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Carlsson, Marianne
Publications (10 of 16) Show all publications
Hedström, M., Carlsson, M., Ekman, A., Gillespie, U., Mörk, C. & Hulter Åsberg, K. (2018). Development of the PHASE-Proxy scale for rating drug-related signs and symptoms in severe cognitive impairment. Aging & Mental Health, 22(1), 53-60
Open this publication in new window or tab >>Development of the PHASE-Proxy scale for rating drug-related signs and symptoms in severe cognitive impairment
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2018 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 1, p. 53-60Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The need for assessment of possible drug-related signs and symptoms in older people with severe cognitive impairment has increased. In 2009, the PHASE-20 rating scale for identifying symptoms possibly related to medication was the first such scale to be found valid and reliable for use with elderly people. In this project, the aim was to develop and examine the psychometric properties and clinical utility of PHASE-Proxy, a similar scale for proxy use in assessing elderly people with cognitive impairment.

METHODS: Three expert groups revised PHASE-20 into a preliminary proxy version, which was then tested for inter-rater reliability, internal consistency, and content validity. Its clinical usefulness was investigated by pharmacist-led medication reviews. Group interviews and a study-specific questionnaire with nursing home staff were used to investigate the feasibility of use.

RESULTS: The PHASE-Proxy scale had satisfactory levels of inter-rater reliability (Spearman's rank correlation coefficient; rs = 0.8), and acceptable internal consistency (Cronbach's alpha coefficient; α = 0.73). The factor analysis resulted in a logical solution with seven factors, grouped into two dimensions: signs of emotional distress and signs of physical discomfort. The medication reviews, interviews, and questionnaires also found the proxy scale to be clinically useful, and feasible to use.

CONCLUSION: The PHASE-Proxy scale appears to be a valid instrument that enables proxies to reliably assess nursing home residents who cannot participate in the assessment, to identify possible drug-related signs and symptoms. It also appears to be clinically useful and feasible for use in this population.

Keywords
Cognitive impairment; medication reviews; proxy rating; signs; symptoms
National Category
Clinical Medicine
Identifiers
urn:nbn:se:hig:diva-22737 (URN)10.1080/13607863.2016.1232364 (DOI)000417735800008 ()27657536 (PubMedID)2-s2.0-84988638000 (Scopus ID)
Funder
Swedish National Board of Health and Welfare, 6.2.4-42858/2011
Available from: 2016-11-11 Created: 2016-11-11 Last updated: 2018-09-05Bibliographically approved
Höglund, A. T., Carlsson, M., Holmström, I. K., Lännerström, L. & Kaminsky, E. (2018). From denial to awareness: a conceptual model for obtaining equity in healthcare.. International Journal for Equity in Health, 17(1), Article ID 9.
Open this publication in new window or tab >>From denial to awareness: a conceptual model for obtaining equity in healthcare.
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2018 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 1, article id 9Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation.

METHOD: A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively.

RESULTS: Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare.

CONCLUSION: A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel.

Keywords
Conceptual model, Equity in health, Ethnicity, Gender, Sweden, Telephone nursing
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-26090 (URN)10.1186/s12939-018-0723-2 (DOI)000423229400001 ()29357884 (PubMedID)2-s2.0-85040925575 (Scopus ID)
Funder
Swedish Research Council
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-12-03Bibliographically approved
Nilsson, A., Carlsson, M., Lindqvist, R. & Kristofferzon, M.-L. (2017). A comparative correlational study of coping strategies and quality of life in patients with chronic heart failure and the general Swedish population. Nursing Open, 4(3), 157-167
Open this publication in new window or tab >>A comparative correlational study of coping strategies and quality of life in patients with chronic heart failure and the general Swedish population
2017 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 157-167Article in journal (Refereed) Published
Abstract [en]

The aim was to compare coping strategies and quality of life (QoL) in patients with chronic heart failure (CHF) with such strategies and QOL in persons from two general Swedish populations as well as to investigate relationships between personal characteristics and coping strategies. Methods:A cross-sectional, comparative and correlational design was used to examine data from three sources. The patient group (n=124), defined using ICD-10, was selected consecutively from two hospitals in central Sweden. The population group (n=515) consisted of persons drawn randomly from the Swedish population. Data were collected with questionnaires in 2011; regarding QoL, Swedish population reference data from 1994 were used. Results: Overall, women used more coping strategies than men did. Compared to the general population data from SF-36, patients with CHF rated lower QoL. In the regression models, perceived low ‘efficiency in managing psychological aspects of daily life’ increased use of coping. Other personal characteristics related to increased use of coping strategies were higher education, lower age and unsatisfactory economic situation. Conclusion: Differences between the patients and the general Swedish population showed an unclear pattern for coping and a clear pattern for QoL. To deal with the psychological consequences of daily life, men with CHF and persons in the general Swedish population seemed to use both problem- and emotion-focused coping. 

Keywords
chronic heart failure, coping, cross sectional survey, general Swedish population, Jalowiec Coping Scale, quality of life, SF-36
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-23789 (URN)10.1002/nop2.81 (DOI)000405085600006 ()28694980 (PubMedID)2-s2.0-85062111850 (Scopus ID)
Projects
LVO-CopQoL
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2019-03-26Bibliographically approved
Holmström, I. K., Kaminsky, E., Höglund, A. T. & Carlsson, M. (2017). Nursing students' awareness of inequity in healthcare - An intersectional perspective.. Nurse Education Today, 48, 134-139
Open this publication in new window or tab >>Nursing students' awareness of inequity in healthcare - An intersectional perspective.
2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 48, p. 134-139Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The overall aim of the present study was to explore awareness of inequity in healthcare and the intersection between different structures of power among nursing students. Another aim was to delineate the knowledge and use of Swedish Healthcare Direct in this group.

DESIGN: The study had a descriptive design with a quantitative approach.

PARTICIPANTS: The sample consisted of 157 nursing students from three universities in central Sweden.

METHODS: The students filled out a study specific questionnaire in class. The questionnaire consisted of short descriptions of twelve fictive persons who differed in gender, age, and ethnicity, with questions about their life situation. The mean was calculated for each assessed fictive person for every item. In the next step, the assessments were ranked from the lowest probability to the highest probability. A 'Good life-index' consisting of quality of life, power over own life, and experience of discrimination, was also calculated. Free text comments were analysed qualitatively.

RESULTS: People with Swedish names were assessed to have the highest probability of having a good life. Among those with Swedish names, the oldest woman was assessed as having the lowest probability of a good life. All students had knowledge about Swedish Healthcare Direct, but more female students had used the service compared to male students.

CONCLUSIONS: The results indicate that the nursing students had awareness of how power and gender, ethnicity and age, are related. Based on the free text comments, the questions and the intersectional perspective seemed to evoke some irritation which points to their sensitive nature. Therefore, the questionnaire could be used as a tool to start a discussion of equity in healthcare and in interventions where the aim is to raise awareness of inequality and intersectionality.

Keywords
Age, Equity in healthcare, Ethnicity, Gender, Intersectionality, Nursing students; Power, Telephone nursing
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-22756 (URN)10.1016/j.nedt.2016.10.009 (DOI)000389730600023 ()27810631 (PubMedID)2-s2.0-84993949798 (Scopus ID)
Funder
Swedish Research Council
Note

Funding agency: Faculty of Medicine, Uppsala University  Grant no: 344-2009-5853

Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-03-13Bibliographically approved
Theander, K., Wilde-Larsson, B., Carlsson, M., Florin, J., Gardulf, A., Johansson, E., . . . Nilsson, J. (2016). Adjusting to future demands in healthcare: curriculum changes and nursing students' self-reported professional competence. Nurse Education Today, 37, 178-183
Open this publication in new window or tab >>Adjusting to future demands in healthcare: curriculum changes and nursing students' self-reported professional competence
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2016 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 37, p. 178-183Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported.

OBJECTIVES: To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented.

SETTING: A higher education nursing program at a Swedish university.

PARTICIPANTS: In total, 119 (2011 n=69, 2014 n=50) nursing students responded.

METHODS: Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale.

RESULTS: There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students.

CONCLUSIONS: Our findings indicate that newly graduated nursing students - both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing.

Keywords
Nurse competence, Professional nursing, Nursing education, Nursing curriculum, Nursing student; NPC scale
National Category
Nursing Educational Sciences
Identifiers
urn:nbn:se:hig:diva-20998 (URN)10.1016/j.nedt.2015.11.012 (DOI)000371098300029 ()26703792 (PubMedID)2-s2.0-84958115385 (Scopus ID)
Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-03-13Bibliographically approved
Nilsson, J., Johansson, E., Carlsson, M., Florin, J., Leksell, J., Lepp, M., . . . Gardulf, A. (2016). Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters. Nurse Education in Practice, 17, 102-108
Open this publication in new window or tab >>Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters
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2016 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, p. 102-108Article in journal (Refereed) Published
Abstract [en]

The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events. 

Keywords
Disaster nursing, NPC Scale, Nursing students, Registered nurses
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-20785 (URN)10.1016/j.nepr.2015.09.012 (DOI)000374622700017 ()26776502 (PubMedID)2-s2.0-84947563359 (Scopus ID)
Available from: 2015-12-04 Created: 2015-12-04 Last updated: 2018-03-13Bibliographically approved
Höglund, A. T., Carlsson, M., Holmström, I. K. & Kaminsky, E. (2016). Impact of telephone nursing education program for equity in healthcare. International Journal for Equity in Health, 15(1), Article ID 152.
Open this publication in new window or tab >>Impact of telephone nursing education program for equity in healthcare
2016 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 1, article id 152Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person's human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses.

METHODS: The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one's own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions.

RESULTS: The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments.

CONCLUSION: The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but could easily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.

Keywords
Equity in health; Intersectional perspective; Intervention study; Sweden; Telephone nursing
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-22730 (URN)10.1186/s12939-016-0447-0 (DOI)000383661300001 ()27654327 (PubMedID)2-s2.0-84988385293 (Scopus ID)
Available from: 2016-11-10 Created: 2016-11-10 Last updated: 2018-03-13Bibliographically approved
Gardulf, A., Nilsson, J., Florin, J., Leksell, J., Lepp, M., Lindholm, C., . . . Johansson, E. (2016). The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation. Nurse Education Today, 36, 165-171
Open this publication in new window or tab >>The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation
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2016 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, p. 165-171Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients.

OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors.

METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated.

RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs).

SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

Keywords
Nurses' competence, Professional nursing, Nursing education, Nursing students, Graduate nurses, Quality in care, Safety in care, NPC Scale
National Category
Nursing Educational Sciences
Identifiers
urn:nbn:se:hig:diva-20769 (URN)10.1016/j.nedt.2015.09.013 (DOI)000367117000028 ()26586256 (PubMedID)2-s2.0-84951263105 (Scopus ID)
Available from: 2015-12-03 Created: 2015-12-03 Last updated: 2018-03-13Bibliographically approved
Nilsson, J., Johansson, E., Egmar, A.-C., Florin, J., Leksell, J., Lepp, M., . . . Gardulf, A. (2014). Development and validation of a new tool measuring nurses self-reported professional competence: the nurse professional competence (NPC) scale. Nurse Education Today, 34(4), 574-580
Open this publication in new window or tab >>Development and validation of a new tool measuring nurses self-reported professional competence: the nurse professional competence (NPC) scale
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2014 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 574-580Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines.

DESIGN: A methodological study including construction of a new scale and evaluation of its psychometric properties.

PARTICIPANTS AND SETTINGS: 1086 newly graduated nurse students from 11 universities/university colleges.

RESULTS: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained.

CONCLUSIONS: The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

Keywords
Graduate nurses; Nurses' competence; Nursing education; Nursing students; Professional nursing; Psychometric properties; Quality of care; Safety in healthcare; Scale development; Validation
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-15283 (URN)10.1016/j.nedt.2013.07.016 (DOI)000333781600016 ()23938092 (PubMedID)2-s2.0-84895135738 (Scopus ID)
Available from: 2013-09-17 Created: 2013-09-17 Last updated: 2018-03-13Bibliographically approved
Kaminsky, E., Carlsson, M., Holmström, I. K., Larsson, J. & Fredriksson, M. (2014). Goals of telephone nursing work - the managers' perspectives: a qualitative study on Swedish Healthcare Direct. BMC Health Services Research, 14, 188
Open this publication in new window or tab >>Goals of telephone nursing work - the managers' perspectives: a qualitative study on Swedish Healthcare Direct
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2014 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 188-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Swedish Healthcare Direct (SHD) receives 6 million calls yearly and aims at increased public sense of security and healthcare efficiency. Little is known about what SHD managers perceive as the primary goals of telephone nursing (TN) work and how the organisation matches goals of health promotion and equitable healthcare, so important in Swedish healthcare legislation. The aim of the study was to explore and describe what the SHD managers perceive as the goals of TN work and how the managers view health promotion and implementation of equitable healthcare with gender as example at SHD.

METHODS: The study was qualitative using an exploratory and descriptive design. All 23 managers employed at SHD were interviewed and data analysis used deductive directed content analysis.

RESULTS: The findings reveal four themes describing the goals of TN work as recommended by the SHD managers. These are: 'create feelings of trust', 'achieve patient safety', 'assess, refer and give advice', and 'teach the caller'. Most of the managers stated that health promotion should not be included in the goals, whereas equitable healthcare was viewed as an important issue. Varying suggestions for implementing equitable healthcare were given.

CONCLUSIONS: The interviewed managers mainly echoed the organisational goals of TN work. The managers' expressed goal of teaching lacked the caller learning components highlighted by telenurses in previous research. The fact that health promotion was not seen as important indicates a need for SHD to clarify its goals as the organisation is part of the Swedish healthcare system, where health promotion should always permeate work. Time used for health promotion and dialogues in a gender equitable manner at SHD is well invested as it will save time elsewhere in the health care system, thereby facing one of the challenges of European health systems.

Keywords
Equitable healthcare, Health promotion, Managers, Paediatric health calls, Qualitative research, Registered nurses, Sweden, Telephone nursing
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hig:diva-17666 (URN)10.1186/1472-6963-14-188 (DOI)000335530600001 ()24762193 (PubMedID)2-s2.0-84899939784 (Scopus ID)
Available from: 2014-10-22 Created: 2014-10-10 Last updated: 2018-03-13Bibliographically approved
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