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Acute admissions to a community hospital: experiences from Hallingdal sjukestugu.

https://arctichealth.org/en/permalink/ahliterature122688
Source
Scand J Public Health. 2012 Jun;40(4):309-15
Publication Type
Article
Date
Jun-2012
Author
Øystein Lappegard
Per Hjortdahl
Author Affiliation
Department of Hallingdal sjukestugu, Medical Clinic of Ringerike General Hospital, Vestre Viken Hospital Trust, Norway and Hallingforsk, Ål Municipality, Ål, Norway. oystein.lappegard@vestreviken.no
Source
Scand J Public Health. 2012 Jun;40(4):309-15
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Acute Disease - epidemiology
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Hospitalization - statistics & numerical data
Hospitals, Community - organization & administration - statistics & numerical data
Humans
Infant
Infant, Newborn
Length of Stay - statistics & numerical data
Male
Middle Aged
Norway - epidemiology
Patient Admission - statistics & numerical data
Rural Health
Young Adult
Abstract
Acute admissions to anywhere other than general hospitals are uncommon in Norway, but at Hallingdal sjukestugu, a community hospital in a rural district, this has been practiced for years. This article presents experiences from this practice. Materials and
Hallingdal sjukestugu is a decentralized, specialist healthcare service, under the administration and funding of Ringerike sykehus, the nearest general hospital, which is 170 km away. General practitioners under telephone supervision of the hospital specialists run the inpatient department. Six municipalities with 20,000 inhabitants make use of the community hospital. Statistics were obtained from the patient administration systems and from manual statistics continuously registered in 2009-10.
In 2009-10 the inpatient department, an intermediate care unit with 14 beds, had an average of 605 admissions a year, with a mean length of stay of 6.3 days. There were 455 acute admissions to Hallingdal sjukestugu. Forty per cent of these patients were younger than 67 and 36% were older than 80 years of age. Half were admitted for observation and half for treatment. The main diagnostic groups were infections, injuries and palliative care. Seventeen per cent of the acute admitted patients were later transferred to the general hospital for further work-up or treatment; 70% were discharged to their homes.
The experiences from Hallingdal sjukestugu indicate that it is feasible to give a selected group of patients an alternative to acute admissions to a general hospital.
PubMed ID
22786914 View in PubMed
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Acute admissions to a community hospital - health consequences: a randomized controlled trial in Hallingdal, Norway.

https://arctichealth.org/en/permalink/ahliterature267407
Source
BMC Fam Pract. 2014;15:198
Publication Type
Article
Date
2014
Author
Øystein Lappegard
Per Hjortdahl
Source
BMC Fam Pract. 2014;15:198
Date
2014
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Female
Home Nursing - utilization
Hospitalization
Hospitals, Community
Hospitals, General
Humans
Length of Stay
Longitudinal Studies
Male
Middle Aged
Norway
Nursing Homes - utilization
Patient Outcome Assessment
Patient Readmission - statistics & numerical data
Abstract
Health care professionals in several countries are searching for alternatives to acute hospitalization. In Hallingdal, Norway, selected acute patients are admitted to a community hospital. The aim of this study was to analyse whether acute admission to a community hospital as an alternative to a general hospital had any positive or negative health consequences for the patients.
Patients intended for acute admission to the local community hospital were asked to join a randomized controlled trial. One group of the enrolled patients was admitted as planned (group 1, n = 33), while another group was admitted to the general hospital (group 2, n = 27). Health outcomes were measured by the Nottingham Extended Activity of Daily Living Questionnaire and by collection of data concerning specialist and community health care services in a follow-up year.
After one year, no statistical significant differences in the level of daily function was found between group 1 (admissions to the community hospital) and group 2 (admissions to the general hospital). Group 1 had recorded fewer in-patient days at hospitals and nursing homes, as well as lower use of home nursing, than group 2. For outpatient referrals, the trend was the opposite. However, the differences between the two groups were not at a 5% level of statistical significance.
No statistical significant differences at a 5% level were found related to health consequences between the two randomized groups. The study however, indicates a consistent trend of health benefits rather than risk from acute admissions to a community hospital, as compared to the general hospital. Emergency admission and treatment at a lower-level facility than the hospital thus appears to be a feasible solution for a selected group of patients.
ClinicalTrials.gov NCT01069107 . Registered 2 April 2010.
Notes
Cites: Nurs Stand. 2010 Jul 14-20;24(45):35-920701051
Cites: Scand J Public Health. 2012 Jun;40(4):309-1522786914
Cites: Scand J Prim Health Care. 1995 Dec;13(4):250-68693208
Cites: BMC Public Health. 2007;7:6817475006
Cites: J Am Geriatr Soc. 2007 Dec;55(12):1995-200217979957
Cites: Int J Geriatr Psychiatry. 2008 Nov;23(11):1141-718457336
Cites: Age Ageing. 1993 Nov;22(6):419-248310887
Cites: BMC Fam Pract. 2013;14:8723800090
Cites: Lancet. 2013 Dec 21;382(9910):2069-7624054816
Cites: Soc Sci Med. 2014 Oct;119:27-3525137645
Cites: Aust N Z J Med. 2000 Apr;30(2):252-6010833119
Cites: Transplant Proc. 2009 Nov;41(9):3693-619917369
Cites: Fam Pract. 2004 Apr;21(2):173-915020387
Cites: Br J Gen Pract. 2001 Feb;51(463):95-10011217640
PubMed ID
25491726 View in PubMed
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Comparing self-reported communication skills of medical students in traditional and integrated curricula: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature173544
Source
Patient Educ Couns. 2005 Sep;58(3):271-8
Publication Type
Article
Date
Sep-2005
Author
Tore Gude
Anders Baerheim
Are Holen
Tor Anvik
Arnstein Finset
Hilde Grimstad
Per Hjortdahl
Terje Risberg
Per Vaglum
Author Affiliation
Department of Behavioral Sciences in Medicine, University of Oslo, P.O. Box 1111-Blindern, N-0317 Oslo, Norway. tore.gude@medisin.uio.no
Source
Patient Educ Couns. 2005 Sep;58(3):271-8
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Communication
Curriculum
Education, Medical
Educational Measurement
Female
Humans
Linear Models
Male
Middle Aged
Norway
Physician-Patient Relations
Stress, Psychological
Abstract
To investigate medical students' self-assessments of their communication skills through medical school related to background factors, curriculum design and perceived medical school stress.
Medical students at all year levels attending Norwegian universities in the spring of 2003 were mailed the Oslo Inventory of Self-reported Communication Skills (OSISCS) developed by the authors. Of the total number of students (N=3055), 60% responded. One school had a traditional curriculum, the other three ran integrated models.
Students assessed their instrumental communication skills to increase linearly year by year, while the relational skills showed a curve-linear trajectory reaching the optimum level half-way into the curriculum. Students attending the traditional school reported lower levels of instrumental skills compared to the students from the integrated schools. In relational skills, a similar difference was maintained half-way into the curriculum, but disappeared towards the end. Perceived medical school stress correlated to the self-reported end point levels of the two types of communication skills.
The trajectories of self-reported instrumental and relational skills indicate significant variations in facilitating mechanisms between curricula, cognitive processing and perceived medical school stress.
Self-reported instrumental and relational communication skills develop differently in medical students over the years according to the type of curriculum.
Curricula should be evaluated for improvement implementations.
PubMed ID
16061342 View in PubMed
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Curriculum factors influencing knowledge of communication skills among medical students.

https://arctichealth.org/en/permalink/ahliterature160934
Source
BMC Med Educ. 2007;7:35
Publication Type
Article
Date
2007
Author
Anders Baerheim
Per Hjortdahl
Are Holen
Tor Anvik
Ole Bernt Fasmer
Hilde Grimstad
Tore Gude
Terje Risberg
Per Vaglum
Author Affiliation
Department of Public Health and Primary Health Care, University of Bergen, Norway. anders.barheim@isf.uib.no
Source
BMC Med Educ. 2007;7:35
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Communication
Cross-Sectional Studies
Curriculum
Education, Medical - organization & administration
Female
Humans
Male
Middle Aged
Norway
Physician-Patient Relations
Questionnaires
Abstract
Communication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training. We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design also play a role. The aim of this study was to determine which elements of the curriculum influence acquisition of knowledge regarding clinical communication skills by medical students.
The study design was a cross-sectional survey performed in the four Norwegian medical schools with different curricula, spring 2003. A self-administered questionnaire regarding knowledge of communication skills (an abridged version of van Dalen's paper-and-pencil test) was sent to all students attending the four medical schools. A total of 1801 (59%) students responded with complete questionnaires.
At the end of the 1st year of study, the score on the knowledge test was higher in students at the two schools running communication courses and providing early patient contact (mean 81%) than in the other two medical schools (mean 69-75%, P
Notes
Cites: Med Educ. 2002 Feb;36(2):108-911869435
Cites: Med Educ. 2002 Feb;36(2):125-3411869439
Cites: Med Educ. 2002 Feb;36(2):148-5311869442
Cites: Can J Neurol Sci. 2002 Jun;29 Suppl 2:S23-912139082
Cites: BMJ. 2002 Sep 28;325(7366):697-70012351365
Cites: JAMA. 2003 Sep 3;290(9):1157-6512952997
Cites: Arch Dis Child. 2006 Apr;91(4):367-7016551795
Cites: J Adv Nurs. 1995 Feb;21(2):371-77714297
Cites: Med Educ. 1995 May;29(3):247-537623721
Cites: Patient Educ Couns. 2005 Sep;58(3):265-7016023822
Cites: J Palliat Med. 2005 Aug;8(4):857-6616128661
Cites: Med Teach. 2005 Nov;27(7):644-616332559
Cites: Tidsskr Nor Laegeforen. 2003 Aug 28;123(16):2277-8014508554
PubMed ID
17925041 View in PubMed
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Do physicians improve their communication skills between finishing medical school and completing internship? A nationwide prospective observational cohort study.

https://arctichealth.org/en/permalink/ahliterature153235
Source
Patient Educ Couns. 2009 Aug;76(2):207-12
Publication Type
Article
Date
Aug-2009
Author
Tore Gude
Per Vaglum
Tor Anvik
Anders Baerheim
Ole Bernt Fasmer
Hilde Grimstad
Per Hjortdahl
Are Holen
Tone Nordøy
Hilde Eide
Author Affiliation
Department of Behavioral Sciences in Medicine and Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo, Norway. tore.gude@medisin.uio.no
Source
Patient Educ Couns. 2009 Aug;76(2):207-12
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Analysis of Variance
Clinical Competence
Communication
Curriculum
Education, Medical, Graduate
Educational Status
Female
Humans
Internship and Residency
Linear Models
Male
Norway
Patient Education as Topic
Physician-Patient Relations
Physicians
Prospective Studies
Schools, Medical
Statistics as Topic
Students, Medical
Abstract
To test whether young physicians improve their communication skills between graduating from medical school and completing clinical internship, and to explore contributing background and/or internship factors.
Norwegian medical students graduating June 2004 were invited to take part in a videotaped standardized patient interview February 2004. Of the 111 students who originally participated, 62 completed a second interview February 2006. Observed communication skills were assessed with the Arizona Communication Interview Rating Scale (ACIR).
The level of communication skills increased significantly during the period for participants overall; and for females but not males. General social skills reached significantly higher levels than specific professional skills, both types of skill improving during the study. Independent predictors were working in local hospitals, learning atmosphere and low stress. At school completion, 50% reached a level defined as 'advanced beginner'. Towards the end of the internship, 58% reached 'capable' and 27% 'competent' levels of communication skills.
Female physicians improved most in communication skills, the gender difference being multivariate mediated through low stress levels and learning atmosphere. The findings support the division of communication skills into general social and specific professional skills.
The relatively low proportion of young physicians, especially males, developing the capability to practise independently at internship completion indicates a need for more effective training in communication skills, during both medical school and internship.
PubMed ID
19135826 View in PubMed
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[Insufficient communication and information regarding patient medication in the primary healthcare].

https://arctichealth.org/en/permalink/ahliterature162764
Source
Tidsskr Nor Laegeforen. 2007 Jun 28;127(13):1766-9
Publication Type
Article
Date
Jun-28-2007
Author
Kjersti Bakken
Eli Larsen
Per Christian Lindberg
Ellen Rygh
Per Hjortdahl
Author Affiliation
Nasjonalt senter for telemedisin, Universitetssykehuset Nord-Norge, Postboks 359038 Tromsø. kjersti.bakken@telemed.no
Source
Tidsskr Nor Laegeforen. 2007 Jun 28;127(13):1766-9
Date
Jun-28-2007
Language
Norwegian
Publication Type
Article
Keywords
Communication
Community Health Nursing
Documentation - standards
Drug Prescriptions - standards
Family Practice
Home Care Services
Humans
Interviews as Topic
Medical Records - standards
Medical Secretaries
Norway
Pharmaceutical Preparations - administration & dosage
Physician-Nurse Relations
Physicians, Family
Primary Health Care
Abstract
Medicine management in primary health care involves several participants: the prescribing physicians, various health care personnel involved in drug administration and patients with varying degrees of will and competence to be compliant. Many things can go wrong in this process, resulting in medication errors. This qualitative survey focuses on how information is transferred within primary healthcare and how prescription and administration of medicines are documented.
A random selection of GPs and medical secretaries in nine regular GP practices and a strategic selection of community nurses, personnel in nursing homes and emergency clinics and in hospital departments at the University Hospital of Northern Norway were interviewed in a semi-structured way during the spring of 2005. Observations were undertaken in both nursing homes and units for community nurses. Observations were logged, interviews taped, transcribed and the total material analysed.
Necessary information on medication was not easily accessible to health care personnel in charge of patient care. Obtaining the information was time-consuming and the quality was variable and perceived as unreliable. Five out of nine GPs regarded a pharmacy prescription to be sufficient information to community nurses regarding alterations in patient medication. GPs seldom signed prescriptions in the nurses' medication chart. Patient medication information was not present when needed. Community nurses on night duty therefore often did not know what drugs they were handing out during their home visits. Discharge notes from the hospitals were often delayed, they were not sent to community nurses and just three out of nine GPs updated their medication summaries when receiving such information.
There is a need for improved communication and handling of information related to patient medication in primary health care. Patients in an ambulatory setting, who are not in charge of their own medication, are especially vulnerable to failure.
PubMed ID
17599123 View in PubMed
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Mandates of trust in the doctor-patient relationship.

https://arctichealth.org/en/permalink/ahliterature135228
Source
Qual Health Res. 2011 Sep;21(9):1182-90
Publication Type
Article
Date
Sep-2011
Author
Helge Skirbekk
Anne-Lise Middelthon
Per Hjortdahl
Arnstein Finset
Author Affiliation
Centre for Medical Ethics, Institute of Health and Society, Medical Faculty, University of Oslo, Oslo, Norway. helge.skirbekk@medisin.uio.no
Source
Qual Health Res. 2011 Sep;21(9):1182-90
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Communication
Cross-Sectional Studies
Emotions
Empathy
Female
Humans
Interview, Psychological
Male
Middle Aged
Norway
Physician-Patient Relations
Physicians - psychology
Qualitative Research
Trust - psychology
Abstract
We examine the conditions for trust relationships between patients and physicians. A trust relationship is not normally negotiated explicitly, but we wanted to discuss it with both patients and physicians. We therefore relied on a combination of interviews and observations. Sixteen patients and 8 family physicians in Norway participated in the study. We found that trust relationships were negotiated implicitly. Physicians were authorized by patients to exercise their judgment as medical doctors to varying degrees. We called this phenomenon the patient's mandate of trust to the physician. A mandate of trust limited to specific complaints was adequate for many medical procedures, but more open mandates of trust seemed necessary to ensure effective and humane treatment for patients with more complex and diffuse illnesses. More open mandates of trust were given if the physician showed an early interest in the patient, was sensitive, gave time, built alliances, or bracketed normal behavior.
PubMed ID
21498826 View in PubMed
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[Norwegian use of Internet health services]

https://arctichealth.org/en/permalink/ahliterature71442
Source
Tidsskr Nor Laegeforen. 2002 Jun 30;122(17):1640-4
Publication Type
Article
Date
Jun-30-2002
Author
Hege Andreassen
Anne-Grete Sandaune
Deede Gammon
Per Hjortdahl
Author Affiliation
Nasjonalt senter for telemedisin Universitetssykehuset Nord-Norge Postboks 35 9038 Tromsø. hege.andreassen@telemed.no
Source
Tidsskr Nor Laegeforen. 2002 Jun 30;122(17):1640-4
Date
Jun-30-2002
Language
Norwegian
Publication Type
Article
Keywords
Adult
Attitude to Health
Computer Communication Networks
Databases
English Abstract
Family Practice - statistics & numerical data
Female
Health Behavior
Health Education - statistics & numerical data - utilization
Humans
Internet - statistics & numerical data - utilization
Male
Patient Education - statistics & numerical data
Physician-Patient Relations
Questionnaires
Self Care - methods - statistics & numerical data - utilization
Waiting Lists
Abstract
BACKGROUND: This study investigates the assumption that the Norwegian population's use of Internet health services has an impact on health related attitudes and behaviour. MATERIAL AND METHODS: In 2000 and 2001, 1,006 and 1,018 subjects were randomly selected from the general population in Norway and interviewed over the telephone. In 2001, a web-based questionnaire was presented to 600 of a 2,800 member Internet panel who reported having used the Internet for health purposes; 79% responded. RESULTS: The proportion of Norwegians who use the Internet for health purposes increased from 19% in 2000 to 31% in 2001. The proportion of those wishing to use e-mail in interaction with their doctor increased from 30% to 45%. Based on information from the Internet, 33% of users in 2001 have asked their doctor specific questions; 11% have suggested a diagnosis, 21% have altered their diet and/or lifestyle; 10% have started with health products or programmes without consulting their doctor. 13% have experienced anxiety, while 48% have experienced relief. INTERPRETATION: Norwegians' use of the Internet appears to supplement rather than replace ordinary health services. Health personnel will need to respond to Internet-generated expectations and behaviour.
PubMed ID
12555603 View in PubMed
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[Patient-physician interaction over the internet]

https://arctichealth.org/en/permalink/ahliterature68851
Source
Tidsskr Nor Laegeforen. 2004 Oct 21;124(20):2633-6
Publication Type
Article
Date
Oct-21-2004
Author
Per Egil Kummervold
Marianne Trondsen
Hege Andreassen
Deede Gammon
Per Hjortdahl
Author Affiliation
Nasjonalt senter for telemedisin, Universitetssykehuset Nord-Norge, Postboks 35, 9038 Tromsø. per.egil.kummervold@telemed.no
Source
Tidsskr Nor Laegeforen. 2004 Oct 21;124(20):2633-6
Date
Oct-21-2004
Language
Norwegian
Publication Type
Article
Keywords
Communication
Electronic Mail
English Abstract
Family Practice
Female
Humans
Internet
Male
Norway
Patient satisfaction
Physician-Patient Relations
Questionnaires
Telemedicine - methods - trends
Abstract
BACKGROUND: Nearly half of the Norwegian population claim that they would like to use the internet to communicate with their general practitioner. A web-based system complying with Norway's strict statutory requirements for the processing of personal data was developed and tested in an effort to assess the implications of this mode of communication. MATERIAL AND METHOD: The system was tested for one year in a group practice with six doctors. 200 patients were recruited and randomized into intervention and control groups. Data was collected through questionnaires, interviews and system logs. RESULTS: The 48 patients who used the system sent on average 3.3 messages, the six doctors sent between nine and 65 messages each. Traditional inquiries (visits, telephones) to the doctor averaged 3.2 and 4.5 for the intervention and control group respectively. 41% of the messages were inquiries about health issues, 22% were about renewals of prescriptions and sick leave notes, while 13% were requests for an appointment. Patients and doctors were both positive to this mode of communication. Patients who did not use the service said that they expected to use it in the future. INTERPRETATION: Electronic communication appears to replace some consultations and telephone inquiries. The study gives reason to expect that communication between patients and general practitioners over the internet will be more important in the future.
PubMed ID
15534640 View in PubMed
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Patients who use e-mediated communication with their doctor: new constructions of trust in the patient-doctor relationship.

https://arctichealth.org/en/permalink/ahliterature70454
Source
Qual Health Res. 2006 Feb;16(2):238-48
Publication Type
Article
Date
Feb-2006
Author
Hege K Andreassen
Marianne Trondsen
Per Egil Kummervold
Deede Gammon
Per Hjortdahl
Author Affiliation
Norwegian Centre for Telemedicine, Tromsø, Norway.
Source
Qual Health Res. 2006 Feb;16(2):238-48
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Communication
Female
Humans
Internet
Interviews
Male
Norway
Physician-Patient Relations
Trust
Abstract
The introduction of information and communication technology (ICT) into the patient-doctor relationship represents a significant change in modern health care. Communication via computers-e-mediated communication-is affecting the context of patient-doctor interaction, touching core elements of the relationship. Based on data from a qualitative study conducted among Norwegian patients who had used ICT to communicate with their doctors, the authors argue that patients' use of ICT and the element of trust in the patient-doctor relationship influence each other. Furthermore, they contend that patients' constructions of trust in this relationship can be understood in light of basic mechanisms in modern society. The study sheds light on some potential concerns and benefits as communication technology increasingly is integrated into the patient-doctor relationship.
PubMed ID
16394212 View in PubMed
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