Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care

Background: Evidence-based practice for healthy lifestyle promotion in primary health care is supported internationally by national policies and guidelines but implementation in routine primary health care has been slow. Referral to digital interventions could lead to a larger proportion of patients accessing structured interventions for healthy lifestyle promotion, but such referral might have unknown implications for clinicians with patients accessing such interventions. This qualitative study aimed to explore the perceptions of clinicians in primary care on healthy lifestyle promotion with or without digital screening and intervention. Methods: Focus group interviews were conducted at 10 primary care clinics in Sweden with clinicians from different health professions. Transcribed interviews were analyzed using content analysis, with inspiration from a phenomenological-hermeneutic method involving na\uefve understanding, structural analysis and comprehensive understanding. Results: Two major themes captured clinicians\u27 perceptions on healthy lifestyle promotion: 1) the need for structured professional practice and 2) deficient professional practice as a hinder for implementation. Sub-themes in theme 1 were striving towards professionalism, which for participants meant working in a standardized fashion, with replicable routines regardless of clinic, as well as being able to monitor statistics on individual patient and group levels; and embracing the future with critical optimism, meaning expecting to develop professionally but also being concerned about the consequences of integrating digital tools into primary care, particularly regarding the importance of personal interaction between patient and provider. For theme 2, sub-themes were being in an unmanageable situation, meaning not being able to do what is perceived as best for the patient due to lack of time and resources; and following one\u27s perception, meaning working from a gut feeling, which for our participants also meant deviating from clinical routines. Conclusions: In efforts to increase evidence-based practice and lighten the burden of clinicians in primary care, decision- and policy-makers planning the introduction of digital tools for healthy lifestyle promotion will need to explicitly define their role as complements to face-to-face encounters. Our overriding hope is that this study will contribute to maintaining meaningfulness in the patient-clinician encounter, when digital tools are added to facilitate patient behavior change of unhealthy lifestyle behaviors

Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study

A41 Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study In: Addiction Science & Clinical Practice 2017, 12(Suppl 1): A4

Vardagslivet och vårdandet för kvinnor och män med alkoholberoende : En studie om alkoholberoende kvinnor och mäns levda erfarenhet av att leva med och vårdas för alkoholberoende

The number of men and women suffering from alcohol dependency is increasing.Today there are shortcomings in knowledge about the lived experiences of being a woman or a man with alcohol dependency; knowledge which might be of importance for meeting these individual’s specific care needs. The overall aim of the study was to obtain a deeper understanding of women and men's experience of living with alcohol dependency and being professionally cared for. The qualitative investigation design was exploratory and founded in a life world perspective. Data were collected from fourteen women and fifteen men with alcohol dependency by means of open in-depth interviews and subjected to a phenomenological-hermeneutic analysis. It was found that living with alcohol dependency encompasses a complex but limited life situation in which both women and men strive for social acceptance and adjustment. Women turned out to live a more introverted life than men and presented false facades. Men turned out to live a life in action, risk taking and control. Professional caring was shown to mean availability and confirmation of needs. For men with alcohol dependency professional caring meant support and gentle guidance in their active struggle against their alcohol dependency. For women, professional caring meant having an active caregiver who cherished them and enabled them to rest. Professional caring reduced senses of shame in both women and men. It may be concluded that in order to offer care for men and women with alcohol dependency professional carers have to consider gender specific needs of support and guidance. In addition, in order to alleviate suffering, professional caregivers have to be accessible, supportive and directed toward the alcohol dependent women's and men’s everyday world

Staff experiences of encountering and treating outpatients with substance use disorder in the psychiatric context : a qualitative study

Background: High comorbidity exists between mental illness and substance use disorders (SUD). Patients in psychiatry living with problematic alcohol or drug consumption can experience a sense of exclusion, where seeking help for SUD can be perceived as stigmatizing. The aim of this study is to illuminate staff experiences of encountering patients with SUD within the psychiatric outpatient context. Methods: The study was exploratory, with a qualitative design. Interviews with outpatient psychiatry managers and focus groups with clinical staff focused on the experience of encountering patients with SUD. Data were evaluated using content analysis inspired by phenomenological-hermeneutic methodology. Results: Three themes were identified and each illuminated by two sub-themes. Bridging the organizational gap included sub-themes of having an established collaboration and facing difficulties in the collaboration; Having beliefs about the patient you encounter included sub-themes of working with patients who are exposed to prejudicial thoughts and expressing prejudicial thoughts about the patient. Striving to achieve a therapeutic alliance included sub-themes of having a feeling of developing together and supporting the patient towards recovery. Conclusion: A life-world perspective, used to interpret results, indicated that caring for patients with SUD in psychiatry was perceived as difficult, where collaboration between psychiatry and addiction care was often experienced as problematic. Based on these findings, we believe that the current gap between the psychiatry and addiction care could be reduced to some extent by offering patients digital treatment for SUD. In this way, patients could remain under the care of their regular psychiatric clinic without having to physically visit SUD services. Thus, a virtual bridge could be established to bring psychiatry and addiction care closer to each other for the patients' benefit

Creating interactions with children who have deafblindness – a review

Bakgrund: Få barn föds varje år med dövblindhet som varierar i grader av syn- samt hörselnedsättning. Information om kommunikationsstrategier till pedagoger och närstående krävs och audionomen bör vara inläst på hur interaktion skapas mellan barnet, pedagogerna och närstående. Audionomen bör veta vilken roll pedagoger och närstående spelar i samverkan med barnet. Syfte: Att utifrån litteraturen belysa interaktionen mellan pedagoger och närstående och barnet med dövblindhet samt se på de karaktäristiska kommunikationssätten för barnet med dövblindhet. Metod: Litteraturstudie där kvalitativa och kvantitativa studier använts.                                Resultat: Två olika utbildningsmodeller hittades. En återkom i flera studier och byggde på lämpliga samt olämpliga beteenden, en beskrev tillvägagångssätten i interaktionen. Ett varierat resultat påvisades hos pedagogerna/närstående, mestadels positivt och ett fåtal mindre optimala resultat. En fallstudie beskrev interaktionen mellan 6 barn och deras föräldrar. Studien visar fungerande, om än i varierande grad, interaktion mellan samtliga barn och föräldrar. En studie behandlade mor- och farföräldrars roll i kommunikationen med barnen där oro inför umgänge med, och framtiden för, barnbarnen utrycktes. Två studier studerade interaktion mellan barnen och lärare. Den visade att interaktion fanns mellan parterna, med få initiativ från eleverna. Slutsatser: Pedagoger och närstående bör få kontinuerlig utbildning för utveckling av interaktion med barnet med dövblindhe