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Acute alcohol consumption and motivation to reduce drinking among injured patients in a Swedish emergency department.

https://arctichealth.org/en/permalink/ahliterature120290
Source
J Addict Nurs. 2012 Oct;23(3):152-8
Publication Type
Article
Date
Oct-2012
Author
Anna Trinks
Karin Festin
Preben Bendtsen
Cheryl J Cherpitel
Per Nilsen
Author Affiliation
Anna Trinks, MSc, Karin Festin, PhD, Preben Bendtsen, PhD, and Per Nilsen, PhD, Department of Medical and Health Sciences, Linköping, Sweden. Cheryl J. Cherpitel, DrPH, Alcohol Research Group, Berkeley, California.
Source
J Addict Nurs. 2012 Oct;23(3):152-8
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Binge Drinking - epidemiology - psychology
Emergency Service, Hospital - statistics & numerical data
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Motivation
Prevalence
Risk factors
Sweden - epidemiology
Wounds and Injuries - epidemiology
Young Adult
Abstract
Injuries constitute a major public health problem. Millions of people are injured each year, and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. This study aims to investigate the prevalence of acute alcohol consumption (drinking before the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. All patients aged 18-69 years were requested to answer alcohol-related questions on a touchscreen computer. Fifteen percent of injured patients were categorized as acute drinkers, and of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and nonacute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than nonacute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than nonacute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than nonacute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the nonacute drinkers. Acute drinkers had considerably more detrimental alcohol consumption than nonacute drinkers, and the acute drinkers were more motivated to reduce their drinking than the nonacute drinkers.
Notes
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PubMed ID
24335731 View in PubMed
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Adverse events in spine surgery in Sweden: a comparison of patient claims data and national quality register (Swespine) data .

https://arctichealth.org/en/permalink/ahliterature129817
Source
Acta Orthop. 2011 Dec;82(6):727-31
Publication Type
Article
Date
Dec-2011
Author
Annica Ohrn
Anders Olai
Hans Rutberg
Per Nilsen
Hans Tropp
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Sweden. annica.ohrn@lio.se
Source
Acta Orthop. 2011 Dec;82(6):727-31
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Disability Evaluation
Dura Mater - injuries
Female
Humans
Insurance Claim Review
Male
Orthopedic Procedures - adverse effects - methods - standards
Outcome Assessment (Health Care)
Prosthesis Failure
Quality Assurance, Health Care
Registries
Reoperation
Spinal Diseases - surgery
Spinal Nerves - injuries
Spine - surgery
Surgical Wound Infection - etiology
Sweden
Abstract
Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine).
We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 2005. The medical records of the patients filing these claims were reviewed and compared with Swespine data for the same period.
Two-thirds (119/182, 65%) of patients who claimed economic compensation from the insurance company were registered in Swespine. Of the 210 complications associated with these 182 claims, only 74 were listed in Swespine. The most common causes of compensated injuries (n = 139) were dural lesions (n = 40) and wound infections (n = 30). Clinical outcome based on global assessment, leg pain, disability, and quality of health was worse for patients who claimed economic compensation than for the total group of Swespine patients.
We found considerable under-reporting of complications in Swespine. Dural lesions and infections were not well recorded, although they were important reasons for problems and contributed to high levels of disability. By analyzing data from more than one source, we obtained a better understanding of the patterns of adverse events and outcomes after spine surgery.
Notes
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PubMed ID
22066564 View in PubMed
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Alcohol assessment and feedback by email for university students: main findings from a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature107016
Source
Br J Psychiatry. 2013 Nov;203(5):334-40
Publication Type
Article
Date
Nov-2013
Author
Jim McCambridge
Marcus Bendtsen
Nadine Karlsson
Ian R White
Per Nilsen
Preben Bendtsen
Author Affiliation
Jim McCambridge, PhD, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK; Marcus Bendtsen, MSc, Department of Medicine and Health, and Department of Computer and Information Science, Linköping University, Linköping, Sweden; Nadine Karlsson, PhD, Department of Medicine and Health, Linköping University, Linköping, Sweden; Ian R. White, PhD, MRC, Biostatistics Unit, Institute of Public Health, Cambridge, UK; Per Nilsen, PhD, Preben Bendtsen, PhD, Department of Medicine and Health, Linköping University, Linköping, Sweden.
Source
Br J Psychiatry. 2013 Nov;203(5):334-40
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcohol Drinking - prevention & control - psychology
Binge Drinking - diagnosis - prevention & control - psychology
Electronic Mail
Feedback, Psychological
Female
Humans
Intention to Treat Analysis
Internet
Male
Outcome Assessment (Health Care) - statistics & numerical data
Students - psychology - statistics & numerical data
Sweden
Universities
Young Adult
Abstract
Brief interventions can be efficacious in changing alcohol consumption and increasingly take advantage of the internet to reach high-risk populations such as students.
To evaluate the effectiveness of a brief online intervention, controlling for the possible effects of the research process.
A three-arm parallel groups design was used to explore the magnitude of the feedback and assessment component effects. The three groups were: alcohol assessment and feedback (group 1); alcohol assessment only without feedback (group 2); and no contact, and thus neither assessment nor feedback (group 3). Outcomes were evaluated after 3 months via an invitation to participate in a brief cross-sectional lifestyle survey. The study was undertaken in two universities randomising the email addresses of all 14 910 students (the AMADEUS-1 study, trial registration: ISRCTN28328154).
Overall, 52% (n = 7809) of students completed follow-up, with small differences in attrition between the three groups. For each of the two primary outcomes, there was one statistically significant difference between groups, with group 1 having 3.7% fewer risky drinkers at follow-up than group 3 (P = 0.006) and group 2 scoring 0.16 points lower than group 3 on the three alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) (P = 0.039).
This study provides some evidence of population-level benefit attained through intervening with individual students.
PubMed ID
24072758 View in PubMed
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Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study.

https://arctichealth.org/en/permalink/ahliterature284184
Source
BMC Public Health. 2016 Aug 02;16:694
Publication Type
Article
Date
Aug-02-2016
Author
Hjördis Högberg
Janna Skagerström
Fredrik Spak
Per Nilsen
Margareta Larsson
Source
BMC Public Health. 2016 Aug 02;16:694
Date
Aug-02-2016
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking
Attitude to Health
Binge drinking
Counseling
Cross-Sectional Studies
Ethanol - administration & dosage
Fathers
Female
Humans
Male
Midwifery
Motivation
Patient satisfaction
Pregnancy
Pregnant Women
Prenatal Care
Sexual Partners
Social Behavior
Surveys and Questionnaires
Sweden
Abstract
Antenatal care in Sweden involves a visit in pregnancy week 6-7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife's counseling about alcohol.
The study was conducted at 30 antenatal care centers across Sweden in 2009-2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption.
Questionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p?=?0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife's counseling on alcohol.
A majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife's talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking, also for the partners. Written information addressing alcohol use and directed to partners is needed.
Notes
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PubMed ID
27484750 View in PubMed
Less detail

Alcohol email assessment and feedback study dismantling effectiveness for university students (AMADEUS-1): study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature124868
Source
Trials. 2012;13(1):49
Publication Type
Article
Date
2012
Author
Jim McCambridge
Preben Bendtsen
Marcus Bendtsen
Per Nilsen
Author Affiliation
Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. Jim.McCambridge@lshtm.ac.uk
Source
Trials. 2012;13(1):49
Date
2012
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control - psychology
Alcoholic Intoxication - prevention & control - psychology
Deception
Electronic Mail
Feedback, Psychological
Humans
Patient Selection
Preventive Health Services
Questionnaires
Research Design
Risk Reduction Behavior
Risk-Taking
Student Health Services
Students - psychology
Sweden
Therapy, Computer-Assisted
Time Factors
Treatment Outcome
Abstract
Alcohol causes huge problems for population health and for society, which require interventions with individuals as well as populations to prevent and reduce harms. Brief interventions can be effective and increasingly take advantage of the internet to reach high-risk groups such as students. The research literature on the effectiveness of online interventions is developing rapidly and is confronted by methodological challenges common to other areas of e-health including attrition and assessment reactivity and in the design of control conditions.
The study aim is to evaluate the effectiveness of a brief online intervention, employing a randomized controlled trial (RCT) design that takes account of baseline assessment reactivity, and other possible effects of the research process. Outcomes will be evaluated after 3 months both among student populations as a whole including for a randomized no contact control group and among those who are risky drinkers randomized to brief assessment and feedback (routine practice) or to brief assessment only. A three-arm parallel groups trial will also allow exploration of the magnitude of the feedback and assessment component effects. The trial will be undertaken simultaneously in 2 universities randomizing approximately 15,300 students who will all be blinded to trial participation. All participants will be offered routine practice intervention at the end of the study.
This trial informs the development of routine service delivery in Swedish universities and more broadly contributes a new approach to the study of the effectiveness of online interventions in student populations, with relevance to behaviors other than alcohol consumption. The use of blinding and deception in this study raise ethical issues that warrant further attention.
ISRCTN28328154.
Notes
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PubMed ID
22540638 View in PubMed
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Alcohol prevention in Swedish antenatal care: effectiveness and perceptions of the Risk Drinking project counseling model.

https://arctichealth.org/en/permalink/ahliterature125722
Source
Acta Obstet Gynecol Scand. 2012 Jun;91(6):736-43
Publication Type
Article
Date
Jun-2012
Author
Per Nilsen
Janna Skagerström
Mikael Rahmqvist
Eva Hultgren
Marie Blomberg
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. per.nilsen@liu.se
Source
Acta Obstet Gynecol Scand. 2012 Jun;91(6):736-43
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Alcohol Drinking - epidemiology - prevention & control
Attitude to Health
Cohort Studies
Counseling
Female
Humans
Logistic Models
Parity
Pregnancy
Prenatal Care
Questionnaires
Sweden - epidemiology
Young Adult
Abstract
To compare an earlier Swedish antenatal care counseling routine concerning alcohol consumption with an expanded model in terms of effectiveness in achieving abstinence in pregnancy. A further objective was to assess the women's perceptions of the alcohol counseling.
Cohort study.
Antenatal care center in a provincial Swedish university town.
Women who received alcohol counseling; 1533 in cohort 1 (routine counseling) and 1476 in cohort 2 (expanded model). Approximately 93% of all pregnant women in Linköping are registered at this center.
Data were collected by means of an anonymous questionnaire. Thirteen questions in the questionnaire were analysed for this study.
Replies from three questions concerning pre-pregnancy drinking and three questions on drinking during pregnancy.
The response rate was 60% for cohort 1 and 64% for cohort 2. Perceptions of the advice from the antenatal care center were generally favorable. Similar proportions of women, approximately 6%, in both cohorts drank at least once during the pregnancy (after pregnancy recognition). There were four predictors for drinking during pregnancy: older age; having previously given birth to a child; frequency of pre-pregnancy drinking; and perceiving the message from antenatal care as "small amounts of alcohol during pregnancy don't matter."
An expanded counseling model implemented in Swedish antenatal care did not reduce the proportion of women who continued drinking during pregnancy in comparison with a previous counseling model, although the advice provided in the new model was perceived more favorably.
PubMed ID
22458909 View in PubMed
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Applying self-determination theory for improved understanding of physiotherapists' rationale for using research in clinical practice: a qualitative study in Sweden.

https://arctichealth.org/en/permalink/ahliterature108367
Source
Physiother Theory Pract. 2014 Jan;30(1):20-8
Publication Type
Article
Date
Jan-2014
Author
Petra Dannapfel
Anneli Peolsson
Christian Ståhl
Birgitta Öberg
Per Nilsen
Author Affiliation
Department of Medical and Health Sciences, Linköping University , Linköping , Sweden.
Source
Physiother Theory Pract. 2014 Jan;30(1):20-8
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Clinical Competence
Evidence-Based Practice
Health Knowledge, Attitudes, Practice
Humans
Interviews as Topic
Models, Psychological
Motivation
Personal Autonomy
Physical Therapists - psychology
Professional Autonomy
Professional Role
Qualitative Research
Sweden
Abstract
Physiotherapists are generally positive to evidence-based practice (EBP) and the use of research in clinical practice, yet many still base clinical decisions on knowledge obtained during their initial education and/or personal experience. Our aim was to explore motivations behind physiotherapists' use of research in clinical practice. Self-Determination Theory was applied to identify the different types of motivation for use of research. This theory posits that all behaviours lie along a continuum of relative autonomy, reflecting the extent to which a person endorses their actions. Eleven focus group interviews were conducted, involving 45 physiotherapists in various settings in Sweden. Data were analysed using qualitative content analysis and the findings compared with Self-Determination Theory using a deductive approach. Motivations underlying physiotherapists use of research in clinical practice were identified. Most physiotherapists expressed autonomous forms of motivation for research use, but some exhibited more controlled motivation. Several implications about how more evidence-based physiotherapy can be achieved are discussed, including the potential to tailor educational programs on EBP to better account for differences in motivation among participants, using autonomously motivated physiotherapists as change agents and creating favourable conditions to encourage autonomous motivation by way of feelings of competence, autonomy and a sense of relatedness.
PubMed ID
23899352 View in PubMed
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Applying the RE-AIM framework to evaluate two implementation strategies used to introduce a tool for lifestyle intervention in Swedish primary health care.

https://arctichealth.org/en/permalink/ahliterature136238
Source
Health Promot Int. 2012 Jun;27(2):167-76
Publication Type
Article
Date
Jun-2012
Author
Siw Carlfjord
Agneta Andersson
Preben Bendtsen
Per Nilsen
Malou Lindberg
Author Affiliation
Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83 Linköping, Sweden. siw.carlfjord@liu.se
Source
Health Promot Int. 2012 Jun;27(2):167-76
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Computers
Female
General Practitioners - psychology
Health Behavior
Health Promotion - methods
Humans
Life Style
Male
Nurses - psychology
Primary Health Care - methods
Sweden
Abstract
The aim of this study was to evaluate two implementation strategies for the introduction of a lifestyle intervention tool in primary health care (PHC), applying the RE-AIM framework to assess outcome. A computer-based tool for lifestyle intervention was introduced in PHC. A theory-based, explicit, implementation strategy was used at three centers, and an implicit strategy with a minimum of implementation efforts at three others. After 9 months a questionnaire was sent to staff members (n= 159) and data from a test database and county council registers were collected. The RE-AIM framework was applied to evaluate outcome in terms of reach, effectiveness, adoption and implementation. The response rate for the questionnaire was 73%. Significant differences in outcome were found between the strategies regarding reach, effectiveness and adoption, in favor of the explicit implementation strategy. Regarding the dimension implementation, no differences were found according to the implementation strategy. A theory-based implementation strategy including a testing period before using a new tool in daily practice seemed to be more successful than a strategy in which the tool was introduced and immediately used for patients.
PubMed ID
21398336 View in PubMed
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Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

https://arctichealth.org/en/permalink/ahliterature280008
Source
J Clin Nurs. 2016 Oct;25(19-20):2786-97
Publication Type
Article
Date
Oct-2016
Author
Jeanette W Kirk
Ditte M Sivertsen
Janne Petersen
Per Nilsen
Helle V Petersen
Source
J Clin Nurs. 2016 Oct;25(19-20):2786-97
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Aged
Communication Barriers
Denmark
Emergencies - nursing
Emergency Service, Hospital
Evidence-Based Medicine
Female
Focus Groups
Geriatric Assessment
Health Services for the Aged
Humans
Interviews as Topic
Male
Models, Theoretical
Nursing Assessment
Severity of Illness Index
Abstract
The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team.
A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed.
Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers.
The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described.
Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation.
Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived.
The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned.
PubMed ID
27273150 View in PubMed
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Brief interventions in routine health care: a population-based study of conversations about alcohol in Sweden.

https://arctichealth.org/en/permalink/ahliterature134996
Source
Addiction. 2011 Oct;106(10):1748-56
Publication Type
Article
Date
Oct-2011
Author
Per Nilsen
Jim McCambridge
Nadine Karlsson
Preben Bendtsen
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. per.nilsen@liu.se
Source
Addiction. 2011 Oct;106(10):1748-56
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - epidemiology - prevention & control - therapy
Alcoholism - epidemiology - prevention & control - therapy
Counseling - methods - statistics & numerical data
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health services
Humans
Logistic Models
Male
Middle Aged
Primary Health Care
Professional-Patient Relations
Questionnaires
Sweden
Time Factors
Young Adult
Abstract
To investigate how brief alcohol interventions are delivered in routine practice in the Swedish health-care system.
A cross-sectional sample of 6000 individuals representative of the adult population aged 18-64 years registered in the Swedish total population register was drawn randomly. Data were collected in 2010 by means of a mail questionnaire. The response rate was 54%.
The questionnaire consisted of 27 questions, of which 15 variables were extracted for use in this study. Whether alcohol had been discussed and the duration, contents, experiences and effects of any conversations about alcohol, as reported by patients themselves, were assessed.
Sixty-six per cent of the respondents had visited health-care services in the past 12 months and 20% of these had had one or more conversations about alcohol during these visits (13% of the population aged 18-64 years). The duration of the conversations was generally brief, with 94% taking less than 5 minutes, and were not experienced as problematic. The duration, contents, experiences and effects of these conversations generally varied between abstainers, moderate, hazardous and excessive drinkers. Twelve per cent of those having a conversation about alcohol reported that it led to reduced alcohol consumption. Reduced alcohol consumption was more likely when conversations lasted for 1-10 minutes rather than less than 1 minute and included advice on how to reduce consumption.
Population survey data in Sweden suggest that when health-care professionals give brief advice to reduce alcohol consumption, greater effects are observed when the advice is longer and includes advice on how to achieve it.
Notes
Comment In: Addiction. 2011 Oct;106(10):1757-921917038
PubMed ID
21518068 View in PubMed
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