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Absence of response: a study of nurses' experience of stress in the workplace.

https://arctichealth.org/en/permalink/ahliterature183994
Source
J Nurs Manag. 2003 Sep;11(5):351-8
Publication Type
Article
Date
Sep-2003
Author
Brita Olofsson
Claire Bengtsson
Eva Brink
Author Affiliation
Northern Elvsborg County Hospital, University of Trollhättan/Uddevalla, Sweden.
Source
J Nurs Manag. 2003 Sep;11(5):351-8
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Attitude of Health Personnel
Burnout, Professional - psychology
Feedback
Frustration
Humans
Interprofessional Relations
Job Satisfaction
Models, Psychological
Morale
Nursing Methodology Research
Nursing Staff - psychology
Power (Psychology)
Questionnaires
Rehabilitation Centers
Risk factors
Sweden
Workload
Workplace - psychology
Abstract
It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.
PubMed ID
12930542 View in PubMed
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[A controlled study of the short-term and long-term effects of a "train the trainers" course--secondary publication].

https://arctichealth.org/en/permalink/ahliterature154394
Source
Ugeskr Laeger. 2008 Oct 27;170(44):3553-6
Publication Type
Article
Date
Oct-27-2008
Author
Sune Rubak
Lene Mortensen
Charlotte Ringsted
Bente Malling
Author Affiliation
Arhus Universitetshospital, Skejby, Paediatrisk Afdeling, Viborg Hospital, Medicinsk Afdeling, og Aarhus Universitet, Center for Medicinsk Uddannelse. sr@alm.au.dk
Source
Ugeskr Laeger. 2008 Oct 27;170(44):3553-6
Date
Oct-27-2008
Language
Danish
Publication Type
Article
Keywords
Case-Control Studies
Clinical Competence
Denmark
Education, Medical, Graduate - methods
Educational Measurement
Feedback
Humans
Internal Medicine - education
Learning
Orthopedics - education
Professional Competence
Questionnaires
Teaching - methods
Abstract
This is an intervention-study discussing the long-term effects of a 3-day "Train the trainers course" (TTC). In the intervention (I) group 98.4% of doctors participated in a TTC, both specialists and trainees. Knowledge about teaching skills increased in the I group by 25% after the TTC; a result which was sustained at six months. Teaching behaviour was significantly changed as the use of feedback and supervision had increased from a score of 4 to 6 (max. score = 9).
A 3-day residential TTC has a significant impact on knowledge gain concerning teaching skills, teaching behaviour and clinical learning culture after six months.
PubMed ID
18985941 View in PubMed
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Acting on audit & feedback: a qualitative instrumental case study in mental health services in Norway.

https://arctichealth.org/en/permalink/ahliterature295007
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
01-31-2018
Author
Monica Stolt Pedersen
Anne Landheim
Merete Møller
Lars Lien
Author Affiliation
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway. monica.stolt.pedersen@sykehuset-innlandet.no.
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Date
01-31-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Benchmarking
Evidence-Based Practice
Feedback
Health Personnel
Humans
Medical Audit
Mental Disorders - rehabilitation - therapy
Mental Health Services - organization & administration - standards
Norway
Organizational Case Studies
Qualitative Research
Quality Improvement
Abstract
The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation process. It aims to measure the research-practice gap, but its effect varies greatly. Less is known of how audit and feedback is used in natural settings. The aim of this study was to describe and investigate what is discussed and thematised when Quality Improvement (QI) teams in a District Psychiatric Centre (DPC) work to complete an action form as part of an A&F cycle in 2014.
This was an instrumental multiple case study involving four units in a DPC in Norway. We used open non-participant observation of QI team meetings in their natural setting, a total of seven teams and eleven meetings.
The discussions provided health professionals with insight into their own and their colleagues' practices. They revealed insufficient knowledge of substance-related disorders and experienced unclear role expectations. We found differences in how professional groups sought answers to questions of clinical practice and that they were concerned about whether new tasks fitted in with their routine ways of working.
Acting on A&F provided an opportunity to discuss practice in general, enhancing awareness of good practice. There was a general need for arenas to relate to practice and QI team meetings after A&F may well be a suitable arena for this. Self-assessment audits seem valuable, particular in areas where no benchmarked data exists, and there is a demand for implementation of new guidelines that might change routines and develop new roles. QI teams could benefit from having a unit leader present at meetings. Nurses and social educators and others turn to psychiatrists or psychologists for answers to clinical and organisational questions beyond guidelines, and show less confidence or routine in seeking research-based information. There is a general need to emphasise training in evidence-based practice and information seeking behaviour for all professional groups.
Notes
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PubMed ID
29386020 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 assessment & feedback by e-mail for university student hazardous and harmful drinkers: study protocol for the AMADEUS-2 randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature105186
Source
BMC Public Health. 2013;13:949
Publication Type
Article
Date
2013
Author
Jim McCambridge
Marcus Bendtsen
Nadine Karlsson
Ian R White
Preben Bendtsen
Source
BMC Public Health. 2013;13:949
Date
2013
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control - psychology
Electronic Mail
Feedback, Psychological
Female
Follow-Up Studies
Humans
Male
Research Design
Risk-Taking
Student Health Services - methods
Students - psychology
Sweden
Therapy, Computer-Assisted
Treatment Outcome
Universities
Abstract
Alcohol is responsible for a large and growing proportion of the global burden of disease, as well as being the cause of social problems. Brief interventions are one component of comprehensive policy measures necessary to reduce these harms. Brief interventions increasingly take advantage of the Internet to reach large numbers of high risk groups such as students. The research literature on the efficacy and effectiveness of online interventions is developing rapidly. Although many studies show benefits in the form of reduced consumption, other intervention studies show no effects, for reasons that are unclear. Sweden became the first country in the world to implement a national system in which all university students are offered a brief online intervention via an e-mail.
This randomized controlled trial (RCT) aims to evaluate the effectiveness of this national system comprising a brief online intervention among university students who are hazardous and harmful drinkers. This study employs a conventional RCT design in which screening to determine eligibility precedes random allocation to immediate or delayed access to online intervention. The online intervention evaluated comprises three main components; assessment, normative feedback and advice on reducing drinking. Screening is confined to a single question in order to minimise assessment reactivity and to prevent contamination. Outcomes will be evaluated after 2 months, with total weekly alcohol consumption being the primary outcome measure. Invitations to participate are provided by e-mail to approximately 55,000 students in 9 Swedish universities.
This RCT evaluates routine service provision in Swedish universities via a delay in offer of intervention to the control group. It evaluates effects in the key population for whom this intervention has been designed. Study findings will inform the further development of the national service provision.
ISRCTN02335307.
Notes
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PubMed ID
24456668 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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The alliance in couple therapy: Partner influence, early change, and alliance patterns in a naturalistic sample.

https://arctichealth.org/en/permalink/ahliterature140464
Source
J Consult Clin Psychol. 2010 Oct;78(5):635-45
Publication Type
Article
Date
Oct-2010
Author
Morten G Anker
Jesse Owen
Barry L Duncan
Jacqueline A Sparks
Author Affiliation
Bufetat, Familievernkontoret i Vestfold, Tønsberg, Norway.
Source
J Consult Clin Psychol. 2010 Oct;78(5):635-45
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Couples Therapy - methods
Family Conflict - psychology
Feedback
Female
Follow-Up Studies
Humans
Male
Norway
Patient satisfaction
Professional-Patient Relations
Prognosis
Questionnaires
Sex Factors
Abstract
The purpose of this study was to explore the relationship between the alliance and outcome in couple therapy and examine whether the alliance predicted outcomes over and above early change. The authors also investigated partner influence and gender and sought to identify couple alliance patterns that predicted couple outcomes.
The authors examined the alliances and outcomes at posttreatment and follow-up of 250 couples seeking treatment for marital distress in a naturalistic setting. The Session Rating Scale was used to measure the alliance; the Outcome Rating Scale and Locke Wallace Marital Adjustment Scale were used to measure outcomes. Couples were White, Euro-Scandinavian, and heterosexual, with a mean age of 38.5 years and average number of years together of 11.8. On a subsample (n = 118) that included couples with 4 or more sessions, the authors investigated the relationship between the alliance and outcome controlling for early change, and patterns of alliance development were delineated.
In the full sample, first-session alliances were not predictive of outcomes, but last-session alliances were predictive for both individuals and their partners. In the subsample, third-session alliances predicted outcome significantly above early change (d = 0.25) that exceeded the reliable change index. Couple alliances that started over the mean and increased were associated with significantly more couples achieving reliable or clinically significant change. Gender influences were mixed.
Given the current findings suggesting a potential alliance impact over and above symptom relief as well as the importance of ascending alliance scores, continuous assessment of the alliance appears warranted.
PubMed ID
20873899 View in PubMed
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An audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospital.

https://arctichealth.org/en/permalink/ahliterature276521
Source
BMC Infect Dis. 2016;16:96
Publication Type
Article
Date
2016
Author
June Utnes Høgli
Beate Hennie Garcia
Frode Skjold
Vegard Skogen
Lars Småbrekke
Source
BMC Infect Dis. 2016;16:96
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Community-Acquired Infections - drug therapy
Disease Progression
Female
Formative Feedback
Guideline Adherence - statistics & numerical data
Hospitals, University - standards - statistics & numerical data
Humans
Inappropriate Prescribing - prevention & control - statistics & numerical data
Male
Medical Audit
Norway
Pneumonia - drug therapy
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Pulmonary Disease, Chronic Obstructive - drug therapy
Retrospective Studies
Abstract
Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in hospital is scarce and requested. Preliminary studies have shown improvement potentials regarding antibiotic prescribing according to guidelines. We aimed to promote appropriate antibiotic prescribing in patients with community-acquired pneumonia (CAP) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at a respiratory medicine department in a Norwegian University hospital. Our specific objectives were to increase prescribing of appropriate empirical antibiotics, reduce high-dose benzylpenicillin and reduce total treatment duration.
We performed an audit and feedback intervention study, combined with distribution of a recently published pocket version of the national clinical practice guideline. We included patients discharged with CAP or AECOPD and prescribed antibiotics during hospital stay, and excluded those presenting with aspiration, nosocomial infection and co-infections. The pre- and post-intervention period was 9 and 6 months, respectively. Feedback was provided orally to the department physicians at an internal-educational meeting. To explore the effect of the intervention on appropriate empirical antibiotics and mean total treatment duration we applied before-after analysis (Student's t-test) and interrupted time series (ITS). We used Pearson's ?2 to compare dose changes.
In the pre-and post-intervention period we included 253 and 155 patients, respectively. Following the intervention, overall mean prescribing of appropriate empirical antibiotics increased from 61.7 to 83.8 % (P
Notes
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PubMed ID
26920549 View in PubMed
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An online practice and educational networking system for technical skills: learning experience in expert facilitated vs. independent learning communities.

https://arctichealth.org/en/permalink/ahliterature126772
Source
Stud Health Technol Inform. 2012;173:393-7
Publication Type
Article
Date
2012
Author
David Rojas
Jeffrey J H Cheung
Bryce Weber
Bill Kapralos
Heather Carnahan
Darius J Bägli
Adam Dubrowski
Author Affiliation
The Learning Institute, The Hospital for Sick Children, Toronto, Canada.
Source
Stud Health Technol Inform. 2012;173:393-7
Date
2012
Language
English
Publication Type
Article
Keywords
Clinical Competence
Feedback
Humans
Internet
Learning
Ontario
Questionnaires
Students, Medical
User-Computer Interface
Abstract
This study explored the activities of trainees learning technical skills using an educational networking tool with and without expert facilitation. Medical students (participants) were video-recorded practicing suturing and knot tying techniques and the resulting videos were uploaded to an educational networking site. Participants were then divided into two groups (one group containing an expert facilitator while the other group did not) and encouraged to comment on the videos within their group. We monitored the number of logins and comments posted and all participants completed an exit survey. There were no differences between the activities the two groups (p = 0.387). We conclude that the presence of an expert within collaborative Internet environments in not necessary to promote interactivity amongst the learners.
PubMed ID
22357024 View in PubMed
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[A pop-up menu linked to a computerized drug prescribing system. Prescribing pattern's feedback via a simple and quick method].

https://arctichealth.org/en/permalink/ahliterature191941
Source
Lakartidningen. 2001 Dec 12;98(50):5772-6
Publication Type
Article
Date
Dec-12-2001
Author
I. Ovhed
J. Berglund
S. Oistämö
K. Lenhoff
H. Odeberg
Author Affiliation
Lyckeby vårdcentral. ovhed_i@blekingefou.pp.se
Source
Lakartidningen. 2001 Dec 12;98(50):5772-6
Date
Dec-12-2001
Language
Swedish
Publication Type
Article
Keywords
Attitude of Health Personnel
Clinical Pharmacy Information Systems
Community Health Centers - statistics & numerical data
Decision Making, Computer-Assisted
Drug Prescriptions - standards
Family Practice - statistics & numerical data
Feedback
Humans
Patient satisfaction
Product Surveillance, Postmarketing - methods
Questionnaires
Software
Sweden
Abstract
It takes time for a GP to acquire sufficient experience of a new drug to be able to prescribe competently. This article describes a project studying the use of computerized records to afford a group of GP's swift feedback on recently introduced drugs of special interest. In the south-east of Sweden a network of primary health care centers has been created in two neighboring counties. The pharmacies of the region are also taking part. When new drugs of particular interest are introduced, each participating GP will automatically see a pop-up menu, asking questions pertaining to each computer-assisted prescription. In the pharmacies, patients are given a questionnaire regarding their expectations with respect to the drug. In this way it will be possible to provide the individual GP swift feedback from a large number of colleagues and patients concerning the drug's effectiveness in clinical practice. We have now been studying the COX-2 inhibitors rofecoxib (Vioxx) and celecoxib (Celebrex). Results show that a pop-up menu used in this way provides the general practitioner quick feed-back on prescribing behavior as well as drug effectiveness in clinical practice.
PubMed ID
11789101 View in PubMed
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