Dorthe Susanne Nielsen

Men’s Experiences of Living With Osteoporosis: Focus Group Interviews

Osteoporotic fractures in men are an increasing public health problem. Male osteoporosis is often a low-prioritized issue, however. To examine men’s experiences with osteoporosis and how they handle osteoporosis in their everyday lives, the authors collected data from four focus groups with a total of 16 men aged 51 to 82 years diagnosed with osteoporosis. Critical psychology was used as a theoretical framework for the data analysis, which aimed to elicit information about the men’s daily lives. The men handled osteoporosis in different ways using different strategies. The authors found patterns that resonated with the social construction of hegemonic masculinity as displayed through the men’s fear of weakness and endurance through physical activity, as well as identity construction through active decision making in relation to health. Understanding and implementation of these issues is necessary in the development of preventive, screening, and monitoring strategies, as well as in the clinical care of men with osteoporosis.

Persistence to medical treatment of osteoporosis in women at three different clinical settings – A historical cohort study

Purpose: This study was undertaken to assess persistence with bisphosphonates and raloxifene and to identify determinants of adherence (patient age, level of information, educational status, etc.) among women with osteoporosis in three different clinical settings in Denmark. Methods: We compared persistence to therapy in three historical cohorts of women diagnosed with osteoporosis starting therapy between January 1999 and January 2004. The study comprised 878 patients treated and followed at Odense University Hospital, 285 patients diagnosed and followed at the Hellerup Osteoporosis Clinic (private practice), and 343 patients diagnosed at Aarhus University Hospital and followed by the referring general practitioner. Data on persistence and possible confounders were collected using a mailed questionnaire. Reminders were issued after 1—2 months to non-respondents. Results: Persistence at 2 years as estimated from Kaplan—Meyer analysis was 0.87, 0.84 and 0.88 in the three cohorts, respectively. There were no significant differences between the clinics. Level of persistence was not related to patient assessment of the adequacy of the clinical information provided by the prescribing doctor, presence of prior fractures or a family history of osteoporosis. However, patients who read the information leaflet on their osteoporosis medication tended to be more persistent with treatment (p < 0.09). Conclusions: Women’s persistence with bisphosphonates and raloxifene was surprisingly high and similar between treating centres. This may be due to a high level of public information available on osteoporosis in Denmark.

Quality of life in childhood, adolescence and adult food allergy - Patient and parent perspectives

Studies of children with food allergy typically only include the mother and have not investigated the relationship between the amount of allergen needed to elicit a clinical reaction (threshold) and health‐related quality of life (HRQL). Our aims were (i) to compare self‐reported and parent‐reported HRQL in different age groups, (ii) to evaluate the impact of severity of allergic reaction and threshold on HRQL, and (iii) to investigate factors associated with patient‐reported and parent‐reported HRQL.

Everyday life and occupational deprivation in single migrant mothers living in Denmark

ABSTRACT Background: Socio-economically disadvantaged single migrant mothers in Denmark risk poor health and social marginalisation, which affects participation in relevant occupations. Literature focusing on occupational deprivation in vulnerable groups such as migrants is sparse. Aim/objectives: To explore how single migrant mothers experience their living conditions and the significance of those conditions on their exclusion from everyday life occupations. Material and methods: In-depth interviews were used to find how occupational deprivation manifests in the everyday lives of three women. Based on Ricoeur’s theory of interpretation, data were analysed and the meaning structures, in the form of three themes, were identified. Results: The societal and individual conditions of women’s everyday lives interact in a complex interplay, where immigration, illness and divorce, in particular, deprive the women of participation in social and work-related occupations. The women handled these conditions by trying to create a well-functioning family life. Conclusions and significance: Experiences of occupational deprivation take place in interaction with cultural norms, social position and lack of social opportunities and, as the process takes place over a long period, changes become more complicated.

Reflections on two years after establishing an orthogeriatric unit: a focus group study of healthcare professionals’ expectations and experiences

BackgroundFor decades hospitals have been “vertically” organized, with the risk that specialization leads to fragmented and one-sided views of patient care and treatment that may cause poor communication and coordination of care and treatment. Two years after the introduction of an orthogeriatric unit for elderly patients admitted with fragility fractures, we studied the involved healthcare professionals’ perspectives and experiences with working in an interprofessional organization.MethodsWe performed four focus groups interviews with 19 healthcare workers representing different professions. The interviews were analysed using systematic text condensation (STC).ResultsThree themes were identified: 1) A patient-centred approach, 2) An opportunity for professional growth and 3) The benefits of interprofessional collaboration. The interviewees emphasized in particular the systematic and frequent face-to-face communication enabled by the interprofessional team meetings as essential to their feeling of enhanced collegial solidarity. All groups expressed their respect for other groups’ competences and their vital contributions to good orthogeriatric care. However, collaboration was challenged by the groups’ divergent views of the patients and of the relevance of the information given in the weekly meetings. Heavy workloads were also mentioned. The opportunity for professional growth was also felt to be imperilled by some professionals.ConclusionsAll participants indicated their view that the orthogeriatric organization had improved the quality of care and treatment. Furthermore, good communication, mutual respect for other professional competences and shared goals were found to have enhanced interprofessional collaboration and improved the sense of having a shared mission. However, differences in approaches and expectations continued to challenge the orthogeriatric model after 2 years. Neither did all professionals find orthogeriatric care professionally challenging.

Attitudes towards human papillomavirus vaccination among Arab ethnic minority in Denmark: A qualitative study

Background: Knowledge regarding the human papillomavirus (HPV) and HPV vaccine uptake among ethnic minorities is poorly explored in Denmark. The objective of this study was to explore attitudes and knowledge towards HPV vaccination among Arab mothers and their daughters. Methods: Five Arabic-speaking focus groups with mothers of vaccine-eligible girls and three focus groups with daughters were conducted. The participants were recruited through different social clubs. A phenomenological approach was used to investigate attitudes and knowledge of HPV vaccination. Meaning condensation inspired by Amedeo Giorgi was used to analyse the transcribed material. Results: A total of 23 women and 13 daughters were included in this study. The mothers’ knowledge regarding HPV was limited to the fact that HPV can cause cervical cancer. Two focus groups mentioned that HPV is a sexually transmitted disease and none of the mothers knew that HPV also causes genital warts. Both mothers and daughters acknowledged that the daughters have deeper insight into health-related issues. A gap of knowledge between generations was identified, as mothers and daughters obtained health information from different sources: mothers used the Arabic TV channels as a source of knowledge and daughters had a range of sources, e.g. school, internet, and Western TV channels. The consequence of these differences in obtaining knowledge is that mothers and daughters lack a common language to discuss health issues. Mothers were influenced by Arabic society, while daughters had created a hybrid of Arabic and Danish. Each generation had its own reasons for accepting the vaccine. The level of HPV knowledge and awareness did not affect their uptake decision in that all the participating mothers had accepted the vaccine for their daughters. Conclusions: Educational programs should target both mothers and daughters because mothers have an inadequate knowledge about HPV. This is likely to bridge the gap of knowledge between mothers and daughters, which constitutes a barrier between the generations.

Attitudes to and implementation of video interpretation in a Danish hospital: A cross-sectional study

Aims: Immigrants, refugees, and their descendants comprise 12% of Denmark’s population. Some of these people do not speak or understand Danish well enough to communicate with the staff in a healthcare setting and therefore need interpreter services. Interpretation through video conferencing equipment (video interpretation) is frequently used and creates a forum where the interpreter is not physically present in the medical consultation. The aim of this study was to investigate the attitudes to and experiences with video interpretation among charge nurses in a Danish university hospital. Methods: An electronic questionnaire was sent to 99 charge nurses. The questionnaire comprised both closed and open-ended questions. The answers were analysed using descriptive statistics and thematic text condensation. Results: Of the 99 charge nurses, 78 (79%) completed the questionnaire. Most charge nurses, 21 (91%) of the daily/monthly users, and 21 (72%) of the monthly/yearly users, said that video interpretation increased the quality of their conversations with patients. A total of 19 (24%) departments had not used video interpretation within the last 12 months. Conclusions: The more the charge nurses used video interpretation, the more satisfied they were. Most of the charge nurses using video interpretation expressed satisfaction with the technology and found it easy to use. Some charge nurses are still content to allow family or friends to interpret. To reach its full potential, video interpretation technology has to be reliable and easily accessible for any consultation, including at the bedside.

Tools for Deprescribing in Frail Older Persons and Those with Limited Life Expectancy: A Systematic Review: Deprescribing tools

To summarize available tools that can assist clinicians in identifying and reducing or stopping (deprescribing) potentially inappropriate medications and that specifically consider frailty or limited life expectancy.

Caught in a Generation Gap: A Generation Perspective on Refugees Getting Old in Denmark-A Qualitative Study

Purpose: Older non-Western migrants in Europe are a vulnerable population, due to old age and multiple disadvantages related to language barriers and different understandings of care, health, and disease. Our aim was to gain a better understanding and insight into the care needs of families with refugee background Method: The study was designed as a qualitative exploration using semistructured individual interviews and family group interviews. Results: The results illustrate how vulnerability can “transmit” from one family member to another. Discrepancies between the older person’s expectations and needs and society’s expectations trap family members in ethical and moral dilemmas. This divides and stresses the family and results in difficult decision making, increased stress, and vulnerability. Conclusion and Implication: Migration and displacement can lead to ambivalent feelings among younger relatives regarding their role in caring for older relatives. Health professionals need to address and acknowledge this to be able to provide culturally congruent health care.

Green, Yellow and Red risk perception in everyday life: a communication tool

Adolescents have the highest risk for food allergy‐related fatalities. Our main aim was to investigate the level of risk in everyday social situations as perceived by adolescents/young adults with peanut allergy, their families, and their friends.