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  • 1.
    Akhavan, Sharareh
    Mälardalens högskola.
    Arbetshälsa ur perspektiven klass, genus och etnicitet.2006Ingår i: I: Kors och tvärs: Intersektionalitet och makt i storstadens arbetsliv / [ed] Gunnarsson E., Neergard A., Nilsson A., Stockholm: Normal Förlag , 2006, s. 300-315Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 2.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Class, gender and ethnicity in relation to health care – A study on social disparities in the Swedish health care.2011Ingår i: Reconsidering social identification: race, gender, class and caste. / [ed] Janmohamed A. (Ed.), Routledge, 2011Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 3.
    Akhavan, Sharareh
    Karolinska Institutet, Stockholm.
    Female Immigrants’ Health and Working Conditions in Sweden2007Ingår i: The international journal of diversity in organisations, communities and nations, ISSN 1447-9583, Vol. 7, nr 2, s. 275-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sweden is one of the European countries that has successively changed from a mainly ethnically homogeneous society into a multi-ethnic society. In 2001, almost 20 per cent of the Swedish population was classified as immigrants, i.e., they were either born abroad and naturalized, of foreign nationality or born in Sweden with at least one parent who had been born abroad. Reports, statistics and research have shown that the health of female immigrants is worse than that of the total population and that the incidence of long-term sickness absence and early retirement is higher in this group. The overall aim of this article is to describe, understand and analyze factors that contribute to poor health among female immigrants in Sweden from the perspective of class, gender and ethnicity. Being unemployed, on sick leave or working in occupation with low income and low status are examples that are related to class position, gender and ethnicity. The main three aspects based on class are wage, professional status and female immigrants position in the hierarchical work organisation. Other factors are discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and absence of opportunities for skills upgrade training. Experiences of rape, domestic violence, unanswered emotional and sexual needs and patriarchal culture are examples that are related to gender. And experiencing traumatic events (in pre-migration periods such as experiences of war, prison, etc. and in post-migration periods such as experiences of discrimination and racism) are examples that are related to ethnicity.

  • 4.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Invandrade kvinnors hälsa och arbetsvillkor i Sverige2011Ingår i: Perspektiv på kvinnors hälsa i arbetslivet / [ed] Sandmark H., Lund: Studentlitteratur, 2011, s. 135-142Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 5.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Livssmärta - utanförskap och problem med barn.2003Ingår i: Flyktingskapet i ett långsiktigt integrationsperspektiv. / [ed] Franzen E. ., Tullinge: FOU Södertörn , 2003, s. 195-264Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 6.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Midwives’ views on factors that contribute to health care inequalities among immigrants in Sweden: a qualitative study.2012Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 11, s. article nr: 47-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Ethnic and socioeconomic inequalities in the Swedish health care system have increased. Most indicators suggest that immigrants have significantly poorer health than native Swedes. The purpose of this study was to explore the views of midwives on the factors that contribute to health care inequality among immigrants. Methods: Data were collected via semi-structured interviews with ten midwives. These were transcribed and related categories identified through content analysis. Results: The interview data were divided into three main categories and seven subcategories. The category "Communication" was divided into subcategories "The meeting", "Cultural diversity and language barriers" and "Trust and confidence". The category "Potential barriers to the use of health care services" contained two subcategories, "Seeking health care" and "Receiving equal treatment". Finally, the category "Transcultural health care" had subcategories "Education on transcultural health care" and "The concept". Conclusions: This study suggests that midwives believe that health care inequality among immigrants can be the result of miscommunication which may arise due to a shortage of meeting time, language barriers, different systems of cultural beliefs and practices and limited patient-caregiver trust. Midwives emphasized that education level, country of origin and length of stay in Sweden play a role when an immigrant seeks health care. Immigrants face more difficulties when seeking health care and in receiving adequate levels of care. However, different views among the midwives were also observed. Some midwives were sensitive to individual and intra-group differences, while some others viewed immigrants as a group of "others". Midwives' beliefs about subgroup-specific health services vs. integrating immigrants' health care into mainstream health care services should be investigated further. Patients' perspective should also be considered.

  • 7.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Patienters uppfattning om Vård på lika villkor2015Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, nr 2, s. 189-199Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Att ta reda på patienternas uppfattningar om vård och de välfärdstjänster som samhället erbjuder är viktig för att kunna kvalitetsutveckla vården. Syftet med denna studie var att undersöka patienternas perspektiv om jämlikhet i vård samt deras idéer om metoder för att utveckla en mer jämlik vård. För att nå syftet används kvalitativ metod i form av intervjuer med patienter och representanter för patientföreningar. Resultatet visar att patienter anser att läkarkontinuitet, tid vid besök, tillgänglighet, kommunikation och bemötande kan utvecklas och blir bättre för att en mer jämlik vård ska uppnås. 

  • 8.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Promoting Equity in Primary Health Care2015Ingår i: Primary Health Care, ISSN 2167-1079, Vol. 5, nr 216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Equity in access to primary health care services is a central objective of the Swedish health care system. Yet, several reports have illustrated that disparities still exist in the primary health sector, and have increased since the beginning of the 1990s. This commentary analyzes and explains the reasons for continuing inequality in access to and utilization of primary health care services in a welfare system. Social and structural factors, communication, macro-sociological aspects and health care providers’ attitudes and perceptions are discussed as substantial contributors to inequality in access to and utilization of primary health care services. In conclusion, some intervention strategies for promoting more equitable primary health care are suggested.

  • 9.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Social determinants of health for female Iranian immigrants in Sweden.2012Ingår i: The Iranian community in Sweden – Multidisciplinary perspectives. / [ed] Hosseini-Kaladjani H., Tumba: The Multicultural Centre , 2012Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 10.
    Akhavan, Sharareh
    Högskolan i Skövde.
    Utvärdering av projektet ”Utlandsfödda kvinnor som doulor och kulturtolkar”2009Rapport (Övrigt vetenskapligt)
  • 11.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Vad sker med personalens inställning till Vård på lika villkor när verksamheterna deltar i Lärandeprojektet?2015Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, nr 2, s. 176-188Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Jämlikhet i hälsa och att erbjuda vård på lika villkor är en av de viktigaste aspekterna för ett välfärdssamhälle. Flera rapporter visar att hälso- och sjukvården inte är jämlik. Syftet med denna studie var att studera vårdpersonalens synpunkter på jämlik vård samt om deras tankar om metoder för att uppnå en mer jämlik vård. En webbenkät skickades till all personal före och efter projekttiden i de verksamheter som deltog i Lärande projektet. Resultatet visar att vårdpersonalen anser att de faktorer som påverkar brukares/patienters tillgång till vård på lika villkor består av: Strukturella/organisatoriska faktorer inom vården (t.ex. brist på läkare), eller i samhället (t.ex. bostadsområde) och patienternas/brukarnas sociala situation (t.ex. utbildning).

  • 12.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Aytar, Osman
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Blev det ett genombrott?: Utvärdering av det nationella lärandeprojektet – Vård på lika villkor2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Sjukvården i Sverige är i dag inte jämlik, har brister i tillgänglighet och erbjuds inte på likvärdiga villkor trots Hälso- och sjukvårdslagens mål om en god hälsa och en vård på lika villkor för hela befolkningen.

    För att bryta den pågående trenden och öka jämlikheten gjordes en överenskommelse mellan regeringen och SKL om lärandeprojektet Vård på lika villkor (under åren 2011–2014). Syftet med projektets har varit att inom socioekonomiskt resurssvaga bostadsområden öka jämlikheten i första linjens vård. Detta genom att testa, utveckla och identifiera effektiva arbetssätt och metoder vid sju primärvårdsverksamheter från fem landsting i Sverige.

    Mälardalens högskola, Akademin för hälsa, vård och välfärd, fick av SKL i uppdrag att svara för forskarstöd och att genomföra en utvärdering av de metoder och arbetssätt som utvecklades och testades i lärandeprojektet.

    Resultatet från den genomförda utvärderingen som belyser den genomförda processen, mål- och resultat samt hälsoekonomiska aspekter beskrivs närmare i denna rapport.

  • 13.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Aytar, Osman
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Temaledare: Vård på lika villkor – Vad kan vi lära av Lärandeprojektet?2015Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, nr 2, s. 103-106Artikel i tidskrift (Övrigt vetenskapligt)
  • 14.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. National Institute for Working Life, Sweden.
    Bildt, C
    National Institute for Working Life, Sweden.
    Wamala, S
    National Institute for Working Life, Sweden.
    Work-related health factors among female immigrants in Sweden2007Ingår i: WORK – A Journal of Prevention, Assessment and Rehabilitation, ISSN 1051-9815, Vol. 28, nr 2, s. 135-144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Work-related health has been a focus of research since the rate of sickness-related absences began to increase in Sweden. The incidence of sickness-related absences and early retirement is higher among female immigrants than among others in the total population. This study is based on a questionnaire survey which was conducted in a municipality in Sweden. The study population consisted of 2 429 native and immigrant female employees. The aim was to study work-related health factors for female immigrants. The results of this study show that about 20% of female immigrants who participate in the survey have temporary employment while the proportion is 8% for native women. The perception of ethnic discrimination among female immigrants was three times as much as among native females. The results also show that 69% of female immigrants report having received no opportunity to discuss their wages with managers, in comparison to 63% of native females. About 40% of female immigrants and 35% of native women report that they do not get opportunities to upgrade their skills. Female immigrants over the age of 50 experience gender and ethnic discrimination and lack of access to skills training programs more often than younger immigrants. They also participate in health-care activities more often.

  • 15.
    Akhavan, Sharareh
    et al.
    National Institute for Working Life, Sweden.
    Bildt, C
    National Institute for Working Life, Sweden.
    Wamala, S
    National Institute for Working Life, Sweden.
    Work-related health factors among female immigrants in Sweden – A qualitative study on a sample of twenty workers.2006Ingår i: Italian Journal of Public Health, ISSN 1723-7807, E-ISSN 1723-7815, Italian Journal of Public Health, ISSN 1723-7807, Vol. 3, nr 1, s. 60-67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The purpose of this study was to explore work-related health factors amongst female immigrants in Sweden.

    Methods: Qualitative methods were used in order to get the broadest possible picture of female immigrants’ perceptions on work-related health factors. Semi-structured interviews were conducted with twenty female immigrants who worked in different departments of a municipality adjacent to a large city in Sweden. Most of the interviewed women came from the Middle East, Africa and Latin America, while some came from eastern and southern Europe as well as Finland. The women had lived in Sweden for 5-27 years. Content analysis, which is based on analysis by topic, was used to analyse the data.

    Results: Results from the interviews show that female immigrants perceived that work-related health is strongly associated with class. The three aspects of class that arose from this study were wage, professional status and their position within the organisations hierarchy. Other factors that were identified as being associated to work-related health were discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and lack of training opportunities for upgrading their skills.

    Conclusions: The public health implications of the findings in this study suggest that measures that ought to be taken to improve female immigrants working conditions and health are primarily systematic efforts to counteract discrimination because of gender and ethnicity in areas such as wage setting and opportunities for skill up-grade training. This should result in improved employment opportunities for female immigrants, particularly those who work in low status and low-paid jobs.

  • 16.
    Akhavan, Sharareh
    et al.
    National Institute for Working Life, Stockholm, Sweden.
    Bildt, Carina
    National Institute for Working Life, Stockholm, Sweden.
    Franzen, Elsie
    Wamala, Sarah
    National Institute for Working Life, Stockholm, Sweden.
    Health in relation to unemployment and sick leave among immigrants in Sweden from a gender perspective2004Ingår i: Journal of Immigrant Health, Vol. 6, nr 3, s. 103-118Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to analyze health in relation to unemployment and sick leave among immigrants from a gender perspective. Questionnaire, observations, and group discussions were used for data collection. The study group consisted of 60 unemployed persons with immigrant or refugee background, 30 women and 30 men. Slightly more than half of the participants considered theirhealth to be poor and experienced physical and/or mental disorders. The female participants in comparison to male participants experienced poorer health. The results show that there is a reciprocal influence between health, work, and migration. Immigration may cause poor health, which as a selection effect leads to unemployment and/or sick leave. Immigration may also bring about an inferior position in the labor market, which leads to poor health due to exposure effects. The influence on health is more marked for immigrant women than for immigrant men.

  • 17.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Karlsen, S.
    University College London.
    Practitioner and client explanations for disparities in health care use between migrant and non-migrant groups in Sweden: A qualitative study2013Ingår i: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 15, nr 1, s. 188-197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To investigate variations in explanations given for disparities in health care use between migrant and non-migrant groups, by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five 'migrant' health service clients and five physicians. The interview data generated three categories which were perceived by respondents to produce ethnic differences in health service use: "Communication issues", "Cultural differences in approaches to medical consultations" and "Effects of perceptions of inequalities in care quality and discrimination". Explanations for disparities in health care use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and those using cultural/behavioural explanations. The negative perceptions of 'migrant' clients held by some Swedish physicians place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage. The power disparity between doctors and 'migrant' patients encourages a sense of powerlessness and mistreatment among patients.

  • 18.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Client/patient perceptions of achieving equity in primary health care: a mixed methods study2015Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 14, nr 1, s. 1-12, artikel-id 196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Introduction: To provide health care on equal terms has become a challenge for the health system. As the front line in health services, primary care has a key role to play in developing equitable health care, responsive to the needs of different population groups. Reducing inequalities in care has been a central and recurring theme in Swedish health reforms. The aim of this study is to describe and assess client/patient experiences and perceptions of care in four primary health care units (PHCUs) involved in Sweden's national Care on Equal Terms project. Methods: Mixed Method Research (MMR) was chosen to describe and assess client/patient experiences and perceptions of health care with regard to equity. There was a focus group discussion, and individual interviews with 21 clients/patients and three representatives of patient associations. Data from the Swedish National Patient Survey (NPS), conducted in 2011 and followed up in 2013, were also used. Results: The interview data were divided into two main categories and three subcategories. The first category "Perception of equitable health care" had two subcategories, namely "Health care providers' perceptions" and "Fairness and participation". The second category "To achieve more equitable health care" had four subcategories: "Encounter", "Access", "Interpreters and bilingual/diverse health care providers" and "Time pressure and continuity". Results from the NPS showed that two of the PHCUs improved in some aspects of patient perceived quality of care (PPQC) while two were not so successful. Conclusions: Clients/patients perceived health care providers' perceptions of their ethnic origin and mental health status as important for equitable health care. Discriminatory perceptions may lead to those in need of care refraining from seeking it. More equitable care means longer consultations, better accessibility in terms of longer opening hours, and ways of communicating other than just via voice mail. It also involves continuity in care and access to an interpreter if needed. Employing bilingual/diverse kinds of health providers is a way of providing more equitable primary health care.

  • 19.
    Akhavan, Sharareh
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Aytar, Osman
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Practice and Policy in Promoting Health and Equity –experiences from a national project in primary health care in Sweden2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction: The Swedish Health Care Law requires the health system to provide good care on equal terms to all. However, several reports from different governmental agencies have revealed that health care is uneven in quality, lacking in accessibility, and not offered on equal terms to all people. Recent public health reports show that inequalities in health in the population have increased. To provide health care on equal terms has become a challenge for health care.

    In order to apply methods for developing practice and policy in promoting health and equity the Swedish Association of Local Authorities and Regions developed and implemented a national project entitled Care on Equal Terms. The project began in 2011 and was completed in 2014 at seven Primary Health Care Units (PHCUs) in five regions. The aim of this study was to evaluate the outcomes of this project.

    Methods: Based on a program theoretical approach an evaluation design was developed which included process, results and economical evaluation. In the data collection and analysis mixed methods were applied.

    Results: According to the process evaluation, seven different strategies were applied in the process to develop primary health care on equal terms. One of the key observations was that in order to achieve health on more equal terms, health care needs to be provided on unequal terms, i. e. more needs to be done to reach those who need more assistance to access health services. Health promotion was one of the applied strategies and it was the most common strategy at some of the health care centers with the aim of developing patients' knowledge, awareness and understanding about health, care and self-care. The results evaluation showed that the PHCUs staff identified structural and organizational factors in health care as important factors for developing health promotion and equity in access. The health economic evaluation showed that the costs for implementing the activities for an improved equity were limited. Yet the majority of the PHCUs thought that the detailed regulation of their financing and reporting requirements were a limitation in their work for improved equity. Four of five county councils have recently introduced a primary care provider payment system (ACG) which may not be supportive of efforts to improve equity in access.

    Conclusions: It is possible to develop and maintain practices that can contribute to more equitable care and increase health care personnel’s awareness about practice and policy in promoting health and equity.

  • 20.
    Aytar, Osman
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akahavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Granath, Marianne
    Sveriges kommuner och landsting.
    Wallin, Hanna
    Sveriges kommuner och landsting.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Using program theory-driven evaluation in primary care units: An integrated evaluation perspective on a learning project providing equitable care in Sweden2013Konferensbidrag (Refereegranskat)
  • 21.
    Aytar, Osman
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study2017Ingår i: Quality in Primary Care, ISSN 1479-1072, E-ISSN 1479-1064, Vol. 25, nr 5, s. 289-296Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In June 2011 the Swedish government signed an agreement with The Swedish Association of Local Authorities and Regions (SALAR), for a three year project to develop and implement “Health care on equal terms.” The project, which involved seven Primary Health Care Units (PHCU) from five county councils in different parts in Sweden, was completed in early 2014. The aim of the project was to develop methods and activities that could promote more equal health care provision in socio-economically disadvantaged areas.

    Aim: To assess and compare health care providers’ experiences of and perceptions about equitable health care at the beginning and end of the national project “Health care on equal terms”.

    Methods: A web survey was sent to all staff at the seven participating Primary Health Care Units (PHCU) at the beginning (2012) and the end (2013) of the project. Data were analyzed with descriptive statistics and the open issues with content analysis.

    Results: In 2013, the percentage of health care providers who reported thinking patients’ ethnicity had no or very little impact on access to care increased, but the proportion of those who reported that they had “no idea” that patients’ gender, age, mental health and physical functioning were significant for access to care was lower in 2013 than in 2012. The results from analysis of the open-ended questions did not show meaningful changes in the respondents’ perceptions of the issues addressed in 2012-2013, but the analysis contributes to a deeper explanation of the answers.

    Conclusion: The main conclusion is that it was possible to implement changes aiming for more equitable care through projects with a focus on learning.

  • 22.
    Gustafsson, Gunnel
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Aytar, Osman
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Områdesbeskrivningar av sju vårdverksamheter: Primärvårdens förutsättningar och befolkningens vårdbehov2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Lärandeprojektet Vård på lika villkor har varit en överenskommelse mellan staten och Sveriges Kommuner och Landsting som pågått mellan 2011 och 2014. Målet med projektet har varit att utveckla arbetssätt och metoder som kan främja en mer jämlik första linjens vård. Inom ramen för projektet har SKL uppdragit åt forskare vid Mälardalens högskola att göra områdesbeskrivningar för de sju medverkande vårdverksamheterna.

    Syftet med områdesbeskrivningarna är försöka ge en jämförbar beskrivning av de medverkande sju verksamheterna i projektet. Beskrivningen är gjord utifrån relevant statistik och demografi ska data på patientnivå, samt utifrån organisatoriska förutsättningar och resurser. Förhoppningen är att dessa uppgifter kan ge ökad förståelse för vilka patienter som fi nns i området och fungera som ett stöd i arbetet för en mer jämlik vård.

  • 23.
    Norfjord Van Zyl, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Natl Board Hlth & Welf, Evaluat & Anal Unit, Stockholm, Sweden..
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Asp, Margareta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden2018Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, nr 1, artikel-id 1521256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county.Method:Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted.Results:The screening procedure, such as staff professionalism, was covered. Other people's opinions and the woman's own understanding affected the women's decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude.Conclusions:Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women's continuous willingness to be screened, which in turn may affect public and individual health.

  • 24.
    Norfjord Zidar, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Larm, Peter
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Non-attendance of mammographic screening: the roles of age and municipality in a population-based Swedish sample.2015Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 14, nr 1, artikel-id 157Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Inequality in health and health care is increasing in Sweden. Contributing to widening gaps are various factors that can be assessed by determinants, such as age, educational level, occupation, living area and country of birth. A health care service that can be used as an indicator of health inequality in Sweden is mammographic screening. The non-attendance rate is between 13 and 31 %, while the average is about 20 %. This study aims to shed light on three associations: between municipality and non-attendance, between age and non-attendance, and the interaction of municipality of residence and age in relation to non-attendance.

    METHODS: The study is based on data from the register that identifies attenders and non-attenders of mammographic screening in a Swedish county, namely the Radiological Information System (RIS). Further, in order to provide a socio-demographic profile of the county's municipalities, aggregated data for women in the age range 40-74 in 2012 were retrieved from Statistics Sweden (SCB), the Public Health Agency of Sweden, the National Board of Health and Welfare, and the Swedish Social Insurance Agency. The sample consisted of 52,541 women. Analysis conducted of the individual data were multivariate logistic regressions, and pairwise chi-square tests.

    RESULTS: The results show that age and municipality of residence associated with non-attendance of mammographic screening. Municipality of residence has a greater impact on non-attendance among women in the age group 70 to 74. For most of the age categories there were differences between the municipalities in regard to non-attendance to mammographic screening.

    CONCLUSIONS: Age and municipality of residence affect attendance of mammographic screening. Since there is one sole and pre-selected mammographic screening facility in the county, distance to the screening facility may serve as one explanation to non-attendance which is a determinant of inequity. From an equity perspective, lack of equal access to health and health care influences facility utilization.

  • 25.
    Sandmark, Helene
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sarvento-Håkansson, M
    Sundbyberg Rehab and Fysioterapi Center, Sundbyberg, Sweden.
    Franke, C
    PhysioMind, Nacka, Sweden.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    “I just kept running and running until I hit the wall"- Working men seeking care due to stress-related problems.2014Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 49, nr 2, s. 297-306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Stress problems are major public health problems.

    OBJECTIVE: To gain an increased understanding of howworking men seeking care due to minor metal dysfunctions related to stress recognize their symptoms, what triggers them, and how this impacts their everyday life.

    PARTICIPANTS: Fourteen men of working age, consecutively seeking care due to minor mental dysfunctions indicating stress problems, at two clinics in the Stockholm area in Sweden during 2009 and 2010.

    METHODS: A qualitative methodology was chosen, and interviews were performed and analyzed using qualitative content analysis.

    RESULTS: In the manifest content, categories such as difficulties in setting limits, low socialsupport, high work demands, and mental and physical dysfunctions were identified. Three themes finally emerged (latent content) and indicated that in this group of informants there are stressors both within the individual himself, in working life, and a lack of recovery.

    CONCLUSIONS: Based on our findings it would be possible to implement measures to prevent stress-related problems by promoting coping strategies on an individual level, encouraging social networks, and regular physical exercise. By implementing work policies and workplace modifications, and also providing individual support at the workplace, supervisors and human resources managers could prevent, or modify stress problems among employees.

  • 26. Sriyasak, Atcharaweede
    et al.
    Åkerlind, Ingmar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Childrearing among Thai first-time teenage mothers2013Ingår i: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 22, nr 4, s. 201-211Artikel i tidskrift (Refereegranskat)
  • 27.
    Yuwanich, Nuttapol
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Rangsit Univ, Sch Nursing Sci, Ptumthani, Thailand..
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Nantsupawat, Walaiporn
    Rangsit Univ, Sch Nursing Sci, Ptumthani, Thailand..
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Elfström, Magnus
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Development and psychometric properties of the stressor scale for emergency nurses2018Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 39, s. 77-88Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Emergency department nurses are exposed to specific stressors and report higher stress levels than nurses in other hospital departments. This study aimed to develop and test the psychometric properties of a questionnaire-based instrument for identifying stressors for emergency department nurses. Methods: The instrument's content and face validities were examined by five experts and nurses in emergency nursing field. The test-retest reliability was examined on 30 emergency department nurses. The construct validity, including an exploratory and a confirmatory factor analysis, was tested on 405 emergency department nurses. Cronbach's alpha values and intra-class coefficients were calculated. Results: The instrument's content and face validities were satisfactory. The exploratory factor analysis provided a five-factor solution, whereas the confirmatory factor analysis provided a final four-factor solution with 25 items distributed among the factors Life and death situations, Patients' and families' actions and reactions, Technical and formal support, and Conflicts. The Cronbach's alpha values ranged from 0.89 to 0.93 per factor, and the intra-class correlation coefficient was 0.89, indicating good homogeneity and stability. Conclusions: The instrument's content, face, and construct validities were satisfactory, and the internal consistency and test-retest reliability were good. This instrument can be useful in the management of emergency departments.

  • 28.
    Yuwanich, Nuttapol
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandmark, Hélène
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Ramazzini Research Institute, Lidingo, Sweden .
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand2016Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 53, nr 4, s. 885-897Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. OBJECTIVE: This study aimed to explore nurses' perceptions of occupational stress in an emergency department. METHODS: A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. RESULTS: The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. CONCLUSIONS: The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

  • 29.
    Akhavan, Sharareh (Medarbetare/bidragsgivare)
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Samråd med Sveriges nationella minoriteter Behov, förutsättningar och metoder för datainhämtning om hälsosituationen bland Sveriges nationella minoriteter och urfolk2014Rapport (Övrigt vetenskapligt)
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