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  • 1.
    Addelyan Rasi, Hamideh
    et al.
    University of Skövde, School of Life Sciences.
    Timpka, Toomas
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Lindqvist, Kent
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Moula, Alireza
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Can a psychosocial intervention programme teaching coping strategies improve the quality of life of Iranian women?: A non-randomised quasi-experimental study2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 3, article id e002407Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess whether a psychosocial intervention teaching coping strategies to women can improve quality of life (QOL) in groups of Iranian women exposed to social pressures. Design: Quasi-experimental non-randomised group design involving two categories of Iranian women, each category represented by non-equivalent intervention and comparison groups. Setting: A large urban area in Iran. Participants: 44 women; 25 single mothers and 19 newly married women. Interventions: Seventh-month psychosocial intervention aimed at providing coping strategies. Primary outcome measures: Effect sizes in four specific health-related domains and two overall perceptions of QOL and health measured by the WHOQOL-BREF instrument. Results: Large effect sizes were observed among the women exposed to the intervention in the WHOQOLBREF subdomains measuring physical health (r=0.68; p<0.001), psychological health (r=0.72; p<0.001), social relationships (r=0.52; p<0.01), environmental health (r=0.55; p<0.01) and in the overall perception of QOL (r=0.72; p<0.001); the effect size regarding overall perception of health was between small and medium (r=0.20; not significant). Small and not statistically significant effect sizes were observed in the women provided with traditional social welfare services. Conclusions: Teaching coping strategies can improve the QOL of women in societies where gender discrimination is prevalent. The findings require reproduction in studies with a more rigorous design before the intervention model can be recommended for widespread distribution.

  • 2.
    Hafskjold, Linda
    et al.
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Holmström, Inger K.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden / Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Sundling, Vibeke
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    van Dulmen, Sandra
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway / NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands / Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
    Eide, Hilde
    Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway.
    A cross-sectional study on person-centred communication in the care of older people: The COMHOME study protocol2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4, article id e007864Article in journal (Refereed)
    Abstract [en]

    Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. Methods and analysis: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Ethics and dissemination: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people. © 2015, BMJ Publishing Group. All rights reserved

  • 3.
    Oli, Natalia
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Subedi, Madhusudan
    Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
    Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 9, article id e008197Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Non-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nepalese peri-urban community, aimed to explore mothers' perception of their children's diet and physical activity.

    DESIGN: We notated, tape-recorded and transcribed all data collected from six focus group discussions, and used qualitative content analysis for evaluation and interpretation.

    SETTING: The study was conducted in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal.

    PARTICIPANTS: Local health workers helped recruit 61 women with children aged 5-10 years. We distributed participants among six different groups according to educational status.

    RESULTS: Although participants understood the importance of healthy food, they misunderstood its composition, perceiving it as unappetising and appropriate only for sick people. Furthermore, participants did not prioritise their children's physical activities. Moreover, mothers believed they had limited control over their children's dietary habits and physical activity. Finally, they opined that health educational programmes would help mothers and recommended various intervention strategies to increase knowledge regarding a healthy lifestyle.

    CONCLUSIONS: Our data reveal that mothers of young children in a peri-urban community of Nepal lack adequate and accurate understanding about the impact of a healthy diet and physical activity. Therefore, to prevent future cardiovascular disease and other non-communicable diseases among children, Nepal needs health education programmes to improve mothers' cardiovascular health knowledge, attitude and behaviour.

  • 4.
    Vaidya, Abhinav
    et al.
    Kathmandu Medical College, Kathmandu, Nepal / Nordic School of Public Health NHV, Gothenburg.
    Aryal, Umesh Raj
    Kathmandu Medical College, Kathmandu, Nepal / Nordic School of Public Health NHV, Gothenburg.
    Krettek, Alexandra
    Nordic School of Public Health NHV / Sahlgrenska Academy at University of Gothenburg.
    Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 10, article id e002976Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study determined the knowledge, attitude and practice/behaviour of cardiovascular health in residents of a semiurban community of Nepal.

    DESIGN: To increase the understanding of knowledge, attitude and practice/behaviour towards cardiovascular health, we conducted in-home interviews using a questionnaire based on the WHO STEPwise approach to surveillance and other resources, scoring all responses. We also recorded blood pressure and took anthropometric measurements.

    SETTING: Our study was conducted as part of the Heart-Health-Associated Research and Dissemination in the Community project in the Jhaukhel-Duwakot Health Demographic Surveillance Site in two urbanising villages near Kathmandu.

    PARTICIPANTS: The study population included 777 respondents from six randomly selected clusters in both villages.

    RESULTS: Seventy per cent of all participants were women and 26.9% lacked formal education. The burden of cardiovascular risk factors was high; 20.1% were current smokers, 43.3% exhibited low physical activity and 21.6% were hypertensive. Participants showed only poor knowledge of heart disease causes; 29.7% identified hypertension and 11% identified overweight and physical activity as causes, whereas only 2.2% identified high blood sugar as causative. Around 60% of respondents did not know any heart attack symptoms compared with 20% who knew 2-4 symptoms. Median percentage scores for knowledge, attitude and practice/behaviour were 79.3, 74.3 and 48, respectively. Nearly 44% of respondents had insufficient knowledge and less than 20% had highly satisfactory knowledge. Among those with highly satisfactory knowledge, only 14.7% had a highly satisfactory attitude and 19.5% and 13.9% had satisfactory and highly satisfactory practices, respectively.

    CONCLUSIONS: Our study demonstrates a gap between cardiovascular health knowledge, attitude and practice/behaviour in a semiurban community in a low-income nation, even among those already affected by cardiovascular disease.

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