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Johansson LM, Eriksson M, Dahlin S, Lingfors H, Golsäter M. Healthcare professionals' experiences of targeted health dialogues in primary health care. Scand J Caring Sci 2024; 38:231-239. [PMID: 37749903 DOI: 10.1111/scs.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/19/2023] [Accepted: 09/03/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND In Sweden, population-based targeted health dialogues are an important part of health promotion and disease prevention in primary health care. Targeted health dialogues are performed with a pedagogical approach to allow individuals to reflect over their resources, situation and motivation to change lifestyle habits together with a healthcare professional. AIM The aim of this study was to explore healthcare professionals' experiences of targeted health dialogues in primary health care. METHODS Three focus group interviews were conducted with 20 healthcare professionals. The interviews were analysed using qualitative content analysis. RESULTS The main category A possibility to promote healthy behaviours and prevent disease describes how the targeted health dialogues were experienced as a valuable opportunity to promote health among inhabitants. The significance of the primary healthcare centre's health promotion and prevention strategies was emphasised to enable the targeted health dialogues as a part of the assignment to promote health. These strategies were expressed as shared focus and organisational space and support making it possible for example to reach all socioeconomic groups. The work with targeted health dialogue was described as a complex task requiring extensive competence. Furthermore, the pedagogical tool including the visual health profile was experienced to have an important impact on the dialogue offering direction for actions to promote health and prevent disease. CONCLUSIONS Targeted health dialogues can be a valuable opportunity for healthcare professionals in primary health care to promote a healthy lifestyle among inhabitants. Certain preconditions at both the meso- and the micro level is however required for this to come about.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
- The Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marit Eriksson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Sofia Dahlin
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
- Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Marie Golsäter
- Associate Professor, Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Child Health Services, Region Jönköping County, Jönköping, Sweden
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Johansson LM, Lingfors H, Golsäter M, Kristenson M, Fransson EI. Physical activity related to mastery and vitality in a Swedish adult population with economic difficulties. BMC Public Health 2021; 21:2193. [PMID: 34847894 PMCID: PMC8638203 DOI: 10.1186/s12889-021-12194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background People with low socio-economic status report lower levels of physical activity (PA). There is insufficient knowledge about the availability of psychological resources for those who are physically active despite having a low socio-economic status. The aim of this study is to investigate the association between PA level and mastery and vitality, respectively, within an adult population with self-reported economic difficulties. Method Data from a cross-sectional, population-based study (n = 817) were used. Linear regression was used to estimate the unstandardised regression coefficient (β) with 95% confidence intervals (95% CI), describing associations between PA levels (independent variable) and scale scores of psychological resources in terms of mastery and vitality (outcome variables). Three models were constructed: Model I unadjusted; Model II adjusted for sex and age; and Model III adjusted for sex, age, smoking and food quality. Result After adjusting for sex, age, smoking and food quality and using low-level PA as the reference, high-level PA, but not intermediate-level PA, was related to higher scale scores of mastery (β = 0.72 [95% CI 0.08 to 1.37]). For vitality, both high-level PA and intermediate-level PA were related to higher scale scores (β = 9.30 [95% CI 5.20 to 13.40] and β = 6.70 [95% CI 1.40 to 12.00] respectively). Conclusion In an adult population with self-reported economic difficulties, higher levels of physical activity were related to higher mastery and vitality. Our results support that the association between physical activity and psychological resources in terms of mastery and vitality should be considered in the context of targeted health dialogues. Trial registration number Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12194-6.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden. .,Linköping University, Linköping, Sweden. .,The A.D.U.L.T. Research Group, School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden.
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.,Linköping University, Linköping, Sweden
| | - Marie Golsäter
- Linköping University, Linköping, Sweden.,Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Margareta Kristenson
- Unit for Health, Medicine and Care, Department of Medicine and Health, Linköping University, Linköping, Sweden
| | - Eleonor I Fransson
- The A.D.U.L.T Research Group, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Johnsson A, Wagman P, Boman Å, Pennbrant S. What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people-An ethnographic study. J Clin Nurs 2018; 27:e1651-e1659. [PMID: 29493840 DOI: 10.1111/jocn.14315] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Anette Johnsson
- Department of Health Sciences; University West; Trollhättan Sweden
- School of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Petra Wagman
- Department of Rehabilitation; School of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Åse Boman
- Department of Health Sciences; University West; Trollhättan Sweden
| | - Sandra Pennbrant
- Department of Health Sciences; University West; Trollhättan Sweden
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Andersson S, Svanström R, Ek K, Rosén H, Berglund M. ‘The challenge to take charge of life with long-term illness’: nurses' experiences of supporting patients' learning with the didactic model. J Clin Nurs 2015; 24:3409-16. [DOI: 10.1111/jocn.12960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - Rune Svanström
- School of Health and Education; University of Skövde; Skövde Sweden
| | - Kristina Ek
- School of Health and Education; University of Skövde; Skövde Sweden
| | - Helena Rosén
- Health Sciences; University of Lund; Lund Sweden
| | - Mia Berglund
- School of Health and Education; University of Skövde; Skövde Sweden
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Nymberg P, Drevenhorn E. Patients’ experience of a nurse-led lifestyle clinic at a Swedish health centre. Scand J Caring Sci 2015; 30:349-55. [DOI: 10.1111/scs.12254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 05/12/2015] [Indexed: 12/01/2022]
Affiliation(s)
| | - Eva Drevenhorn
- Department of Health Sciences; Faculty of Medicine; University of Lund; Lund Sweden
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Johnson JE, Gulanick M, Penckofer S, Kouba J. Does knowledge of coronary artery calcium affect cardiovascular risk perception, likelihood of taking action, and health-promoting behavior change? J Cardiovasc Nurs 2015; 30:15-25. [PMID: 24434820 DOI: 10.1097/jcn.0000000000000103] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence indicates that a healthy lifestyle can reduce cardiovascular disease risk, yet many people engage in unhealthy behaviors. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Knowledge of an abnormal finding could provide the "teachable moment" to enhance motivation for change. OBJECTIVE The aim of this study was to examine how knowledge of CAC score affects risk perception, likelihood of taking action, and health-promoting behavior change in persons at high risk for cardiovascular disease. METHODS This study used a descriptive prospective design with 174 high-risk adults (≥3 major risk factors) recruited at a radiology center offering CAC scans. Baseline self-report surveys using the Perception of Risk of Heart Disease Scale, the Benefits and Barriers Scale, the Quality of Life Index, and the Health-Promoting Lifestyle Profile II were completed immediately after a screening CAC scan but before results were known. Follow-up occurred 3 months later using mailed packets. RESULTS Participants' mean age was 58 years; 62% were men, 89% were white, and most were well educated. There was no significant change in risk perception scores over time or between groups, except for a positive interaction in the moderate-risk group (CAC scores of 101-400) (P = .004). Quality of life remained unchanged. Health-promoting behavior changes increased in all groups over time (P < .001). McNemar χ² analysis indicated that risk reduction medication use increased in all groups, with a significant increase in statin (P < .001) and aspirin (P < .001) intake. Predictors of behavior change were perceived barriers (β = -.41; P < .001) and quality of life (β = .44; P < .001). CONCLUSIONS Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC scoring on behavior change, nurses can better assist patients to modify behaviors during teachable moments.
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Affiliation(s)
- Jennie E Johnson
- Jennie E. Johnson PhD, RN-BC Lifestyle Counselor, Owner, Living For A Healthy Heart, LLC, Post Falls, Idaho. Meg Gulanick, PhD, APRN, FAAN Professor Emeritus, Niehoff School of Nursing, Loyola University, Chicago, Illinois. Sue Penckofer, PhD, RN, FAAN Professor and Loyola Faculty Scholar, Niehoff School of Nursing, Loyola University, Chicago, Illinois. Joanne Kouba, PhD, RD, LDN Director, Dietetics Programs, Niehoff School of Nursing, Loyola University, Chicago, Illinois
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Brobeck E, Bergh H, Odencrants S, Hildingh C. Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education? Scand J Caring Sci 2014; 29:118-25. [PMID: 24712639 DOI: 10.1111/scs.12139] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 03/08/2014] [Indexed: 11/29/2022]
Abstract
Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change.
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Affiliation(s)
- Elisabeth Brobeck
- Department of Research, Development and Education, Halmstad, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Hörnsten Å, Lindahl K, Persson K, Edvardsson K. Strategies in health-promoting dialogues--primary healthcare nurses' perspectives--a qualitative study. Scand J Caring Sci 2013; 28:235-44. [PMID: 23594185 DOI: 10.1111/scs.12045] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 03/20/2013] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES The aim of this study was to describe dialogic strategies about health and lifestyle used by primary healthcare nurses (PHNs) in the Västerbotten Intervention Programme (VIP) in Sweden. BACKGROUND The VIP offers all citizens aged 40, 50 and 60 in Västerbotten County an individual health check-up followed by a health-promoting dialogue with a specialist PHN. Inconsistencies in previous reports of the effects of lifestyle counselling and health promotion suggest that it is important to study dialogues about health and lifestyle to understand health-promoting strategies and to highlight aspects important to improving their effects. METHOD In 2010, we conducted in-depth interviews with ten experienced PHNs working with the VIP at eight healthcare centres in Västerbotten County, Sweden. Qualitative content analysis was used to illuminate the nurses' strategies in health-promoting dialogues. The Regional Ethics Board (Dno 06-126M) approved the study. RESULTS The PHNs used various strategies in dialogues about health and lifestyle that fell under the five themes 'Guiding patients vs. pressuring them; Adjusting to patients vs. directing the conversation; Inspiring confidence vs. instilling fear; Motivating and supporting patients vs. demanding responsibility; and lastly, Introducing emotionally charged subjects or avoiding them'. CONCLUSIONS The results of this study may add knowledge about the difficulties and opportunities in health counselling. In the discussion, we suggest professional reflection as a means to increase knowledge and awareness about the self and context in the process of health counselling.
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Affiliation(s)
- Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
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Bergelin E, Lundgren SM. ‘Patients' experiences of seeing their obesity in CT images allow for an active self-care: a qualitative study’. Scand J Caring Sci 2013; 28:122-9. [DOI: 10.1111/scs.12029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 12/17/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Eva Bergelin
- Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
| | - Solveig M. Lundgren
- Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
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Gustafsson LK, Snellma I, Gustafsson C. The meaningful encounter: patient and next-of-kin stories about their experience of meaningful encounters in health-care. Nurs Inq 2012. [DOI: 10.1111/nin.12013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Golsäter M, Sidenvall B, Lingfors H, Enskär K. Adolescents' and school nurses' perceptions of using a health and lifestyle tool in health dialogues. J Clin Nurs 2011; 20:2573-83. [PMID: 21752132 DOI: 10.1111/j.1365-2702.2011.03816.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE To describe and explore adolescents' and nurses' perceptions of using a health and lifestyle tool in health dialogues in the School Health Service. BACKGROUND In Sweden, dialogues concerning health and lifestyle are offered to adolescents aged 14 years with the purpose of encouraging an interest in a healthy lifestyle. A health and lifestyle tool including a health questionnaire and a health profile has recently been developed, with the aim of facilitating the communication about health and lifestyle in these dialogues. DESIGN Qualitative descriptive design. METHOD Twenty-nine adolescents and 23 nurses participated in focus group interviews, which were subjected to qualitative content analysis. RESULTS The health and lifestyle tool was perceived as constituting a structure for the dialogues and as a clear and applicable starting point, focusing on individual aspects. The tool contributed to an understanding of the health situation and to the transmittal of health information on an individual as well as a group level. CONCLUSION The tool was perceived as constituting a useful structure for the dialogues about health and lifestyle. When it was used the individual's health and lifestyle were concretised, which opened up for a dialogue and different aspects of health and lifestyle were detected. However, in some cases the outcome of the tool could be conceived as a stringent assessment and thereby complicate the dialogues. RELEVANCE TO CLINICAL PRACTICE The use of a tool, such as the one used in this study, is one way to improve the dialogues in the School Health Service, allowing them to be more focused on the individual's needs and to detect aspects that would otherwise not be so easily detected. The implications of this study include using the findings to guide counselling sessions in the schools and other health care settings.
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Affiliation(s)
- Marie Golsäter
- CHILD Research Group, Research School of Health and Welfare, School of Health Science, Jönköping University, Jönköping, Sweden.
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