2011In: Acta Medica Lituanica, ISSN 1392-0138, Vol. 18, no 2, p. 86-91Article in journal (Refereed)
    Abstract [en]

    Background. The aim of the study was to establish relations between work experience and health, evaluated by salutogenic health indicators, among school workers.

    Materials and methods. Teachers (n = 180) and other school workers (n = 154) from randomly selected Panevėžys district schools were questioned using instruments developed by scientists of the Kristianstad University: the Work Experience Measurement Scale (WEMS) and Salutogenic Health Indicator Scale (SHIS). The questionnaire of personal data contained questions about sociodemographic and work-related characteristics.

    The differences among the mean values were tested by the independent samples t-test and one-way ANOVA. The Cronbach’s alpha coefficient was used to check the internal consistency. The significance level was accepted at p = 0.05.

    Results. In the teachers’ group, 86.7% were females (75.3% among others), 20.4%were older than 55 years (30.7% in other goups), 18.9% held an executive position(8.5% among others). Teachers, as compared with other school workers, scored higher the domain of internal work experience, (76.9 vs. 62.8, respectively), while other school workers gave higher standardized scores for the time experience domain (71.9 vs. 63.7, p < 0.001 respectively). The SHIS scores among teachers varied from 54.7 (worst experience) to 78.0 (best experience), p < 0.001. In the group of other school workers, the SHIS mean scores varied from 51.9 to 80.0, p < 0.001.

    Conclusions. Teachers more positively evaluated the domain of internal working

    experience, while other school workers were more satisfied with time experience at the workplace. The established strong correlation between work experience and health, measured by salutogenic health indicators, encouraged the idea to implement workrelated health promotion at school.

  • 22.
    Aronsen Torp, Jenny
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Berggren, Vanja
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Erlandsson, Lena-Karin
    Department of Health Sciences , Lund University.
    Somali women's experiences of cooking and meals after immigration to Sweden2013In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 20, no 2, p. 146-159Article in journal (Refereed)
    Abstract [en]

    This article elucidates Somali women's experiences of cooking and meals after immigration to Sweden. Six Somali women participated in repeated focus group interviews. Content analysis of the interviews resulted in four themes: change in routines and content of the daily meals, changed experiences related to cooking and shopping for groceries, the social dimensions in food-related occupations, and change of identity and roles. According to the women, variety of factors related to their life in Sweden had led to changes in their food occupations and meals: environmental changes, societal factors and the fact that the women secured employment. Although their new focus on employment led to altered responsibility and time for the cooking, food-related occupations remained important for the creation of identity and the maintenance of the family. This study may inform the development of strategies to restrict the negative impacts of immigration on Somali women's health. Future research will increase understandings of the relationships between food-related occupations and women's roles, identity and health.

  • 23.
    Arvidsson, Andreas
    et al.
    Osby kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    ”Risk för undernäring”2013Other (Other (popular science, discussion, etc.))
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  • 24.
    Augustinsson, Sören
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Samhällsvetenskap. Kristianstad University, Research environment Governance, Regulation, Internationalization and Performance (GRIP.
    Petersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    On discharge planning  : dynamic complex processes – uncertainty, surprise and standardisation2015In: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 20, no 1, p. 39-53Article in journal (Refereed)
    Abstract [en]

    How can discharge planning (DP) for patients who require care in the home following a period in hospital be understood and developed through the lenses of complexity theory? With the help of complexity theory and practice-based narrative research this study discloses the formal routines and complex dynamic practices that are associated with DP. A study of the literature established that there was an almost total absence of complexity-theoretical perspectives on interpreting and developing DP.                 

    The researchers collected narratives about the DP processes using qualitative interviews with the nurses responsible for this in a hospital ward: these were audio-recorded and transcribed verbatim. They also participated in and documented meetings where these nurses, as a group, discussed DP.                 

    The findings show that nurses have to continuously deal with uncertainty, surprises and the unknown. They have to make sense and take charge of dynamic complex events and new knowledge, and manage complex relations and information. The researchers argue that looking upon practice from the lenses of complexity theory, and therefore accepting the complexity of practice, could facilitate the development of nurses' skills in order to guarantee good quality in DP.

  • 25.
    Axelsson, Lars
    et al.
    Kristianstad University, Department of Health Sciences.
    Andersson, H. Ingemar
    Kristianstad University, Department of Health Sciences.
    Edén, Lena
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Faculty of Health Science, Forskningsmiljön Man - Health - Society (MHS).
    Inequalities of quality of life in unemployed young adults: a population-based questionnaire study2007In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 6, p. 1-Article in journal (Refereed)
    Abstract [en]

    Background: It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and lifesatisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups.

    Methods: The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by χ2 test. Multivariate analysis was carried out by means of a logistic regression model.

    Results: Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making.

    Conclusion: Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development.

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  • 26.
    Axelsson, Lars
    et al.
    Kristianstad University, Department of Health Sciences.
    Andersson, Ingemar
    Kristianstad University, Department of Health Sciences.
    Håkansson, Anders
    Department of Clinical Sciences, Malmö, Family Medicine, Lund University.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Work ethics and general work attitudes in adolescents are related to quality of life, sense of coherence and subjective health: a Swedish questionnaire study2005In: BMC Public Health, E-ISSN 1471-2458, Vol. 5, p. 103-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Working life is an important arena in most people's lives, and the working line concept is important for the development of welfare in a society. For young people, the period before permanent establishment in working life has become longer during the last two decades. Knowledge about attitudes towards work can help us to understand young people's transition to the labour market. Adolescents are the future workforce, so it seems especially important to notice their attitudes towards work, including attitudes towards the welfare system. The aim of this study was to describe and analyse upper secondary school students' work attitudes, and to explore factors related to these attitudes. METHODS: The sample consisted of 606 upper secondary school students. They all received a questionnaire including questions about quality of life (QOL), sense of coherence (SOC), subjective health and attitudes towards work. The response rate was 91%. A factor analysis established two dimensions of work attitudes. Multivariate analyses were carried out by means of logistic regression models. RESULTS: Work ethics (WE) and general work attitudes (GWA) were found to be two separate dimensions of attitudes towards work. Concerning WE the picture was similar regardless of gender or study programme. Males in theoretical programmes appeared to have more unfavourable GWA than others. Multivariate analyses revealed that good QOL, high SOC and good health were significantly related to positive WE, and high SOC was positively related to GWA. Being female was positively connected to WE and GWA, while studying on a practical programme was positively related to GWA only. Among those who received good parental support, GWA seemed more favourable. CONCLUSION: Assuming that attitudes towards work are important to the working line concept, this study points out positive factors of importance for the future welfare of the society. Individual factors such as female gender, good QOL, high SOC and good health as well as support from both parents, positive experience of school and work contacts related positively to attitudes towards work. Further planning and supportive work have to take these factors into account.

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  • 27.
    Axelsson, Lars
    et al.
    Kristianstad University, Department of Health Sciences. Kristianstad University, Faculty of Health Science, Department of Nursing and Integrated Health Sciences.
    Brorsson, A.
    Håkansson, Anders
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Faculty of Health Science, Forskningsmiljön Man - Health - Society (MHS).
    Variations in perception of unemployment and actions as unemployed: interviews with sixteen young adultsManuscript (preprint) (Other academic)
  • 28.
    Axelsson, Lars
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Self-reported health, self-esteem and social support among young unemployed people: a population-based study2002In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 11, no 2, p. 111-119Article in journal (Refereed)
    Abstract [en]

    A population-based study was performed in southern Sweden in the autumn of 1998. The aim was to study connections between self-reported health, self-esteem and social support among unemployed (≥ three months) young people. The sample consisted of 264 unemployed individuals aged 20–25 years, and 528 individuals of the same age, randomly selected from the population register and not registered as unemployed. The response rate was 72%. Defined by means of factor analysis, mental health consisted of the symptoms tearfulness, dysphoria, sleeping disturbance, restlessness, general fatigue and irritability. The unemployed had more mental health problems than young people who were working or studying. Restlessness and dysphoria were significantly over-represented in the unemployed among both sexes. However, good social support seemed to predict mental health. Support from parents was most important, particularly in males. Those with low self-esteem and poor parental support were especially vulnerable.

  • 29. Badersten, Anita
    et al.
    Birkhed, D
    Lundgren, T
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Tandhälsovård1986 (ed. 1)Book (Other academic)
  • 30.
    Bala, Sidona-Valentina
    et al.
    Department of Health Sciences, Lund University.
    Samuelson, Karin
    Department of Health Sciences, Lund University.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Svensson, Björn
    Section of Rheumatology at the Institution of Clinical Science, Lund University.
    Fridlund, Bengt
    Department of Health Sciences, Lund University.
    Hesselgard, Karin
    Corpporate office, Skåne Regional Council, Malmö.
    The experience of care at nurse-led rheumatology clinics2012In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, no 4, p. 202-211Article in journal (Refereed)
    Abstract [en]

    Objective To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. Methods Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. Results Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. Conclusion The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.

  • 31.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    An intervention applying a palliative care approach in residential care: influences on nurse assistants' work situation2013Conference paper (Other academic)
    Abstract [en]

    Introduction

    Palliative care is an approach characterized by a holistic view of the person, which supports the individual for living with dignity and with the best possible level of wellbeing until the end of life. Those who, in practice, provide care in Swedish residential care facilities for older people (RCFs) are nurse assistants (NAs), a work group with limited education. They also often stand alone with difficult decisions with regards to the care provision, as the registered nurse has the role of consultant rather than leader. In an explorative qualitative study we found that NAs experienced that it was difficult to focus on relationship aspects in their work, as the main discourse in the residential care focused on tasks. Palliative care was described as something that was applied only during a short define phase i.e. last days of the residents’ life. These results were used as a basis for development of an intervention focus on a palliative care approach in RCFs. The intervention consisted of study circles with NAs, and workshops together with their leaders, focusing on improvement work.

    Aim

    To investigate how an intervention focusing on a palliative care approach in RCFs influenced the NAs and their work.

    Method

    Two quantitative studies, based on a questionnaire, including several measurements, that was answered pre-, and post- intervention and one qualitative study based on individual interviews after the intervention. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. 

    Results

    The evaluation of the intervention showed that the NAs, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives. The NAs also stated that they experienced less criticism from their superiors as well as from the residents after the intervention. However, the evaluation also showed that the NAs had a more negative view of the leadership, were more critical to the medical and the nursing care, and that their job satisfaction had decreased after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership, standing in the way of the implementation of changes.

    Conclusion

    The results indicate that the NAs, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on relationship aspects. However, in spite of the leaders’ involvement, the intervention was not sufficient for changing the organizational prerequisites for working in line with the palliative care approach. When implementing a palliative care approach in RCFs, more focus on support to the leaders in needed in order to maintain sustainable changes.

  • 32.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Att fokusera på "varandet" i en värld av görande: stöd till personalen i ett palliativt förhållningssätt vid vård- och omsorgsboende för äldre2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to study nurse assistants’ experience of palliative care and to investigate how an intervention with a focus on a palliative care approach in residential care facilities influenced the nurse assistants and their work situation. The thesis is based on two qualitative and two quantitative studies, focusing on nurse assistants working at residential care facilities for older people. The qualitative studies were based on focus-group interviews before the intervention (I) and individual interviews after the intervention (IV). The quantitative studies (II, III) were based on a questionnaire, including several measurements, that was answered pre-, and post- intervention. The intervention consisted of study circles with nurse assistants, and workshops together with their leaders, focusing on improvement work. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. The results show that the nurse assistants experienced that it was difficult to focus on “being”, i.e. on relationship aspects in their work, since the main discourse in residential care focused on “doing”, i.e. on task oriented aspects. Palliative care was described as something that was only applied during a short and defined phase, namely the very last days of the residents’ life. The results also show that nurse assistants experienced difficulties facing emotional and existential issues with regards to both the residents and their relatives (I). The results of study I were, in turn, used as a basis for the development of the intervention. The evaluation of the intervention showed that the nurse assistants, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives (III). The nurse assistants also stated that they experienced less criticism from their superiors as well as from the residents after the intervention (II). However, the evaluation also showed that the nurse assistants had a more negative view of the leadership (II), were more critical to the medical and the nursing care (III), and that their job satisfaction had decreased (II) after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership (IV), standing in the way of the implementation of changes. The results indicate that the nurse assistants, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on “being”, i.e. on relationship aspects. However, it would seem that essential prerequisites, such as support from the leaders and sufficient resources for working in line with a palliative care approach, were not provided. When implementing a palliative care approach in residential care facilities, more focus on support to the leaders is needed in order to maintain sustainable changes.

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  • 33.
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Stödet till personalen vid vård- och omsorgsboende är avgörande för deras möjlighet att möta äldre personers situation och behov2013In: Tidningen Ä, en tidning för Riksföreningen Sjuksköterskan inom Äldrevård, no 4, p. 16-19Article in journal (Other academic)
  • 34.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Runeson, Ingrid
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    To find inner peace: soft massage as an established and integrated part of palliative care2009In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 15, no 11, p. 541-545Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to demonstrate how people with incurable cancer experienced soft massage in a palliative care setting in which massage was used as an established and integrated part of the nursing care. To reach a deep understanding of the experiences of receiving soft massage a qualitative method with a phenomenological approach was chosen. The study was based on interviews with eight patients in an advanced home care setting who had all received soft massage as part of their daily care. Soft massage was experienced by the informants as a way to find inner peace. During the massage the patients felt dignified, while memories from past massage sessions were about becoming free. These experiences of dignity and freedom brought hopes for the future. The conclusion is that soft massage ought to be offered in the ordinary palliative care. More research is needed to understand what is needed to integrate and establish methods such as soft massage in the palliative care.

  • 35.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Lunds universitet & Vårdalinstitutet .
    Törnquist, A
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society.
    Nurse assistants’ experience of an intervention focused on a palliative care approach to frail older people in residential care2011Conference paper (Other academic)
  • 36.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Lunds universitet & Vårdalinstitutet .
    Törnquist, A
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society.
    Nurses’ experience of palliative care in nursing homes2010Conference paper (Other academic)
  • 37.
    Beck, Ingela
    et al.
    Lund University.
    Törnquist, Agneta
    Lund University.
    Broström, Linus
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Having to focus on doing rather than being: nurse assistants' experience of palliative care in municipal residential care settings2012In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 49, no 4, p. 455-464Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Palliative care should be provided, irrespective of setting to all patients facing a life-threatening illness and to their families. The situation and needs of older people differ from those of younger people since they often have several co-existing diseases and health complaints. This implies an extensive need for care and for longer periods of palliative care. The main providers of palliative care for older people are nurse assistants, who are also those with the shortest education. AIM: The aim of this study was to illuminate nurse assistants' experience of palliative care for older people in residential care. DESIGN: The study had an explorative, descriptive design. SETTINGS: Thirteen residential care units in three different districts in a large city in southern Sweden. PARTICIPANTS: Twenty-five nurse assistants selected to represent variations in age, gender workplace and work experience. METHODS: Data were collected from six focus-group interviews and subjected to content analysis to gain an understanding of the phenomenon. RESULTS: The nurse assistants described palliative care as a contrast to the everyday care they performed in that they had a legitimate possibility to provide the care needed and a clear assignment in relation to relatives. Palliative care also meant having to face death and dying while feeling simultaneous that it was unnatural to talk about death and having to deal with their own emotions. They emphasised that they were in need of support and experienced leadership as invisible and opaque, but gained strength from being recognized. CONCLUSION: In order to support nurse assistants in providing high quality end-of-life care, more focus is needed on the trajectory of older peoples' dying, on the importance of involving relatives throughout the period of care provision, and on support when encountering death and dying. There is also a need for engaged care leaders, both registered nurses and managers, to recognize the work of nurse assistants and to support care provision for older people within the framework of palliative care philosophy.

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  • 38.
    Bengtsson Tops, Anita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Våld mot kvinnor med psykisk funktionsnedsättning på grund av psykossjukdom2013In: Våld mot kvinnor med funktionsnedsättning, Uppsala: Nationellt centrum för kvinnofrid (NCK), Uppsala universitet , 2013, p. 75-89Chapter in book (Other academic)
  • 39.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hansson, Lars
    Lunds universitet.
    Clinical and social changes in severely mentally ill individuals admitted to an outpatient psychosis team: an 18-month follow-up study2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 1, p. 3-11Article in journal (Refereed)
    Abstract [en]

    Aim: The study investigated clinical and social changes during an 18-month follow-up period in a group (n = 76) of schizophrenic outpatients admitted to a newly implemented outpatient psychosis team. Changes related to level of contact with the psychosis team were also examined as well as aspects of the content of the treatment interventions and work situation from a staff perspective. Methods: Structured face-to-face interviews with the patients were performed at baseline and after 18 months. The Camberwell Assessment of Need instrument, the Lancashire Quality of Life Profile and the Interview Schedule for Social Interaction were used on both interview occasions along with Global Assessment of Functioning Scale and Brief Psychiatric Rating Scale. Thematic open-ended questions were used in staff interviews. Results: Psychiatric symptoms, number of needs and number of met needs decreased, and perceived quality of life improved for the total sample during the follow-up period. Patients only in contact with a psychiatrist in the psychosis team improved more in symptoms and spent fewer days in hospital during follow-up time compared with those who had combined psychiatric and supportive contacts, and were also more satisfied with their medication. Patients with a combined contact deteriorated in psychosocial functioning compared with the group only in contact with a psychiatrist. Some of the elements in treatment interventions and work situation as well as hindrances in providing community-based care adapted to the patients' needs were identified. Conclusions: Community-based psychiatric services, to a larger extent, need to embrace evidence-based interventions and to perform regular, structured and comprehensive need assessments in order to ensure the effectiveness of interventions. Attention should be paid to staff motivation and education as well as to providing practical guidelines, supervision and support.

  • 40.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hansson, Lars
    Landlords experiences of tenants sufferingfrom severe mental illness2013In: Recovery-Oriented Mental Health Services: Therapeutic, Organisational and Economic challenges, 2013, p. 194-Conference paper (Other academic)
    Abstract [en]

    Background/Objectives

    Persons suffering from severe mental illness (SMI) live – and prefer to live – independently, in either private or public apartment blocks without on-site services. Living in own apartments increase feelings of safety and well-being and function as a robust social status marker. Landlords are important actors in gaining stability and sustainability and it has been found that landlords have a plethora of preconceptions, attitudes, emotions as well as well as ethical dilemmas in offering apartments to this group of persons. Today there is a lack systematic knowledge about the role landlords have come play in providing sustainable housing for these persons. The main aim of this qualitative study was to describe landlords’ experiences of having tenant suffering from SMI

    Methods

    Sixteen landlords in various parts of Sweden participated in open in-depth interviews three years after the government proclaimed a vision zero regarding homelessness among individuals with SMI. Data was subjected to thematic latent content analysis.

    Results

    Landlords experienced being confronted with difficult circumstances such as mismanagement of apartments, sensitivity and provocative behaviors in relation to both tenants with SMI and neighbors. In acute situations landlords tried to collaborate with the community based psychiatric service system but were neglected. As a result and without the knowledge of how to best help they started to provide support to tenants with SMI involving going beyond professional boarders.

    Discussion/Conclusion

    The findings give reasons to conclude that community-based psychiatric services need to be more pro-active in their collaboration with landlords. Also education interventions with a focus on how to best help tenants with SMI need to be developed and implemented.

  • 41.
    Berg, Agneta
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Clausson, Eva K.
    Kristianstad University, School of Health and Society.
    Yrkesmässig handledning för skolsköterskor2012In: Skolsköterskans hälsofrämjande arbete / [ed] Eva K Clausson och Siv Morberg, Lund: Studentlitteratur, 2012, p. 205-219Chapter in book (Other academic)
  • 42.
    Berg, Agneta
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Katajisto, Jouko
    University of Turku, Department of Mathematics and Statistics.
    Suhonen, Riitta
    University of Turku, Department of Nursing Science.
    A comparison between orthopaedic nurses’ and patients’ perception of individualised care2012In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 16, no 3, p. 136-146Article in journal (Refereed)
    Abstract [en]

    This exploratory study compares orthopaedic nurses’ perceptions of individualised nursing care with previously published orthopaedic patients’ perceptions. Orthopaedic nurses (N = 243) from one university, two central and two county hospitals working within in-patient care were surveyed using the Individualised Care Scale-Nurse (ICS-Nurse) in 2009 (response rate 74%, n = 180). The data were analysed using both descriptive and inferential statistics. About 60% of the nurses stated that it was very important that the care provided is individualised in comparison with 86% of the patients as previously reported (p-value <0.001). The highest rated assessment of individualised care was the clinical situation and the lowest the personal life situation which is in line with the patients’ experiences. This result demonstrates the need of managers in healthcare organisations to redouble their efforts in the implementation of individualised care by investigating nurses’ contemporary beliefs about, and forces that hinder the provision of individualised nursing care.

  • 43.
    Berg, Agneta
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Care Research and Development Unit, Kristianstad College for Health Professions.
    Welander Hansson, Ulla
    Hallberg R, Ingalill
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care: comparisons between a ward for severely demented patients and a similar control ward1994In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 20, no 4, p. 742-749Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support.

  • 44.
    Berggren, Vanja
    et al.
    Karolinska Institute.
    Bergström, Staffan
    Karolinska Institute.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden2006In: Journal of Transcultural Nursing, ISSN 1043-6596, E-ISSN 1552-7832, Vol. 17, no 1, p. 50-57Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to explore the encounters with the health care system in Sweden of women from Somalia, Eritrea, and Sudan who have been genitally cut. A qualitative study was performed through interviews with 22 women originally from Somalia, Sudan, and Eritrea who were living in Sweden. The women experienced being different and vulnerable, suffering from being abandoned and mutilated, and they felt exposed in the encounter with the Swedish health care personnel and tried to adapt to a new cultural context. The results of this study indicate a need for more individualized, culturally adjusted care and support and a need for systematic education about female genital cutting for Swedish health care workers.

  • 45.
    Berggren, Vanja
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE. Kristianstad University, Forskningsmiljön Mat, måltid, hälsa i 24-timmarsperspektivet.
    Gottvall, Karin
    Department of Public Health Sciences, Division of Global Health (IHCAR), Karolinska Institute.
    Isman, Elisabeth
    Department of Public Health Sciences, Division of Global Health (IHCAR), Karolinska Institute.
    Bergström, Staffan
    Department of Public Health Sciences, Division of Global Health (IHCAR), Karolinska Institute.
    Ekéus, Cecilia
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute.
    Infibulated women have an increased risk of anal sphincter tears at delivery: a population-based Swedish register study of 250 000 births2013In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 1, p. 101-108Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate the risk for anal sphincter tears (AST) in infibulated women. Design. Population-based cohort study. Setting. Nationwide study in Sweden. Population. The study population included 250 491 primiparous women with a vaginal singleton birth at 37–41 completed gestational weeks during 1999–2008. We only included women born in Sweden and in Africa. The African women were categorized into three groups; a Somalian-group, n = 929, where over 95% are infibulated; the Eritrea-Ethiopia-Sudan-group, n = 955, where the majority is infibulated, compared to other African countries, n = 1035, where few individuals are infibulated, but had otherwise similar anthropometric characteristics. These women were compared to 247 572 Swedish-born women. Methods. Register study with data from the National Medical Birth Registry. Main outcome measures. AST in non-instrumental and instrumental vaginal delivery. Results. Compared to Swedish-born women, women from Somalia had the highest odds ratio for AST in all vaginal deliveries: 2.72 (95% CI 2.08–3.54), followed by women from Eritrea-Ethiophia-Sudan 1.80 (1.41–2.32) and other African countries 1.23 (0.89–1.53) after adjustment for major risk factors. Mediolateral episiotomy was associated with a reduced risk of AST in instrumental deliveries. Conclusion. Delivering African women from countries where infibulation is common have an increased risk of AST compared with Swedish-born women, despite delivering in a highly technical quality healthcare setting. AST can cause anal incontinence and it is important to investigate risk factors for this and try to improve clinical routines during delivery to reduce the incidence of this complication.

  • 46.
    Berggren, Vanja
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsmiljön Mat, måltid, hälsa i 24-timmarsperspektivet.
    Musa Ahmed, Souad
    Ahfad University for Women, Khartoum.
    Hernlund, Y.
    Department of Anthropology, University of Washington, Seattle.
    Johansson, Eva
    Division of International Health Care Research (IHCAR), Department of Public Health, Karolinska Institutet.
    Habbani, B.
    Ahfad University for Women, Khartoum.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Being victims or beneficiaries?: perspectives on female genital cutting and reinfibulation in Sudan2006In: African Journal of Reproductive Health, ISSN 1118-4841, Vol. 10, no 2, p. 24-36Article in journal (Refereed)
    Abstract [en]

    Female Genital Mutilation (FGM) or the more value neutral term, Female Genital Cutting (FGC) is widely practised in northern Sudan, where around 90% of women undergo the most extensive form of FGC, infibulation. One new approach to combating FGC in Sudan is to acknowledge the previously hidden form of FGC, reinfibulation (RI) after delivery, when the woman is sewn back so much as to mimic virginity. Based on a qualitative study in Khartoum State, this article explores Sudanese women's and men's perceptions and experiences of FGC with emphasis on RI after delivery. The results showed that both genders blame each other for the continuation of the practices, and the comprehensive understanding of the perceptions and experiences was that both the women and the men in this study were victims of th e consequences of FGC and RI. The female narratives could be understood in the three categories: viewing oneself as being "normal" in having undergone FGC and RI; being caught between different perspectives; and having limited influence on the practices of FGC and RI. The male narratives could be understood in the three categories: suffering from the consequences of FGC and RI, trying to counterbalance the negative sexual effects of FGC and striving in vain to change female traditions. The results indicate that the complexity of the persistence of FGC and RI goes far beyond being explained by subconscious patriarchal and maternalistic actions, related to socially constructed concepts of normality, female identity,tradition and religion a"silent" culture betweenmen and women.

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  • 47.
    Bergqvist, Inger
    et al.
    Centralsjukhuset Kristianstad.
    Davidsson, Lisa
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Utveckling av ett instrument för vårdtyngdsmätning inom anestesi2003In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 23, no 3, p. 10-15Article in journal (Refereed)
    Abstract [en]

    Patient classification in anaesthetic care is an undeveloped field and it is therefore urgent to construct an instrument for this purpose. The aim of the study was to develop an instrument to measure anaesthetic nursing care with focus on the unique care needed by every single patient. The Delphi technique was used. The method involved five series of inquiries to a panel of experts, consisting of ten nurses. The instrument developed, included 13 nursing care areas, with predefined alternatives graded from1 to 4, where 4 indicated high workload, and 1 indicated low workload. The instrument was tested in a pilot study and showed agreement with the clinical picture of the patients needs. An initial inter-rater reliability test showed very good agreement for all the nursing care areas. The instrument, however, needs to be tested for validity and reliability in a larger sample.

  • 48.
    Bergqvist, Inger
    et al.
    Centralsjukhuset Kristianstad.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Vårdtyngdsmätning inomanestesiologisk omvårdnad: testning av ett instrument2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 2, p. 9-14Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate validity and reliability of an instrument for patient classification in anaesthetic nursing care. The study included two parts. The first part involved two panels of experts, one internal consisting of nurse anaesthetists from the local hospital, and one external represented by nurse anaesthetists from nine different hospitals in Sweden and one in Iceland. The internal experts gave suggestions for improvements of the existing instrument. Thereafter the external experts gave their opinion about both the internal panels elucidation as well as the existing instrument. The instrument was thereafter adjusted in concordance to their suggestions. The second part involved an investigation of the inter-rater reliability, with one hundred double ratings before the changes in the instrument and one hundred ratings after the changes in the instrument. Statistical analyses for inter-rater reliability were performed with Spearmans correlation coefficient. The first assessment showed good inter-rater reliability in four of thirteen items, while the inter-rater reliability on the second version showed good agreement in eleven of thirteen items. Results indicated that the changes in the instrument were positive in terms of reliability. The instrument thus improved in terms of validity and reliability and may be of use in anaesthetic wards with similar context.

  • 49.
    Berlin Hallrup, Leena
    et al.
    Linnéuniversitetet.
    Heikkilä, Kristiina
    Linnéuniversitetet.
    Bengtsson Tops, Anita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Care workers’ experiences of working in a Swedish institutional care setting2010In: Learning Disability Practice, ISSN 1465-8712, Vol. 13, no 7, p. 21-25Article in journal (Refereed)
    Abstract [en]

    Despite the general move to support people with learning disabilities in their own homes or in home-like settings, many institutional settings still exist and little research has been carried out on the role of the care workers who work in them. In this study, participant observations over a 16-month period describe care workers’ experiences of working in an institutional care setting in Sweden, and 18 care workers were interviewed. The three main themes to emerge from the thematic analysis were: care workers were engaged in creating a family-like atmosphere; they were engaged in making the everyday ordered and structured; and they were exposed to stress factors.It became evident that care workers need additional support, training and opportunities for reflection to handle their complex work situation

  • 50.
    Björklund, Margereth
    et al.
    Kristianstad University, School of Health and Society.
    Sarvimäki, Anneli
    The Nordic School of Public Health, Gothenburg.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Health promotion and empowerment from the perspective of individuals living with head and neck cancer2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 1, p. 26-34Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"

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