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Search Results: 1 - 10 of 597 matches for " Katarina Hjelm "
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Dissimilarities in Social Support as Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden  [PDF]
Katarina Hjelm, Carina Berter?
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.43025

Diabetes (DM) requires self-care that is demanding and may cause stress. Social support can buffer effects of stress. No previous study has been found comparing perceptions of foreign-born persons with DM, concerning the content of and need for social support with a population of origin. The aim was to compare the meaning of support and its impact on the life situation in Swedish- and foreign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74 persons; 34 foreign- and 40 Swedish-born, aged 32-80 years, diagnosed with type 2 DM, was included. The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixed methods were used and data were collected by qualitative interviews and quantitative data collected by the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured by NSSQ, no significant differences were found according to gender but foreign-born men scored lower than Swedish, especially in emotional support and aid. The main findings showed that respondents, irrespective of origin, described the meaning of the concept of support mainly as information support in learning to manage DM. However, foreign-born persons also focused on medical support with regular follow-ups while Swedes emphasized the need for emotional support. Foreign- and Swedish-born persons are in general more similar than dissimilar in describing the meaning, need and impact of support. Irrespective of origin they want to learn to manage their disease and thus desire and need regular follow-up and information immediately from being diagnosed. Further studies are needed as the study is based on a limited sample.

Limited Focus on the Use of Health Care by Elderly Migrants—A Literature Review  [PDF]
Katarina Hjelm, Bj?rn Albin
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.46049

Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

Health-care seeking behaviour among persons with diabetes in Uganda: an interview study
Katarina Hjelm, Fortunate Atwine
BMC International Health and Human Rights , 2011, DOI: 10.1186/1472-698x-11-11
Abstract: This is a descriptive study with a snowball sample from a community in Uganda. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis.Healthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions.Healthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.The incidence of Type 2 diabetes mellitus (DM) is increasing worldwide, with a pandemic mostly affecting people in developing countries in Africa and Asia under development [1,2]. The pandemic is related to urbanization with longevity and changes of lifestyle, from a traditional active way of life to a modern sedentary style with unhealthy diets and obesity, combined with genetic susceptibility development [3] and probably also poverty [4].Uganda is reported as having 560 000 registered diabetes patients and it is estimated that the number has passed a million, in a population of 28 million [5]. Figures are expected to double by 2025 [1,2]. Many are unaware of the disease and the healthcare system receives people at the hospitals with DM at very late stages - when they hav
Zimbabwean diabetics' beliefs about health and illness: an interview study
Katarina Hjelm, Esther Mufunda
BMC International Health and Human Rights , 2010, DOI: 10.1186/1472-698x-10-7
Abstract: Exploratory study. Consecutive sample from a diabetes clinic at a central hospital. Semi-structured interviews were held with 21 persons aged 19-65 years. Data were analysed using qualitative content analysis.Health was described as freedom from disease and well-being, and individual factors such as compliance with advice received and drugs were considered important to promote health. A mixture of causes of DM, predominantly individual factors such as heredity, overweight and wrong diet in combination with supernatural factors such as fate, punishment from God and witchcraft were mentioned. Most respondents did not recognize the symptoms of DM when falling ill but related the problems to other diseases, e.g. HIV, malaria etc. Limited knowledge about DM and the body was indicated. Poor economy was mentioned as harmful to health and a consequence of DM because the need to buy expensive drugs, food and attend check-ups. Self-care was used to a limited extent but if used, a combination of individual measures, household remedies or herbs and religious acts such as prayers and holy water were frequently used, and in some cases health care professionals were consulted.Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to the influence of supernatural forces, e.g. fate, God etc., were found, which affected patients' self-care and care-seeking behaviour. Strained economy was stated to be a factor of the utmost importance affecting the management of DM and thus health. To develop cost-effective and optimal diabetes care in a country with limited resources, not only educational efforts based on individual beliefs are needed but also considering systemic and structural conditions in order to promote health and to prevent costly consequences of DM.Diabetes mellitus (DM) affects millions of people worldwide and its related complications continue to be of great concern [1]. Of those diagnosed with DM, 90-
Health care systems in Sweden and China: Legal and formal organisational aspects
Bj?rn Albin, Katarina Hjelm, Wen Chang Zhang
Health Research Policy and Systems , 2010, DOI: 10.1186/1478-4505-8-20
Abstract: To describe and compare health care in Sweden and China with regard to legislation, organisation, and finance.Literature reviews were carried out in Sweden and China to identify literature published from 1985 to 2008 using the same keywords. References in recent studies were scrutinized, national legislation and regulations and government reports were searched, and textbooks were searched manually.The health care systems in Sweden and China show dissimilarities in legislation, organisation, and finance. In Sweden there is one national law concerning health care while in China the law includes the "Hygienic Common Law" and the "Fundamental Health Law" which is under development. There is a tendency towards market-orientated solutions in both countries. Sweden has a well-developed primary health care system while the primary health care system in China is still under development and relies predominantly on hospital-based care concentrated in cities.Despite dissimilarities in health care systems, Sweden and China have similar basic assumptions, i.e. to combine managerial-organisational efficiency with the humanitarian-egalitarian goals of health care, and both strive to provide better care for all.To improve health and health care worldwide, international cooperation should include aspects such as attitudes to patients and the organisation of health care services [1]. The increasing number of elderly people will put pressure on health care systems in many countries [2]. Sharing knowledge and experience can give valuable information on successful systems, while comparative analysis and experiences can strengthen international collaboration [3]. Comparative research can make an important contribution to knowledge concerning health care [4], not least in cost-effective use of resources. Western European countries have seen a move towards evidence-based health care to improve the utilisation of resources and ensure high-quality health care, and to upgrade staff competence
Lower prevalence of hip fractures in foreign-born individuals than in Swedish-born individuals during the period 1987-1999
Bj?rn Albin, Katarina Hjelm, S?lve Elmst?hl
BMC Musculoskeletal Disorders , 2010, DOI: 10.1186/1471-2474-11-203
Abstract: The study was based on national population data. The study population consisted of 321,407 Swedish-born and 307,174 foreign-born persons living in Sweden during the period 1987-1999.Foreign-born individuals had a reduced risk of hip fracture, with odds ratios (ORs) of 0.47-0.77 for men and 0.42-0.88 for women. Foreign-born women had the hip fracture event at a higher age on average, but a longer time spent in Sweden was associated with a small but significant increase in risk.We found that there was a reduced risk of hip fracture in all foreign-born individuals, and that the hip fracture event generally happened at a higher age in foreign-born women. Migration must therefore be considered in relation to the prevalence and risk of hip fracture. Migration can therefore have a positive effect on one aspect of the health of a population, and can influence and lower the total cost of healthcare due to reduced risk and prevalence of hip fracture.The relation between the prevalence of hip fracture and migration is not well understood, and has not been studied longitudinally. Improvement in our knowledge is important in this respect since cultural background and physical environment during childhood and adolescence are known to be able to influence the risk of a hip fracture event [1], and differences in the prevalence of hip fracture might occur between the indigenous population and people who have migrated to a country.Hip fractures are one of the most common reasons for elderly people being admitted to hospital, they are an important cause of death and disability, and measured by frequency and economic costs, they are a large public health problem [2].Hip fractures are an increasing problem, since they are strongly associated with old age and the number of elderly people is increasing worldwide. In a global projection, it was estimated that the numbers will double between 1995 (1.3 million) and 2025 (2.6 million) [3]. The numbers of hip fractures vary in different parts
Residential mobility among foreign-born persons living in Sweden is associated with lower mortality
Bj rn Albin, Katarina Hjelm, Jan Ekberg, et al
Clinical Epidemiology , 2010, DOI: http://dx.doi.org/10.2147/CLEP.S11827
Abstract: idential mobility among foreign-born persons living in Sweden is associated with lower mortality Original Research (3339) Total Article Views Authors: Bj rn Albin, Katarina Hjelm, Jan Ekberg, et al Published Date July 2010 Volume 2010:2 Pages 187 - 194 DOI: http://dx.doi.org/10.2147/CLEP.S11827 Bj rn Albin1,2, Katarina Hjelm1,2, Jan Ekberg3, S lve Elmst hl4 1School of Health and Caring Sciences, Linnaeus University, V xj , Sweden; 2Department of Health Sciences, Division of Geriatric Medicine, Lund University, Sweden; 3Centre of Labour Market Policy Research (CAFO), School of Management and Economics, V xj University, Sweden; 4Department of Health Sciences, Division of Geriatric Medicine, Lund University, Sweden Abstract: There have been few longitudinal studies on the effect of within-country mobility on patterns of mortality in deceased foreign-born individuals. The results have varied; some studies have found that individuals who move around within the same country have better health status than those who do not change their place of residence. Other studies have shown that changing one’s place of residence leads to more self-reported health problems and diseases. Our aim was to analyze the pattern of mortality in deceased foreign-born persons living in Sweden during the years 1970–1999 in relation to distance mobility. Data from Statistics Sweden and the National Board of Health and Welfare was used, and the study population consisted of 281,412 -foreign-born persons aged 16 years and over who were registered as living in Sweden in 1970. Distance mobility did not have a negative effect on health. Total mortality was lower (OR 0.71; 95% CI 0.69–0.73) in foreign-born persons in Sweden who had changed their county of residence during the period 1970–1990. Higher death rates were observed, after adjustment for age, in three ICD diagnosis groups “Injury and poisoning”, “External causes of injury and poisoning”, and “Diseases of the digestive system” among persons who had changed county of residence.
Migration and Health
Katarina Hjelm,Bj?rn Albin,Rosa Benato,Panayota Sourtzi
Nursing Research and Practice , 2012, DOI: 10.1155/2012/621914
Utilization of In-Hospital Care among Foreign-Born Compared to Native Swedes 1987–1999
Bj?rn Albin,Katarina Hjelm,Jan Ekberg,S?lve Elmst?hl
Nursing Research and Practice , 2012, DOI: 10.1155/2012/713249
Abstract: In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987–1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970–1999, was used. Persons were selected if they were admitted to hospital during 1987–1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care. 1. Introduction In previous longitudinal studies of mortality and morbidity among 723,948 foreign-born and native-born Swedes during 1970–1999, increased mortality and dissimilarities in mortality pattern were found [1, 2]. The results showed increased mortality ( , 95% CI: 1.07–1.08) and a lower age at time of death for foreign-born persons compared with the Swedish controls. The highest risk odds were found for men born in Finland ( ), Denmark ( ), and Norway/Iceland ( ). The mortality pattern showed dissimilarities in causes of death, with a significant higher number of deaths from Neoplasm found in migrants from Denmark in, from diseases of the circulatory system in migrants from Finland and Poland and from symptoms, signs, and ill-defined conditions in migrants from former Yugoslavia. The differences in mortality and morbidity pattern could indicate differences in utilization of health care among foreign and native-born Swedes; this needs to be further studied. Earlier studies of utilization of health care among immigrants and the native population have had a predominantly cross-sectional design and have shown diverging results. Lower utilization has been explained as lack of economic resources such as access to health insurance, and the higher utilization could be a consequence of poorer health [3–10]. Results from The
County Differences in Mortality among Foreign-Born Compared to Native Swedes 1970–1999
Bj?rn Albin,Katarina Hjelm,Jan Ekberg,S?lve Elmst?hl
Nursing Research and Practice , 2012, DOI: 10.1155/2012/136581
Abstract: Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations. 1. Introduction Earlier studies have shown that mortality and morbidity vary in different parts of a country both in European countries and the US [1–4]. To our knowledge no study has compared mortality among foreign-born and native-born Swedes in relation to catchment areas such as counties. Geographical variation in mortality is due to influencing factors, in childhood and in adulthood, such as social class, employment status and social and physical environment [5], and unequal utilization of healthcare. Districts with high or low mortality could be identified in the UK [1]. Another investigation showed an association between area of residence and stomach cancer or stroke [3]. In Italy higher mortality for men was found in the north of the country compared to the south but the reversed pattern was evident for women [2]. Previous longitudinal studies of mortality, morbidity, and heath care utilization among foreign- and native-born Swedes during 1970–1999 have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of hospital care [6–8]. The results showed higher mortality and a 2.5 to 2.8 years lower mean age at time of death for foreign-born persons compared to the Swedish
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