HeRA Institution: null

Evaluation of a web portal for improving public access to evidence-based health information and health literacy skills: a pragmatic trial.

Sun, 01 Jan 2012 00:00:00 GMT

Title: Evaluation of a web portal for improving public access to evidence-based health information and health literacy skills: a pragmatic trial. Authors: Austvoll-Dahlgren, Astrid; Bjørndal, Arild; Odgaard-Jensen, Jan; Helseth, Sølvi Abstract: Using the conceptual framework of shared decision-making and evidence-based practice, a web portal was developed to serve as a generic (non disease-specific) tailored intervention to improve the lay public's health literacy skills.; To evaluate the effects of the web portal compared to no intervention in a real-life setting.; A pragmatic randomised controlled parallel trial using simple randomisation of 96 parents who had children aged <4 years. Parents were allocated to receive either access to the portal or no intervention, and assigned three tasks to perform over a three-week period. These included a searching task, a critical appraisal task, and reporting on perceptions about participation. Data were collected from March through June 2011.; Use of the web portal was found to improve attitudes towards searching for health information. This variable was identified as the most important predictor of intention to search in both samples. Participants considered the web portal to have good usability, usefulness, and credibility. The intervention group showed slight increases in the use of evidence-based information, critical appraisal skills, and participation compared to the group receiving no intervention, but these differences were not statistically significant.; Despite the fact that the study was underpowered, we found that the web portal may have a positive effect on attitudes towards searching for health information. Furthermore, participants considered the web portal to be a relevant tool. It is important to continue experimenting with web-based resources in order to increase user participation in health care decision-making.; ClinicalTrials.gov NCT01266798.

The buffering effect of relationship satisfaction on emotional distress in couples.

Sun, 01 Jan 2012 00:00:00 GMT

Title: The buffering effect of relationship satisfaction on emotional distress in couples. Authors: Røsand, Gun-Mette B; Slinning, Kari; Eberhard-Gran, Malin; Røysamb, Espen; Tambs, Kristian Abstract: Marital distress and depression frequently co-occur, and partnership quality is associated with depressive symptoms and mental disorders in both men and women. One aim of this study was to investigate the contribution of a set of risk factors for emotional distress among men and women in couples, with a special focus on satisfaction with partner relationship. The most important aim was to investigate the extent to which high relationship satisfaction in couples acts as a buffer against stressful events.; Pregnant women and their husbands (n = 62,956 couples) enrolled in the Norwegian Mother and Child Cohort Study completed a questionnaire with questions about emotional distress, relationship satisfaction, and other risk factors. Twelve potential risk factors were included in the analyses, including relationship satisfaction, demographic characteristics, and somatic diseases in men and women. Associations between the predictor variables and emotional distress were estimated by multiple linear regression analysis. Cross-spousal effects, in which data reported by one of the spouses predicted emotional distress in the other, were also investigated. Possible interaction effects between certain risk factors and self-reported and partner's relationship satisfaction were tested and further explored with regression analyses in subsamples stratified by relationship satisfaction scores.; The unique effects of relationship satisfaction were of similar sizes for both men and women: substantial for self-reported (β = -0.23 and β = -0.28, respectively) and weak for partner-reported satisfaction (β = -0.04 and β = -0.02, respectively). Other relatively strong risk factors were somatic disease, first-time motherhood, and unemployment. Self-reported as well as partner-reported relationship satisfaction appeared to strongly buffer the effects of a number of stressors.; Partner relationship dissatisfaction is strongly associated with emotional distress in men and women. Good partner relationship, both as perceived by the individual him(her)self and by the spouse, quite strongly moderates adverse effects of various types of emotional strain.

Tvil om tvang. Oppsummering av landsomfattende tilsyn i 2011 og 2012 med tvungen helsehjelp til pasienter i sykehjem

Mon, 01 Apr 2013 00:00:00 GMT

Title: Tvil om tvang. Oppsummering av landsomfattende tilsyn i 2011 og 2012 med tvungen helsehjelp til pasienter i sykehjem Abstract: NORSK SAMMENDRAG: Tvungen helsehjelp til pasienter i sykehjem var tema for landsomfattende tilsyn i 2011 og 2012. Tilsynet undersøkte om pasienter som mangler evne til å gi samtykke og ikke vil ta i mot hjelp, får nødvendig og forsvarlig helsehjelp. Oppsummeringen bygger på tilsynsrapporter fra de kommunene som ble undersøkt. Det ble gjennomført tilsyn med 103 kommuner. I 89 av de undersøkte kommunene ble det påvist lovbrudd (avvik fra regelverket). Det er liten forskjell på påpekte lovbrudd fra 2011 til 2012. Tilsynet avdekket utstrakt bruk av tvang i strid med regelverket og viste at lovbestemmelsene ikke er godt nok kjent og innarbeidet i praksis. Mange ansatte var usikre på reglene om tvungen helsehjelp, hva begrepet tvang innebærer, hvordan motstand identifiseres og håndteres, hvordan og når pasientens evne til å gi samtykke skal vurderes, og hvem som er ansvarlig for å gjennomføre slike vurderinger. Tilsynet avdekket mangler i gjennomføring av opplæringstiltak, oversikt over ansattes opplæringsbehov og rapporteringsrutiner på området. Mange av de undersøkte kommunene hadde betydelige utfordringer i å sikre tilstrekkelig styring og kontroll med bruk av tvungen helsehjelp til pasienter i sykehjem.; ENGLISH SUMMARY: Compulsory health care for patients in nursing homes was the theme for countrywide supervision in 2011 and 2012. We investigated whether patients who lack the competence to give consent receive necessary and adequate health care. The summary is based on supervision reports from the municipalities that were investigated. Supervision was carried out in 103 municipalities. Breaches of the statutory requirements were detected in 89 of these municipalities. There was little difference from 2011 to 2012. The supervision authorities detected widespread use of compulsion and coercion that was in breach of the legislation, and found that the regulations were not well known and used in practice. Many members of staff were unsure about the regulations concerning compulsory health care, what the concept of coercion involves, how resistance can be identified and dealt with, how and when patients’ ability to give consent should be assessed, and who is responsible for making such assessments. We identified deficiencies in training, inadequate overview of the staff’s need for training, and inadequate routines for reporting. Many of the municipalities that were investigated faced serious challenges in order to ensure that management and control of use of compulsory health care for patients in nursing homes is adequate.

Spesialisthelsetjenestens håndtering av henvisninger og utredning av pasienter med tykk- og endetarmskreft. Oppsummering av landsomfattende tilsyn 2012

Mon, 01 Apr 2013 00:00:00 GMT

Title: Spesialisthelsetjenestens håndtering av henvisninger og utredning av pasienter med tykk- og endetarmskreft. Oppsummering av landsomfattende tilsyn 2012 Abstract: NORSK SAMMENDRAG: Fylkesmennene gjennomførte i 2012 tilsyn med håndtering og vurdering av henvisninger og utredning av pasienter med tykk- og endetarmskreft. Tilsynet ble gjennomført som systemrevisjon av regionvise team fra fylkesmennene. For pasienter med mistanke om kreft eller andre alvorlige sykdommer kan svikt få katastrofale følger. Håndtering av henvisninger og en forsvarlig utrednings- og behandlingslogistikk, krever at foretakene har sikre og effektive pasientadministrative systemer. Systemene må være velfungerende og beherskes av de ulike brukergruppene. Systemene må gi nødvendige oversikter og sikre at pasienter som ikke følger ordinært forløp fanges opp og gis forsvarlig helsehjelp. Dette tilsynet har avdekket svikt både når det gjelder spesialisthelsetjenestenes håndtering av henvisninger fra fastlegene og internhenvisninger mellom sykehusavdelinger og viderehenvisninger mellom foretak. Det er etter tilsynets vurdering ikke grunn til å friskmelde spesialisthelsetjenestens styring og kontroll med de helt grunnleggende pasientadministrative systemer for pasientbehandling og data for styring. Det kan fortsatt stilles spørsmål ved om man har kontroll over behandlingstall, kapasitet mv. for planlegging, ressursbruk mv.; ENGLISH SUMMARY: In 2012, the Offices of the County Governors carried out supervision of the way the specialized health services deal with referral and investigation of patients with cancer of the colon and rectum. Supervision was carried out by regional teams as system audits. For patients with suspected cancer or other serious illnesses, deficiencies in health care can have catastrophic consequences. Reliable and effective patient administration systems are needed for dealing with referrals, and for providing adequate and sound investigation and treatment. The systems must function well, and should be understood. The systems must provide a necessary overview, and ensure that patients who need special treatment are detected and receive adequate care. Deficiencies were detected, both in relation to the way in which the specialized health services dealt with referrals from general practitioners, referrals from one hospital department to another, and referrals from one health trust to another. In our view, management and control of basic patient administration systems for providing patient care are not always adequate. There is reason to question whether patient data and data on capacity are used effectively for managing services and allocating resources.