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Hamberg, Katarina
Publications (10 of 130) Show all publications
Asklund, I., Samuelsson, E., Hamberg, K., Umefjord, G. & Sjöström, M. (2019). User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualitative Interview Study. Journal of Medical Internet Research, 21(3), Article ID e11296.
Open this publication in new window or tab >>User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualitative Interview Study
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2019 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 3, article id e11296Article in journal (Refereed) Published
Abstract [en]

Background: Stress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment.

Objective: This study aimed to explore women’s experiences of using an app-based treatment program for SUI.

Methods: This qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory.

Results: The results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment.

Conclusions: Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program.

Trial Registration: ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)

Keywords
mobile applications, urinary incontinence, stress, pelvic floor muscle training, self-management, qualitative research, grounded theory, women’s health
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-157751 (URN)10.2196/11296 (DOI)000461286800001 ()30869644 (PubMedID)2-s2.0-85062859247 (Scopus ID)
Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-04-09Bibliographically approved
Sperens, M., Hamberg, K. & Hariz, G.-M. (2018). Challenges and strategies among women and men with Parkinson's disease: striving toward joie de vivre in daily life. British Journal of Occupational Therapy, 81(12), 700-708
Open this publication in new window or tab >>Challenges and strategies among women and men with Parkinson's disease: striving toward joie de vivre in daily life
2018 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 81, no 12, p. 700-708Article in journal (Refereed) Published
Abstract [en]

Introduction: To offer people with Parkinson's disease optimal occupational therapy, it is important to have a detailed understanding of how they manage everyday life. The aims of this study were to explore how people with Parkinson's disease manage the effect of the disease on everyday life and to investigate gender similarities and differences concerning this issue.

Method: We interviewed 24 people with Parkinson's disease (14 men), at a mean of 8 years after diagnosis. The interviews were analysed according to Grounded Theory.

Findings: 'Striving to maintain a good everyday life' was established as a core category. To overcome obstacles caused by the disease, the interviewees struggled with perpetual adaptation to the medication regime and ongoing changes in their abilities. To achieve best possible everyday life, it was essential to keep their own spirit up; for example, by prioritising valued occupations. Women and men contributed to all categories and used the same strategies.

Conclusion: Men and women with Parkinson's disease used the same strategies to manage daily life challenges. Our findings support the relevance of disease-specific occupational therapy interventions focusing on the individual fit between person, environment and occupation, and highlight the need for joyful occupations to attain a satisfactory daily life.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Parkinson's disease, occupational therapy, activity of daily living, coping strategies, quality of life, gender
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-154900 (URN)10.1177/0308022618770142 (DOI)000452512500004 ()
Funder
Swedish Research Council, 2009-5833Swedish Research Council, 2012-5210
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-05-16Bibliographically approved
Kristoffersson, E., Diderichsen, S., Verdonk, P., Lagro-Janssen, T., Hamberg, K. & Andersson, J. (2018). To select or be selected - gendered experiences in clinical training affect medical students' specialty preferences. BMC Medical Education, 18, Article ID 268.
Open this publication in new window or tab >>To select or be selected - gendered experiences in clinical training affect medical students' specialty preferences
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2018 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, article id 268Article in journal (Refereed) Published
Abstract [en]

Background: The literature investigating female and male medical students' differing career intentions is extensive. However, medical school experiences and their implications for professional identity formation and specialty choice have attracted less attention. In this study we explore the impact of medical school experiences on students' specialty preferences, investigate gender similarities and differences, and discuss how both might be related to gender segregation in specialty preference.

Methods: In a questionnaire, 250 Swedish final-year medical students described experiences that made them interested and uninterested in a specialty. Utilizing a sequential mixed methods design, their responses were analyzed qualitatively to create categories that were compared quantitatively.

Results: Similar proportions of women and men became interested in a specialty based on its knowledge area, patient characteristics, and potential for work-life balance. These aspects, however, often became secondary to whether they felt included or excluded in clinical settings. More women than men had been deterred by specialties with excluding, hostile, or sexist workplace climates (W = 44%, M = 16%). In contrast, more men had been discouraged by specialties' knowledge areas (W = 27%, M = 47%).

Conclusions: Male and female undergraduates have similar incentives and concerns regarding their career. However, the prevalence of hostility and sexism in the learning environment discourages especially women from some specialties. To reduce gender segregation in specialty choice, energy should be directed towards counteracting hostile workplace climates that explain apparent stereotypical assumptions about career preferences of men and women.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Medical students, Specialty preference, Professional identity formation, Sexism, Mixed methods
National Category
Gender Studies
Identifiers
urn:nbn:se:umu:diva-154055 (URN)10.1186/s12909-018-1361-5 (DOI)000451080300003 ()30453953 (PubMedID)
Funder
Swedish Research CouncilVästerbotten County Council
Available from: 2018-12-19 Created: 2018-12-19 Last updated: 2018-12-19Bibliographically approved
Sperens, M., Hamberg, K. & Hariz, G.-M. (2017). Are Patients Ready for "EARLYSTIM"?: Attitudes towards Deep Brain Stimulation among Female and Male Patients with Moderately Advanced Parkinson's Disease. Parkinson's Disease, Article ID 1939831.
Open this publication in new window or tab >>Are Patients Ready for "EARLYSTIM"?: Attitudes towards Deep Brain Stimulation among Female and Male Patients with Moderately Advanced Parkinson's Disease
2017 (English)In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, article id 1939831Article in journal (Refereed) Published
Abstract [en]

Objective: To explore, in female and male patients with medically treated, moderately advanced Parkinson's disease (PD), their knowledge and reasoning about Deep Brain Stimulation (DBS).

Methods: 23 patients with PD (10 women), aged 46- 70, were interviewed at a mean of 8 years after diagnosis, with open-ended questions concerning their reflections and considerations about DBS. The interviews were transcribed verbatim and analysed according to the difference and similarity technique in Grounded Theory.

Results: From the patients' narratives, the core category "Processing DBS: balancing symptoms, fears and hopes" was established. The patients were knowledgeable about DBS and expressed cautious and well considered attitudes towards its outcome but did not consider themselves ill enough to undergo DBS. They were aware of its potential side-effects. They considered DBS as the last option when oral medication is no longer sufficient. There was no difference between men and women in their reasoning and attitudes towards DBS.

Conclusion: This study suggests that knowledge about the pros and cons of DBS exists among PD patients and that they have a cautious attitude towards DBS. Our patients did not seem to endorse an earlier implementation of DBS, and they considered that it should be the last resort when really needed.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2017
Keywords
Parkinson's disease, DBS, gender
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-134831 (URN)10.1155/2017/1939831 (DOI)000399239900001 ()
Funder
Swedish Research Council, 2009-5833Swedish Research Council, 2012-5210
Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2019-05-16Bibliographically approved
Georgiev, D., Hamberg, K., Hariz, M., Forsgren, L. & Hariz, G.-M. (2017). Gender differences in Parkinson's disease: a clinical perspective. Acta Neurologica Scandinavica, 136(6), 570-584
Open this publication in new window or tab >>Gender differences in Parkinson's disease: a clinical perspective
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2017 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 136, no 6, p. 570-584Article in journal (Refereed) Published
Abstract [en]

Available data indicate that there are gender differences in many features of Parkinson's disease (PD). Precise identification of the gender differences is important to tailor treatment, predict outcomes, and meet other individual and social needs in women and men with PD. The aim of this study was to review the available clinical data on gender differences in PD. Original articles and meta-analyses published between 1990 and 2016 systematically exploring gender differences in PD were reviewed. There is slight male preponderance in incidence and prevalence of PD. PD starts earlier in men. Women tend to be more prone to develop tremor-dominant PD but are less rigid than men. Motor improvement after deep brain stimulation is equal in both sexes, but women tend to show better improvement in activities of daily living. Furthermore, women with PD show better results on tests for general cognitive abilities, outperform men in verbal cognitive tasks, show more pain symptoms, and score higher on depression scales. It seems, however, that the differences in cognition, mood, and pain perception are not disease specific as similar gender differences can be found in healthy subjects and in other neurological conditions. Despite PD being the most frequently studied movement disorder, studies investigating gender differences in PD are still scarce with most of the studies being cross-sectional. Good-quality, prospective, longitudinal studies analyzing gender differences in PD and comparing them to matched healthy controls are needed in order to properly address the issues of gender differences in PD.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
activities of daily living, gender differences, motor symptoms, non-motor symptoms, Parkinson's disease, quality of life
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-140684 (URN)10.1111/ane.12796 (DOI)000414488000002 ()28670681 (PubMedID)
Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2018-06-09Bibliographically approved
Malterud, K., Hamberg, K. & Reventlow, S. (2017). Qualitative methods in PhD theses from general practice in Scandinavia. Scandinavian Journal of Primary Health Care, 35(4), 309-312
Open this publication in new window or tab >>Qualitative methods in PhD theses from general practice in Scandinavia
2017 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 4, p. 309-312Article in journal (Refereed) Published
Abstract [en]

Qualitative methodology is gaining increasing attention and esteem in medical research, with general practice research taking a lead. With these methods, human and social interaction and meaning can be explored and shared by systematic interpretation of text from talk, observation or video. Qualitative studies are often included in Ph.D. theses from general practice in Scandinavia. Still, the Ph.D. programs across nations and institutions offer only limited training in qualitative methods. In this opinion article, we draw upon our observations and experiences, unpacking and reflecting upon values and challenges at stake when qualitative studies are included in Ph.D. theses. Hypotheses to explain these observations are presented, followed by suggestions for standards of evaluation and improvement of Ph.D. programs. The authors conclude that multimethod Ph.D. theses should be encouraged in general practice research, in order to offer future researchers an appropriate toolbox.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2017
Keywords
PhD, Qualitative research, Scandinavia, general practice, research training
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-142038 (URN)10.1080/02813432.2017.1397257 (DOI)000416735200002 ()29094644 (PubMedID)
Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2018-06-09Bibliographically approved
Hariz, G.-M., Limousin, P. & Hamberg, K. (2016). "DBS means everything - for some time": Patients' Perspectives on Daily Life with Deep Brain Stimulation for Parkinson's Disease. Journal of Parkinson's Disease, 6(2), 335-347
Open this publication in new window or tab >>"DBS means everything - for some time": Patients' Perspectives on Daily Life with Deep Brain Stimulation for Parkinson's Disease
2016 (English)In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 6, no 2, p. 335-347Article in journal (Refereed) Published
Abstract [en]

Background: Deep brain stimulation (DBS) is an established treatment for Parkinson's disease. However, patients' own perceptions of the impact of DBS on their daily living is not fully explored. 

Objective: We aimed to collect and analyse patients' narratives about their everyday experiences of being on chronic DBS. 

Methods: Semi-structured interviews with open-ended questions were conducted with 42 patients (11 women) who had been on DBS for a mean of three years. The questions were related to patients' ordinary daily life and eventual changes, both negative and positive, brought about by DBS. The interviews were transcribed verbatim and analysed according to the difference and similarity technique in grounded theory. 

Results: From the patients' narratives the core category `DBS means everything - for some time' was established, and supported by the following categories: 1) Relief from invasive tremor. 2) A rescue from cramps and pain. 3) Easier movement swings and more predictable living space. 4) Hard, but compared to previous suffering, bearable adverse events. 5) Parkinson's disease is progressing despite DBS. 

Conclusions: The analysis of the participants' narratives shed light on patients' unique perceptions and perspectives of the impact of DBS on their everyday lives. Patients with advanced PD highly appreciated the positive impact of DBS on their daily life even if this impact is limited in time. For the majority, the relief from the severe parkinsonian symptoms, especially tremor and painful cramps, outweighed the side effects of DBS. The study provided information not readily captured by pre-formulated questionnaires and scales.

Keywords
Parkinson disease, deep brain stimulation, qualitative research, grounded theory, adverse effects, tient satisfaction, activities of daily living
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-124158 (URN)10.3233/JPD-160799 (DOI)000378352200007 ()27003786 (PubMedID)
Available from: 2016-07-21 Created: 2016-07-21 Last updated: 2018-06-07Bibliographically approved
Phillips, S. P. & Hamberg, K. (2016). Doubly blind: a systematic review of gender in randomised controlled trials. Global Health Action, 9, 1-18, Article ID 29597.
Open this publication in new window or tab >>Doubly blind: a systematic review of gender in randomised controlled trials
2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, p. 1-18, article id 29597Article, review/survey (Refereed) Published
Abstract [en]

Background: Although observational data show social characteristics such as gender or socio-economic status to be strong predictors of health, their impact is seldom investigated in randomised controlled studies (RCTs).

Objective & design: Using a random sample of recent RCTs from high-impact journals, we examined how the most often recorded social characteristic, sex/gender, is considered in design, analysis, and interpretation. Of 712 RCTs published from September 2008 to 31 December 2013 in the Annals of Internal Medicine, British Medical Journal, Lancet, Canadian Medical Association Journal, or New England Journal of Medicine, we randomly selected 57 to analyse funding, methods, number of centres, documentation of social circumstances, inclusion/exclusion criteria, proportions of women/men, and reporting about sex/gender in analyses and discussion.

Results: Participants' sex was recorded in most studies (52/57). Thirty-nine percent included men and women approximately equally. Overrepresentation of men in 43% of studies without explicit exclusions for women suggested interference in selection processes. The minority of studies that did analyse sex/gender differences (22%) did not discuss or reflect upon these, or dismissed significant findings. Two studies reinforced traditional beliefs about women's roles, finding no impact of breastfeeding on infant health but nevertheless reporting possible benefits. Questionable methods such as changing protocols mid-study, having undefined exclusion criteria, allowing local researchers to remove participants from studies, and suggesting possible benefit where none was found were evident, particularly in industry-funded research.

Conclusions: Social characteristics like sex/gender remain hidden from analyses and interpretation in RCTs, with loss of information and embedding of error all along the path from design to interpretation, and therefore, to uptake in clinical practice. Our results suggest that to broaden external validity, in particular, more refined trial designs and analyses that account for sex/gender and other social characteristics are needed.

Keywords
clinical trials, randomised controlled trial, gender, socio-economic status, social determinants, social epidemiology, sex differences
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-123388 (URN)10.3402/gha.v9.29597 (DOI)000376071300001 ()27087576 (PubMedID)
Available from: 2016-07-04 Created: 2016-07-01 Last updated: 2018-06-07Bibliographically approved
Kristoffersson, E., Andersson, J., Bengs, C. & Hamberg, K. (2016). Experiences of the gender climate in clinical training: a focus group study among Swedish medical students. BMC Medical Education, 16, Article ID 283.
Open this publication in new window or tab >>Experiences of the gender climate in clinical training: a focus group study among Swedish medical students
2016 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, article id 283Article in journal (Refereed) Published
Abstract [en]

Background: Research shows that medical education is characterized by unequal conditions for women and men, but there is a lack of qualitative studies investigating the social processes that enable and maintain gender inequalities that include both male and female students. In this focus group study, we therefore explored male aswell as female medical students’ experiences of the gender climate – i.e., how beliefs, values, and norms about gender were communicated – during clinical training and how the students dealt with these experiences.

Methods: Focus group interviews were conducted with 24 medical students (nine men) at Umeå University, Sweden. The interviews were structured around personal experiences in clinical training where the participants perceived that gender had mattered. Data were analysed using qualitative content analysis.

Results: The students described gender-stereotyped expectations, discriminatory treatment, compliments, comments, and demeaning jargon. Female students gave more personal and varied examples than the men.The students’ ways of handling their experiences were marked by efforts to fit in, for example, by adapting their appearance and partaking in the prevailing jargon. They felt dependent on supervisors and staff, and due to fear of repercussions they kept silent and avoided unpleasant situations and people rather than challenging humiliating jargon or supervisors who were behaving badly.

Conclusions: Everyday communication of gender beliefs combined with students’ adaptation to stereotyped expectations and discrimination came across as fundamental features through which unequal conditions for male and female students are reproduced and maintained in the clinic. Because they are in a dependent position, it is often difficult for students to challenge problematic gender attitudes. The main responsibility for improvements, therefore, lies with medical school leadership who need to provide students and supervisors with knowledge about gendered processes, discrimination, and sexism and to organize reflection groups about the gender climate in order to improve students’ opportunities to discuss their experiences, and hopefully find ways to protest and actively demand change.

Place, publisher, year, edition, pages
London: BioMed Central, 2016
Keywords
Medical education, Clinical training, Gender equality, Attitudes, Sexism, Focus groups
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology
Identifiers
urn:nbn:se:umu:diva-128667 (URN)10.1186/s12909-016-0803-1 (DOI)000386329100002 ()27784300 (PubMedID)
Available from: 2016-12-12 Created: 2016-12-12 Last updated: 2018-06-09Bibliographically approved
Wennberg, A.-L., Isaksson, U., Sandström, H., Lundqvist, A., Hörnell, A. & Hamberg, K. (2016). Swedish women’s food habits during pregnancy up to six months post-partum:: A longitudinal study. Sexual & Reproductive HealthCare, 8, 31-36
Open this publication in new window or tab >>Swedish women’s food habits during pregnancy up to six months post-partum:: A longitudinal study
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2016 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 8, p. 31-36Article in journal (Refereed) Published
Abstract [en]

Objectives: Diet influences the health of the foetus and the woman during pregnancy and later in life. Itis therefore important to investigate pregnant women’s food habits. The aim of this study was to describewomen’s food habits during pregnancy and up to six months post-partum.Study design: A Food Frequency Questionnaire (VIP-FFQ) was distributed to 163 pregnant women on fiveoccasions during and after pregnancy. Data were analysed using Friedman’s ANOVA and a Bonferronipost-hoc test.Main outcome measures: Food habits in relation to the National Food Agency’s (NFA) food index.Results: The pregnant women’s diets were inadequate according to the NFA food index. A tendency towardsan even poorer diet after delivery was identified, something which was related to an increased intakeof discretionary food, e.g. sweets, cakes, cookies, crisps, ice cream, and decreased intake of fruit and vegetable.The alcohol consumption was low throughout.Conclusions: The food habits during pregnancy were inadequate compared to recommendations and thesehabits became unhealthier after delivery. These suggest that dietary counselling needs to be more effectiveand continued into the lactating period. An increased focus should be given to healthy eating fromthe life course perspective, not just focus on effects on the foetus and pregnancy outcomes.

Keywords
Pregnancy, Food habit, Longitudinal study, Questionnaire, Counselling
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-119820 (URN)10.1016/j.srhc.2016.01.006 (DOI)000376839500006 ()27179375 (PubMedID)
Available from: 2016-04-28 Created: 2016-04-28 Last updated: 2018-06-07Bibliographically approved
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