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Ahonen, H., Neher, M., Fransson, E. I., Broström, A. & Lindmark, U. (2023). Views on oral health determinants as described by persons with continuous positive airway pressure-treated obstructive sleep apnoea: a qualitative study. BMC Oral Health, 23(1), Article ID 407.
Open this publication in new window or tab >>Views on oral health determinants as described by persons with continuous positive airway pressure-treated obstructive sleep apnoea: a qualitative study
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2023 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 407Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Oral diseases have been associated with cardiovascular diseases, and persons with continuous positive airway pressure [CPAP]-treated obstructive sleep apnoea [OSA] have an increased risk for negative consequences for both oral and general health. CPAP treatment is often life-long and adherence to treatment is essential. Xerostomia is a common side-effect which can lead to treatment abandonment. Oral health is a changeable part of our general health and well-being and exploring the views of oral health determinants from persons with experience of CPAP-treatment is important to prevent adverse oral health outcomes. The purpose of this study was to explore what persons with experience of CPAP-treated OSA view as determinants for their oral health.

METHODS: Eighteen persons with long-term experience of CPAP-treated OSA were purposively selected. Data were collected by semi-structured individual interviews. A code book based on the World Dental Federation's [FDI] theoretical framework for oral health was developed and used to analyse the data using directed content analysis. The domains in the framework's component driving determinants were used as pre-determined categories. Using the description of driving determinants as a guide, meaning units were extracted from the interview transcripts through an inductive approach. Then, by employing a deductive approach the code book was used to categorise the meaning units into the pre-determined categories.

FINDINGS: The views on oral health determinants described by the informants were compatible with the five domains in the component driving determinants in the FDI's theoretical framework. Ageing, heredity, and salivation (biological and genetic factors), influences from family and the wider society (social environment), location and re-localisation (physical environment), oral hygiene habits, motivation, willingness to change, professional support (health behaviours), and availability, control, finances, and trust (access to care) were viewed as important oral health determinants by the informants.

CONCLUSION: The study points to a variety of individual oral health-related experiences that oral healthcare professionals could consider when designing interventions to reduce xerostomia and prevent adverse oral health outcomes for persons undergoing long-term CPAP-treatment.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
CPAP-treatment, Determinants, Obstructive sleep apnoea, Oral health
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-61668 (URN)10.1186/s12903-023-03108-6 (DOI)001012054500002 ()37340329 (PubMedID)2-s2.0-85162848585 (Scopus ID)GOA;;888184 (Local ID)GOA;;888184 (Archive number)GOA;;888184 (OAI)
Funder
Medical Research Council of Southeast Sweden (FORSS), FORSS-847071; FORSS-931569
Available from: 2023-06-27 Created: 2023-06-27 Last updated: 2023-08-14Bibliographically approved
Alm Mårtensson, A., Boström, A., Lindmark, U., Lundgren, C. & Östlund, L. (2022). Ansvarsområden för olika samhällsfunktioner. In: L. Östlund (Ed.), Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv (pp. 91-112). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Ansvarsområden för olika samhällsfunktioner
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2022 (Swedish)In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 91-112Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022
National Category
Social Work Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-58753 (URN)9789144155142 (ISBN)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2022-11-17Bibliographically approved
Ahonen, H., Pakpour, A. H., Norderyd, O., Broström, A., Fransson, E. I. & Lindmark, U. (2022). Applying World Dental Federation Theoretical Framework for Oral Health in a General Population. International Dental Journal, 72(4), 536-544
Open this publication in new window or tab >>Applying World Dental Federation Theoretical Framework for Oral Health in a General Population
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2022 (English)In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 72, no 4, p. 536-544Article in journal (Refereed) Published
Abstract [en]

Introduction: The World Dental Federation (FDI) has recently proposed a new definition and theoretical framework of oral health. The theoretical framework includes 4 main components and describes the relationships amongst them. In 2020, an international work group proposed the minimum Adult Oral Health Standard Set (AOHSS) of variables to measure oral health, which was mapped onto the FDI's theoretical framework. By using an empirical data set, the proposed variables in the AOHSS and the potential interactions amongst the components of the FDI's theoretical framework can be tested. The purpose of this research was to investigate structural relations of the components of the FDI's theoretical framework of oral health based on data from a general adult population.

Methods: Data from a previously conducted Swedish cross-sectional study focusing on oral health were utilised (N = 630; women, 55.2%; mean age, 49.7 years [SD, 19.2]). Variable selection was guided by the AOHSS. Structural equation modeling was used to analyse relationships amongst the components of the FDI's theoretical model (core elements of oral health, driving determinants, moderating factors, and overall health and well-being).

Results: The Oral Health Impact Profile (OHIP)-14, xerostomia, and aesthetic satisfaction had statistically significant direct effects on overall health and well-being (p < .05). Driving determinants and moderating factors had statistically significant direct effects on all core elements of oral health (p < .05) except aesthetic satisfaction (p = .616). The predictors explained 24.1% of the variance of the latent variable overall health and well-being. Based on several indices, the proposed model showed acceptable model fit.

Conclusions: The FDI's theoretical framework can be used to describe different components of oral health and the relationship amongst them in an adult general population. Further research based on the FDI's theoretical framework in other populations and settings is needed to explore complex interactions and possible relationships that form oral health and to investigate other or additional important social determinants.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Adult, General population, Oral health, Structural equation modeling, Theoretical framework
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-55518 (URN)10.1016/j.identj.2021.09.001 (DOI)000861694200015 ()34953571 (PubMedID)2-s2.0-85121709941 (Scopus ID)HOA;;789888 (Local ID)HOA;;789888 (Archive number)HOA;;789888 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden, 844881
Available from: 2022-01-12 Created: 2022-01-12 Last updated: 2022-10-21Bibliographically approved
Alm Mårtensson, A., Boström, A., Lindmark, U., Lundgren, C., Ludvigsson, M. & Simmons, J. (2022). Att möta våldsutsatta äldre personer. In: L. Östlund (Ed.), Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv (pp. 183-220). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Att möta våldsutsatta äldre personer
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2022 (Swedish)In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 183-220Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022
National Category
Social Work Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-58755 (URN)9789144155142 (ISBN)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2022-10-31Bibliographically approved
Boström, A., Lindmark, U., Ludvigsson, M., Saveman, B.-I., Simmons, J., Siverskog, A. & Åkerlund, N. (2022). Förekomsten av våld i nära relationer bland äldre personer. In: L. Östlund (Ed.), Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv (pp. 31-64). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Förekomsten av våld i nära relationer bland äldre personer
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2022 (Swedish)In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 31-64Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022
National Category
Social Work Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-58750 (URN)9789144155142 (ISBN)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2022-10-31Bibliographically approved
Ahlstrand, I., Larsson, I., Larsson, M., Ekman, A., Hedén, L., Laakso, K., . . . Hallgren, J. (2022). Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study. BMC Public Health, 22(1), Article ID 1314.
Open this publication in new window or tab >>Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study
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2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1314Article in journal (Refereed) Published
Abstract [en]

Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
Health and health-promoting resources, Health behavior, Healthy lifestyles, Higher education, Occupational Balance Questionnaire, Salutogenesis, Salutogenic Health Indicator Scale, Sense of coherence, Students’ health, adult, article, controlled study, cross-sectional study, educational status, female, habit, health program, healthy lifestyle, high intensity exercise, human, longitudinal study, major clinical study, male, multicenter study, Sense of Coherence Scale, sleep, social work, Sweden, Swedish citizen, tertiary education, wellbeing, clinical trial, health care delivery, questionnaire, student, Cross-Sectional Studies, Delivery of Health Care, Humans, Longitudinal Studies, Students, Surveys and Questionnaires
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-58048 (URN)10.1186/s12889-022-13690-z (DOI)000823651600001 ()35804344 (PubMedID)2-s2.0-85133710137 (Scopus ID)GOA;;822881 (Local ID)GOA;;822881 (Archive number)GOA;;822881 (OAI)
Available from: 2022-07-26 Created: 2022-07-26 Last updated: 2023-08-28Bibliographically approved
Berggren, K., Broström, A., Firestone, A., Wright, B., Josefsson, E. & Lindmark, U. (2022). Oral health problems linked to obstructive sleep apnea are not always recognized within dental care—As described by dental professionals. Clinical and Experimental Dental Research, 8(1), 84-95
Open this publication in new window or tab >>Oral health problems linked to obstructive sleep apnea are not always recognized within dental care—As described by dental professionals
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2022 (English)In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 1, p. 84-95Article in journal (Refereed) Published
Abstract [en]

Objectives: Obstructive sleep apnea (OSA) has an impact on an individual's quality of life and general health, and can also affect their oral health. The patient's experiences, together with intraoral signs and symptoms could indicate the presence of OSA. Knowledge that the patient has, or is at high risk for having OSA can help the dental healthcare provider maintain the oral health and general health for these patients. The purpose was to explore dentists and dental hygienists' experiences when encountering adult patients with potential, untreated and treated OSA.

Methods: A qualitative inductive approach was used. Experienced dentists and dental hygienists working within Swedish Public Dental Service were strategically selected. Semi-structured face-to-face interviews were performed followed by qualitative content analysis.

Results: Interviews from 13 participants, seven dental hygienist and six dentists, led to three areas describing varied experience: Importance of the patient encounter and identifying intraoral signs both of which describe experiences related to the importance of the initial unstructured conversation and focused clinical assessments, and strategies for nurturing care which point to interest about care, treatment, and collaborations with medical health care providers.

Conclusions: Dental professionals are not able to consistently recognize patients who have, or are at high risk for OSA. During the patient encounter, is it important to determine if a patient is at risk for, or has oral signs of OSA.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
dental hygienist, dentist, health, obstructive sleep apnea, oral health
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-55135 (URN)10.1002/cre2.517 (DOI)000719626900001 ()34791818 (PubMedID)2-s2.0-85119144010 (Scopus ID)HOA;intsam;778237 (Local ID)HOA;intsam;778237 (Archive number)HOA;intsam;778237 (OAI)
Available from: 2021-11-22 Created: 2021-11-22 Last updated: 2023-06-22Bibliographically approved
Ahonen, H., Broström, A., Fransson, E. I., Neher, M. & Lindmark, U. (2022). Oral health-related situations among patients with experience of continuous positive airway pressure treatment: a critical incident analysis of experiences and actions. Journal of Sleep Research, 31(Suppl 1), Article ID P085.
Open this publication in new window or tab >>Oral health-related situations among patients with experience of continuous positive airway pressure treatment: a critical incident analysis of experiences and actions
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2022 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 31, no Suppl 1, article id P085Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-58852 (URN)000870433500441 ()
Available from: 2022-11-10 Created: 2022-11-10 Last updated: 2023-02-13Bibliographically approved
Ahonen, H., Broström, A., Fransson, E. I., Neher, M. & Lindmark, U. (2022). “The terrible dryness woke me up, I had some trouble breathing”- critical situations related to oral health as described by CPAP-treated persons with obstructive sleep apnea. Journal of Sleep Research, 31(6), Article ID e13670.
Open this publication in new window or tab >>“The terrible dryness woke me up, I had some trouble breathing”- critical situations related to oral health as described by CPAP-treated persons with obstructive sleep apnea
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2022 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 31, no 6, article id e13670Article in journal (Refereed) Published
Abstract [en]

Continuous positive airway pressure is a common and effective treatment for obstructive sleep apnea, but adherence remains an issue. Both obstructive sleep apnea and oral diseases are associated with cardiovascular diseases, and as oral dryness contributes to treatment abandonment, oral health is of importance for this patient group. The aim was therefore to explore how persons with continuous positive airway pressure-treated obstructive sleep apnea experience situations associated with their oral health, and which actions they take to manage these. An explorative and descriptive design was adopted using the critical incident technique. Based on a purposeful selection, 18 adults with long-term experience of continuous positive airway pressure-treatment were interviewed using a semi-structured interview guide. Both negative and positive situations were described. Negative situations consisted of challenges with breathing, including mouth-breathing, choking sensations, problems with night-time and daytime oral dryness, changes in the saliva composition, and deteriorating oral health. Positive situations included experiences of reduced mouth-breathing and oral dryness. The situations were often successfully managed by mimicking daytime movements, changing sleeping position, adjusting the CPAP-device and mask, increasing oral hygiene efforts, drinking water, using a humidifier or chinstrap, or contacting their oral healthcare clinic. Long-term experience of persons with continuous positive airway pressure-treated obstructive sleep apnea regard situations and actions from everyday life. Successful management can contribute to long-term adherence and decrease negative effects on oral health. More interdisciplinary collaborations could enable identification and adequate recommendations for persons who experience negative situations during their continuous positive airway pressure treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
adherence; experiences; humidification; management; patient perspective; qualitative
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-56447 (URN)10.1111/jsr.13670 (DOI)000817789500001 ()35765213 (PubMedID)2-s2.0-85132908291 (Scopus ID)HOA;;1657484 (Local ID)HOA;;1657484 (Archive number)HOA;;1657484 (OAI)
Funder
Medical Research Council of Southeast Sweden (FORSS), 847071
Note

Included in thesis in manuscript form.

Available from: 2022-05-11 Created: 2022-05-11 Last updated: 2023-02-13Bibliographically approved
Wåhlin, C., Lindmark, U., Wagman, P., Johnston, V. & Rolander, B. (2022). Work and health characteristics of oral health providers who stay healthy at work – a prospective study in public dentistry. European Journal of Physiotherapy, 24(6), 349-357
Open this publication in new window or tab >>Work and health characteristics of oral health providers who stay healthy at work – a prospective study in public dentistry
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2022 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 24, no 6, p. 349-357Article in journal (Refereed) Published
Abstract [en]

Objectives

Research into work-related factors that positively influence Oral Health Providers (OHPs) health is scarce. This study aimed to analyse which OHPs in dental services remain healthy over time in relation to work- and health-related factors.

Methods

OHPs took part in this prospective cohort study (n=168). In 2012 and 2014 they answered a questionnaire featuring questions about demographics, health indicators, work and organisational factors.

Results

OHPs were classified into three subgroups; healthy group (n=66), semi-healthy group (n=45) and unhealthy group (n=57). The healthy group reported no sick leave or sickness presence in 2012 or 2014. Factors that explained a greater likelihood of belonging to the healthy group were: good work ability, not having neck pain, perceived low exertion at the end of the working day, not having sleeping problems. They scored higher on health indicators than OHPs in the unhealthy group.

Conclusions

OHPs with no sick leave or sickness presence report much better salutogenic health, better physical work ability and lower perceived exertion at the end of their workday compared with unhealthy group of OHPs. Understanding the relationship between working conditions and well-being is crucial to target interventions for OHPs which improve work conditions and health.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Dental hygienist; dental nurse; dentist; occupational health; well-being; workhealth promotion
National Category
Dentistry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-52159 (URN)10.1080/21679169.2021.1905876 (DOI)000640215800001 ()2-s2.0-85103889776 (Scopus ID)HOA;intsam;1542244 (Local ID)HOA;intsam;1542244 (Archive number)HOA;intsam;1542244 (OAI)
Funder
Medical Research Council of Southeast Sweden (FORSS), FORSS-467461
Available from: 2021-04-07 Created: 2021-04-07 Last updated: 2022-12-06Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2786-707x

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