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Sahlen, Klas-Göran
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Publications (10 of 32) Show all publications
Norström, F., Waenerlund, A.-K., Lindholm, L., Nygren, R., Sahlén, K.-G. & Brydsten, A. (2019). Does unemployment contribute to poorer health-related quality of life among Swedish adults?. BMC Public Health, 19, Article ID 457.
Open this publication in new window or tab >>Does unemployment contribute to poorer health-related quality of life among Swedish adults?
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 457Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Previous studies have shown that unemployment has negative impacts on various aspects of health. However, little is known about the effect of unemployment on health-related quality of life. Our aim was to examine how unemployment impacts upon health-related quality of life among Swedish adults, and to investigate these effects on population subgroups defined by education level, marital status, previous health, and gender.

METHODS: As part of a cross-sectional study, a questionnaire was sent to 2500 randomly selected individuals aged 20 to 64 years living in Sweden in 2016. The questionnaire included the EuroQol 5 dimensions (EQ-5D) instrument and was answered by 967 individuals (39%). Quality-adjusted life year (QALY) scores were derived from the EQ-5D responses. Of the respondents, 113 were unemployed and 724 were employed. We used inverse probability-weighted propensity scores in our analyses to estimate a risk difference. Gender, age, education level, marital status, and previous health were used as covariates in our analyses.

RESULTS: There was a statistically significant lower QALY score by 0.096 points for the unemployed compared to the employed. There were also statistically significant more problems due to unemployment for usual activities (6.6% more), anxiety/depression (23.6% more), and EQ-5D's Visual Analogue Scale (7.5 point lower score). Grouped analyses indicated a larger negative health effect from becoming unemployed for men, those who are married, and young individuals.

CONCLUSIONS: In our study, we show that the health deterioration from unemployment is likely to be large, as our estimated effect implies an almost 10% worse health (in absolute terms) from being unemployed compared to being employed. This further highlights that unemployment is a public health problem that needs more focus. Our study also raises further demands for determining for whom unemployment has the most negative effects and thus suggesting groups of individuals who are in greatest need for labor market measures.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
EuroQol 5 dimensions, Labor market, Propensity scores, Quality-adjusted life years
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
Identifiers
urn:nbn:se:umu:diva-158631 (URN)10.1186/s12889-019-6825-y (DOI)000467017800001 ()31035994 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00647
Available from: 2019-05-03 Created: 2019-05-03 Last updated: 2019-06-13Bibliographically approved
Moshi, H., Sundelin, G., Sahlén, K.-G., Anthea, R. & Sörlin, A. (2018). Coping Resources for Persons With Traumatic Spinal Cord Injury in A Tanzania Rural Area. Global Journal of Health Science, 10(5), 138-153
Open this publication in new window or tab >>Coping Resources for Persons With Traumatic Spinal Cord Injury in A Tanzania Rural Area
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2018 (English)In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 10, no 5, p. 138-153Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persons with traumatic spinal cord injury (TSCI) in Tanzanian rural settings face a variety of geographical and socioeconomic challenges that make life almost impossible for them. However, some have managed to live relatively long lives despite these difficult conditions. This study aimed at exploring secrets behind successful lives of persons with TSCI in typical resource-constrained rural Tanzanian settings.

METHODS: A modified constructivist grounded theory was employed for the analysis of data from 10 individuals who have lived between 7 and 28 years with TSCI in typical Tanzanian rural area. The 10 were purposively selected from 15 interviews that were conducted in 2011. The analysis followed the constructivist approach in which data was first open and axial coded, prior to categories being constructed. The categories were frequently reviewed in light of the available literature to determine the over-arching core category that described or connected the rest.

RESULTS: Nine categories (identified as internal and external coping resources) were constructed. The internal coping resources were: secured in God, increase in awareness on health risk, problem-solving skills and social skills. External coping resources were: having a reliable family, varying support from the community, a matter of possession and left without means for mobility. Acceptance was later identified as a core category that determines identification and utilization of the rest of the coping resources.

CONCLUSION: Persons with traumatic spinal cord injury can survive for a relatively long time despite the hostile environment. Coping with these environments requires the employment of various coping resources, acceptance being the most important.

Place, publisher, year, edition, pages
Canadian Center of Science and Education, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-147731 (URN)10.5539/gjhs.v10n5p138 (DOI)
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-12-11Bibliographically approved
Lindholm, L., Ivarsson, A., Löfgren, C., Meili, K., Nygren, L., Pulkki-Brännström, A.-M. & Sahlen, K.-G. (2018). Nytt sätt att mäta livskvalitet öppnar för effektivare insatser. Dagens samhälle (31), pp. 26-26
Open this publication in new window or tab >>Nytt sätt att mäta livskvalitet öppnar för effektivare insatser
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2018 (Swedish)In: Dagens samhälle, ISSN 1652-6511, no 31, p. 26-26Article in journal, News item (Other (popular science, discussion, etc.)) Published
Keywords
perspektiv, välfärd, kvalitet, forskning
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-154101 (URN)
Note

Publicerad online med rubriken "Forskare: Mät välfärdens kvalitet i antal "goda år"!"

Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2019-02-27Bibliographically approved
Zingmark, M., Nilsson, I., Norström, F., Sahlén, K.-G. & Lindholm, L. (2017). Cost effectiveness of an intervention focused on reducing bathing disability. European Journal of Ageing, 14(3), 233-241
Open this publication in new window or tab >>Cost effectiveness of an intervention focused on reducing bathing disability
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2017 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 14, no 3, p. 233-241Article in journal (Refereed) Published
Abstract [en]

The onset of bathing disability among older people is critical for a decline in functioning and has implications for both the individuals’ quality of life and societal costs. The aim of this study was to evaluate longterm cost effectiveness of an intervention targeting bathing disability among older people. For hypothetical cohorts of community-dwelling older people with bathing disability, transitions between states of dependency and death were modelled over 8 years including societal costs. A five-state Markov model based on states of dependency was used to evaluate Quality-adjusted life years (QALYs) and costs from a societal perspective. An intervention group was compared with a no intervention control group. The intervention focused on promoting safe and independent performance of bathing-related tasks. The intervention effect, based on previously published trials, was applied in the model as a 1.4 increased probability of recovery during the first year. Over the full follow-up period, the intervention resulted in QALY gains and reduced societal cost. After 8 years, the intervention resulted in 0.052 QALYs gained and reduced societal costs by €2410 per person. In comparison to the intervention cost, the intervention effect was a more important factor for the magnitude of QALY gains and long-term societal costs. The intervention cost had only minor impact on societal costs. The conclusion was that an intervention targeting bathing disability among older people presents a cost-effective use of resources and leads to both QALY gains and reduced societal costs over 8 years.

Keywords
Cost effectiveness, QALY, Occupational therapy intervention, Reablement
National Category
Occupational Therapy Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-100062 (URN)10.1007/s10433-016-0404-1 (DOI)000409468500003 ()
Note

Orginally published in manuscript form with title: Recovery from bathing disability among older people - modeling long term cost-effectiveness of an occupational therapy intervention

Available from: 2015-02-20 Created: 2015-02-20 Last updated: 2018-06-07Bibliographically approved
Edin-Liljegren, A., Daerga, L., Sahlén, K.-G. & Jacobsson, L. (2017). Psychosocial Perspectives on Working Conditions among Men and Women in Reindeer Breeding in Sweden. Journal of Northern Studies, 11(2), 31-47
Open this publication in new window or tab >>Psychosocial Perspectives on Working Conditions among Men and Women in Reindeer Breeding in Sweden
2017 (English)In: Journal of Northern Studies, ISSN 1654-5915, Vol. 11, no 2, p. 31-47Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this project was to describe the work organisation in the Sami communities and in reindeer-herding work and to explore the range of female duties and compare how men and women experience their psychosocial working conditions. Design: A kind of intervention study was performed by means of a questionnaire sent out to 200 individuals from seven Sami communities. Questions were asked about work organisation, communication, personal relations, solitary work, support, participation and appreciation from colleagues and women's tasks. Meetings and discussions were held about what was perceived as being important in the life of the Sami communities. Notes from 16 group discussions were written down and analysed according to themes of topics relating to how men and women in the Sami communities experience their lives. Results: Communication and relations were described as being inadequate and some respondents experienced a heavy workload. The women reported more troubled relations, less participation in decision-making and less appreciation from colleagues. Positive issues reported were the Sami identity and a strong connection to the reindeer and to nature. Conclusions: This study indicates a need for a more systematic study of the psychosocial work conditions in the Sami communities in Sweden. Measures should be taken to develop the organisation of work, e.g. through developing communication strategies and conflict management, which has been requested by several Sami communities.

Place, publisher, year, edition, pages
Umeå: Umeå University & The Royal Skyttean Society, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health; Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-146408 (URN)
Funder
Västerbotten County Council
Note

Projektet är också finansierat via EU Mål 1 Sápmi, Norra Norrland, dnr. SN 1.43-4/03

Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2018-06-09Bibliographically approved
Dalmar, A. A., Hussein, A. S., Walhad, S. A., Ibrahim, A. O., Abdi, A. A., Ali, M. K., . . . Wall, S. (2017). Rebuilding research capacity in fragile states: the case of a Somali-Swedish global health initiative. Global Health Action, 10(1), Article ID 1348693.
Open this publication in new window or tab >>Rebuilding research capacity in fragile states: the case of a Somali-Swedish global health initiative
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2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, article id 1348693Article in journal (Refereed) Published
Abstract [en]

This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2017
Keywords
Diaspora, Somalia, fragile states, health research training, health systems
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138141 (URN)10.1080/16549716.2017.1348693 (DOI)000407952800001 ()28799463 (PubMedID)
Available from: 2017-08-14 Created: 2017-08-14 Last updated: 2018-06-09Bibliographically approved
Moshi, H., Sundelin, G., Sahlen, K.-G. & Sörlin, A. (2017). Traumatic spinal cord injury in the north-east Tanzania: describing incidence, etiology and clinical outcomes retrospectively. Global Health Action, 10(1), Article ID 1355604.
Open this publication in new window or tab >>Traumatic spinal cord injury in the north-east Tanzania: describing incidence, etiology and clinical outcomes retrospectively
2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, article id 1355604Article in journal (Refereed) Published
Abstract [en]

Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting.

Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010–2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients’ condition on discharge were recorded and analyzed descriptively.

Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most docu- mented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%.

Conclusion: Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed. 

Keywords
Traumatic spinal cord injury, etiology, rural, Tanzania, Africa
National Category
Physiotherapy Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-138838 (URN)10.1080/16549716.2017.1355604 (DOI)000408679400001 ()28856978 (PubMedID)
Available from: 2017-09-01 Created: 2017-09-01 Last updated: 2018-12-11Bibliographically approved
Sahlen, K.-G., Boman, K. & Brännström, M. (2016). A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial. Palliative Medicine: A Multiprofessional Journal, 30(3), 296-302
Open this publication in new window or tab >>A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial
2016 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 30, no 3, p. 296-302Article in journal (Refereed) Published
Abstract [en]

Background: Previous economic studies of person-centered palliative home care have been conducted mainly among patients with cancer. Studies on cost-effectiveness of advanced home care for patients with severe heart failure are lacking when a diagnosis of heart failure is the only main disease as the inclusion criterion.

Aim: To assess the cost-effectiveness of a new concept of care called person-centered integrated heart failure and palliative home care.

Design: A randomized controlled trial was conducted from January 2011 to 2013 at a center in Sweden. Data collection included cost estimates for health care and the patients’ responses to the EQ-5D quality of life instrument.

Setting/participants: Patients with chronic and severe heart failure were randomly assigned to an intervention (n = 36) or control (n = 36) group. The intervention group received the Palliative Advanced Home Care and Heart Failure Care intervention over 6 months. The control group received the same care that is usually provided by a primary health care center or heart failure clinic at the hospital.

Results: EQ-5D data indicated that the intervention resulted in a gain of 0.25 quality-adjusted life years, and cost analysis showed a significant cost reduction with the Palliative Advanced Home Care and Heart Failure Care intervention. Even if costs for staffing are higher than usual care, this is more than made up for by the reduced need for hospital-based care. This intervention made it possible for the county council to use €50,000 for other needs.

Conclusion: The Palliative Advanced Home Care and Heart Failure Care working mode saves financial resources and should be regarded as very cost-effective.

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
Cost-effectiveness, heart failure, home care
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-112067 (URN)10.1177/0269216315618544 (DOI)000370816400009 ()26603186 (PubMedID)
Note

Special Issue.

Available from: 2015-12-01 Created: 2015-12-01 Last updated: 2018-06-07Bibliographically approved
Kobayashi, H. & Sahlen, K.-G. (2016). Distributed resources and care choice: formulation through the capability approach. In: : . Paper presented at 9th European Public Health Conference, 9–12 November, 2016, Vienna, Austria. OXFORD UNIV PRESS, 26
Open this publication in new window or tab >>Distributed resources and care choice: formulation through the capability approach
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2016
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-134282 (URN)10.1093/eurpub/ckw174.040 (DOI)000398600403199 ()
Conference
9th European Public Health Conference, 9–12 November, 2016, Vienna, Austria
Note

Supplement 1

Available from: 2017-05-15 Created: 2017-05-15 Last updated: 2018-06-09
Edin-Liljegren, A., Sahlen, K.-G., Jacobsson, L. & Daerga, L. (2016). Reindeer-herding Sami experiences of seeking care in the mainstream society. International Journal of Circumpolar Health, 75(33200)
Open this publication in new window or tab >>Reindeer-herding Sami experiences of seeking care in the mainstream society
2016 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, no 33200Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-134315 (URN)10.3402/ijch.v75.33200 (DOI)000396153800234 ()
Available from: 2017-04-28 Created: 2017-04-28 Last updated: 2018-06-09Bibliographically approved
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