Leeni Berntsson

Gender differences in work–home interplay and symptom perception among Swedish white-collar employees

Objective: To analyse gender differences in paid and unpaid workload and symptoms in matched groups of Swedish white-collar workers with children. Design and setting: Paid and unpaid workload and perceived stress from paid work, conflict between demands and control over household work were measured by a total workload (TWL) questionnaire. Some symptoms were rated with regard to frequency and severity as a measure of health. Cross-sectional analyses were performed. Participants: Matched groups of male (n = 440) and female (n = 529) well-educated white-collar workers in full-time employment, aged 32–58 years and living with children in the home. Results: Women in higher positions in Sweden are healthier than the average population of women, but report more symptoms than men in the same position as well as more stress from paid work, more conflict between demands and a greater TWL. However, women also reported more control over household duties and TWL was not associated with more symptoms. The men were mainly focused on their paid work role and perhaps even more so than men in the general population as they were fairly resistant to feelings of conflicting demands. Conclusion: Even among matched groups of full-time employed, well-educated men and women, traditional gender differences in division of responsibilities and time allocation were found. Even though the women were healthy at this stage, they might risk future ill health, owing to high workload, stress and feelings of conflicting demands.

Quality of life in children with pulmonary atresia and intact ventricular septum

OBJECTIVE To measure quality of life in children with pulmonary atresia and intact ventricular septum, and make comparisons with a healthy group of children from the general Swedish population. An additional aim was to compare quality of life in two subgroups, children undergoing biventricular and univentricular repair, the latter by establishment of the Fontan circulation. METHODS Quality of life was measured using a mailed questionnaire, taking into consideration the three spheres of personal, interpersonal, and external living conditions. In all, 52 children received the questionnaire, and the answers were compared with those of a random sample of 1856 healthy Swedish children. RESULTS We received responses from 42 children and parents. The overall differences between groups were small, and no difference was found when comparing the children undergoing univentricular as opposed to biventricular surgical repair. In terms of personal quality of life, we found a higher level of psychosomatic complaints, and lower satisfaction with their own and parent-child activities, in those with the congenital anomaly than in their normal peers. In terms of the interpersonal sphere, more time was available for those with malformed hearts, but the experience of support from the relatives was significantly lower. CONCLUSIONS Overall, quality of life was equal between children with pulmonary atresia and intact ventricular septum and the children in the reference group. The personal psychological conditions were less favourable for children with pulmonary atresia and intact ventricular septum. The perceived lack of support from relatives was also higher in these families. No difference was found when comparing the children undergoing univentricular and biventricular surgical repair.

Children’s use of general practitioner services in the five Nordic countries

Objective: To compare socioeconomic, sociodemographic, and living area differences in children’s use of GP services in five Nordic countries from the 1980s to the 1990s and to analyse trends during the period. Design: Cross sectional population surveys using random samples comprising 3000 children aged 2–17 years were conducted in 1984 and 1996 in five Nordic countries. Time trends in use of GP services were studied in each country by age, sex, parents’ highest level of education, and living area. Setting: Five Nordic countries, Denmark, Finland, Iceland, Norway, and Sweden in 1984 and 1996. Participants: A total sample of 15 000 children aged 2–17 years. Altogether 3000 children were selected at random from the national population registers of the national bureaus of statistics in each country. Main outcome: Health services utilisation on the basis of responses to a questionnaire item asking whether the parents had consulted a GP with regard to their children’s health during the previous three months. Main results: The prevalence of children’s utilisation of GP services varied from 14% in 1984 in Sweden to 28% in 1996 in Iceland. A clear time trend towards increasing utilisation of GP services (p<0.05) was found in all countries except in Denmark. Odds ratios for time trends (1984 = 1.00) varied from 1.22 (1.02 to 1.46) in Sweden to 1.92 (1.62 to 2.30) in Norway. After adjusting for independent variables, a statistically borderline significant declining utilisation trend (OR = 0.85 (0.70 to 1.03)) was found for Denmark. Conclusion: Children’s use of GP services has increased significantly in four of the five Nordic countries.

Children’s use of dental services in the five Nordic countries

Background: An increase in the use of general practitioner services for children has taken place since the 1980s in the Nordic countries, but little is known about the use of dental services during this time. Aim: To compare differences in children’s use of dental services in the five Nordic countries and to analyse changes over time from the 1980s to the 1990s. Methods: The participants were 20 500 children aged 2–17 years from Denmark, Finland, Iceland, Norway and Sweden. Cross-sectional population surveys using random samples comprising 3000 children in each country were conducted in 1984 and 1996. Changes over time in the use of dental services were studied in each country by age, sex, level of parental education and living area. Results: The prevalence of children’s utilisation of dental services varied between 60% and 34% in 1984, and between 42% and 30% in 1996. A clear change towards decreasing utilisation over time (p<0.05) was found in all countries except Finland, where utilisation increased statistically significantly (p<0.05). Odds ratios (1984 _ 1.00) for the changes ranged between 0.66 (95% confidence interval 0.58 to 0.75) in Sweden and 0.71 (0.62 to 0.81) in Iceland, while the corresponding figure was 1.32 (1.16 to 1.48) in Finland. In 1996, children from families with the lowest education in Finland and Norway used dental services more frequently than children from families with higher education. Conclusion: Children’s use of dental services decreased significantly in four of the five Nordic countries between the mid-1980s and the mid-1990s.