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  • 1.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain: a literature review2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 23, p. 2255-2270Article, review/survey (Refereed)
    Abstract [en]

    Purpose: The purpose of this study is to assess and describe the meanings given to "gender" in scientific publications that evaluate multidisciplinary, interdisciplinary or multimodal rehabilitation for patients with chronic musculoskeletal pain.

    Method: A systematic literature search for papers evaluating multimodal rehabilitation was conducted. The PubMed and EBSCO databases were searched from 1995 to 2015. Two or three researchers independently read each paper, performed a quality assessment and coded meanings of gender using qualitative content analysis.

    Results: Twenty-seven papers were included in the review. Gender was used very differently in the MMR studies investigated but primarily it referred to factual differences between men and women. Only one paper provided a definition of the concept of gender and how it had been used in that study. In the content analysis, the meaning of gender formed three categories: "Gender as a factual difference", "The man is the ideal" and "Gender as a result of social role expectations".

    Conclusions: The meaning of the concept of gender in multimodal rehabilitation is undefined and needs to be developed further. The way the concept is used should be defined in the design and evaluation of multimodal rehabilitation in future studies.

    Implications for rehabilitation

    Healthcare professionals should reflect on gender relations in encounters with patients, selection of patients into rehabilitation programs and design of programs. In rehabilitation for chronic pain the patients' social circumstances and cultural context should be given the same consideration as biological sex and pain symptoms.

  • 2.
    Andersson, Jenny
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Verdonk, Petra
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lagro-Janssen, Toine
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Comparing gender awareness in Dutch and Swedish first-year medical students: results from a questionaire2012In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 12, p. 3-Article in journal (Refereed)
    Abstract [en]

    Background: To ascertain good and appropriate healthcare for both women and men implementation of gender perspectives in medical education is needed. For a successful implementation, knowledge about students' attitudes and beliefs about men, women, and gender is crucial. The aim of this study was to compare attitudes to gender and gender stereotyping among Dutch and Swedish male and female medical students.

    Methods: In this cross-sectional study, we measured the attitudes and assumptions about gender among 1096 first year medical students (616 Dutch and 480 Swedish) with the validated Nijmegen Gender Awareness in Medicine Scale (N-GAMS). The response rate was 94% in the Netherlands and 93% in Sweden. Univariate analysis of variance (ANOVA) was used to compare the scores between Dutch and Swedish male and female students. Linear regressions were used to analyze the importance of the background variables.

    Results: There were significant differences in attitudes to gender between Dutch and Swedish students. The Swedish students expressed less stereotypical thinking about patients and doctors and the Dutch were more sensitive to gender differences. The students' sex mattered for gender stereotyping, with male students in both countries agreeing more with stereotypical statements. Students' age, father's birth country and mother's education level had some impact on the outcome.

    Conclusions: There are differences between cultures as well as between men and women in gender awareness that need to be considered when implementing gender in medical education. This study suggests that to arouse the students' interest in gender issues and make them aware of the significance of gender in medical work, the examples used in discussions need to be relevant and challenging in the context of the specific country. Due to different levels of knowledge and different attitudes within the student population it is important to create a climate for dialogue where students feel permitted to disclose their ideas and attitudes in order to become aware of what these are as well as their possible consequences on interaction and decision-making in medical work.

  • 3.
    Andersson, Åsa
    et al.
    Umeå University, Faculty of Arts, Historical Studies.
    Johansson, Eva E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    The state of the art2007In: Present challenges in gender research / [ed] Åsa Andersson & Eva E. Johansson, Umeå: Umeå universitet , 2007, p. 6-14Chapter in book (Other academic)
  • 4.
    Bengs, Carita
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Danielsson, Ulla EB
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gendered portraits of depression in Swedish newspapers2008In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 18, no 7, p. 962-973Article in journal (Refereed)
    Abstract [en]

    Mass media are influential mediators of information, knowledge, and narratives of health and illness. In this article, we report on an examination of personal accounts of illness as presented in three Swedish newspapers, focusing on the gendered representation of laypersons' experiences of depression. A database search identified all articles mentioning depression during the year 2002. Twenty six articles focusing on personal experiences of depression were then subjected to a qualitative content analysis. We identified four themes: displaying a successful facade, experiencing a cracking facade, losing and regaining control, and explaining the illness. We found both similarities and differences with regard to gendered experiences. The mediated accounts of depression both upheld and challenged traditional gender stereotypes. The women's stories were more detailed, relational, emotionally oriented, and embodied. The portrayal of men was less emotional and expressive, and described a more dramatic onset of depression, reflecting hegemonic patterns of masculinity.

  • 5. Björk, Anna-Bell
    et al.
    Sjöström, Malin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Samuelsson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Umefjord, Goran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Women's Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence2014In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 24, no 4, p. 484-493Article in journal (Refereed)
    Abstract [en]

    Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women's experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient-provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.

  • 6.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berglin, Björn
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    "It should be an ordinary thing": a qualitative study about young people´s experiences of taking the HIV-test and getting the test result2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 678-683Article in journal (Refereed)
    Abstract [en]

    Aim:  Increased HIV-testing has public health benefits, but for youth there is a multitude of barriers against the test. The aim of this study is to explore how young women and men in Sweden experience HIV-testing within primary healthcare.

    Method:  Six focus-group interviews were tape recorded, transcribed verbatim and analysed according to qualitative content analysis.

    Results:  Three themes emerged, describing how the informants were met before, during and after testing; ‘Obstacles accessing the clinic’– describes their perceptions on how to overcome different barriers and enter into primary health care. ‘Quick and easy testing’– describes perceptions of the testing procedure and ‘Conflicting and unclear information about test results’– describes inconsistencies concerning communication of the test result and a concern about ‘what would happen’ in the event of an HIV-positive finding. Most of these youth preferred the HIV-test ‘quick and easy’ and preferred a telephone referral of the test result. A minority of them worried about HIV, and they thought that the staff seemed to be unprepared for an HIV-positive test result.

    Conclusion:  According to these youth, a quick and easy testing procedure together with a short pretest discussion may be sufficient and may also help normalising the testing practice. In a Swedish context, it may be common to see heterosexual youth as a risk-free population, and this perception may act as a barrier for HIV-testing and increase missed opportunities for early diagnose of HIV within primary care.

  • 7.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    "One-night stands" - risky trips between lust and trust: qualitative interviews with Chlamydia trachomatis infected youth in north Sweden2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 31, no 1, p. 44-50Article in journal (Refereed)
  • 8.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Concepts of risk among young Swedes tested negative for HIV in primary care.2007In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 25, no 1, p. 38-43Article in journal (Refereed)
  • 9.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lalos, Anne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    The law of communicable diseases act and disclosure to sexual partners among HIV-positive youth.2008In: Vulnerable Children and Youth Studies, ISSN 1745-0128, E-ISSN 1745-0136, Vol. 3, no 3, p. 234-242Article in journal (Refereed)
    Abstract [en]

    In Sweden, human immunodeficiency virus (HIV) is included among the venereal diseases covered by the Law of Communicable Diseases Act. HIV-positive (HIV(+)) people are required to inform their sexual partners about their infection and adopt safe sex behaviours. However, it is unclear how the law is perceived. This study explores how HIV(+) youth in Sweden perceive the law, handle their sexuality and disclose their HIV diagnosis to sexual partners. Ten HIV(+) women and men between 17 and 24 years of age were recruited from three different HIV infection clinics. These participants were interviewed in depth. The interviews were tape-recorded, transcribed verbatim and analysed according to a grounded theory approach. The core category-cultured to take responsibility-illuminates the informants' double-edged experiences regarding the law and how they handle disclosure to sexual partners. The legislation implies both support and burden for these HIV(+) youth; they feel that they have a great deal of responsibility, sometimes more than they can handle. 'Switch off lust', 'balancing lust, fear and obedience' and 'switch off the disease' are strategies that describe how the informants manage sexuality and disclosure. Young HIV(+) people have a difficult time informing partners of their HIV diagnosis and discussing safe sex strategies. These are challenges that health care providers need to take seriously. HIV(+) youth need better communication strategies to negotiate safer sex. Staff with extended education on sexuality should be a part of HIV health care.

  • 10.
    Danielsson, Ulla E
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Beyond weeping and crying: a gender analysis of women´s and men´s expressions of depression2005In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 23, p. 171-177Article in journal (Refereed)
    Abstract [en]

    Objective. To explore depression from a gender perspective, by capturing depressed women's and men's formulations of their experiences and understanding of their situation. Design. Qualitative interview study. Setting. A healthcare centre in northern Sweden. Subjects. Eighteen patients who had been diagnosed with depression and treated for at least 6 months were interviewed in depth, both women and men of different ages and social status. Open questions were posed around the themes of Malterud's key questions, focusing especially on how the informants conveyed their experiences. Interviewing and qualitative data analysis went on simultaneously. Results. The experience of depression held similarities for men and women, but the outward manifestations differed by gender as well as socioeconomic status. Though experiences of high demands underlay the narratives of all informants, home or work had different priority. Men talked more easily about physical distress – often the heart – than about emotions. Women verbalized more readily emotional distress – shame and guilt – while physical symptoms often revolved around the stomach. Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Conclusion. As clinicians we must listen attentively not only to the manifest but to the avoided or unarticulated. By doing so we might counteract normative gender patterns that highlight the depression of women and conceal that of men.

  • 11.
    Danielsson, Ulla EB
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Struck by lightning or slowly suffocating: gendered trajectories into depression2009In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 10, no 1, p. 56-Article in journal (Refereed)
    Abstract [en]

    Background: In family practice depression is a common mental health problem and one with marked gender differences; women are diagnosed as depressed twice as often as men. A more comprehensive explanatory model of depression that can give an understanding of, and tools for changing, this gender difference is called for. This study explores how primary care patients experience, understand and explain their depression.

    Methods: Twenty men and women of varying ages and socioeconomic backgrounds diagnosed with depression according to ICD-10 were interviewed in-depth. Data were assessed and analyzed using Grounded Theory.

    Results: The core category that emerged from analysis was "Gendered trajectories into depression". Thereto, four categories were identified – "Struck by lightning", "Nagging darkness", "Blackout" and "Slowly suffocating" – and presented as symbolic illness narratives that showed gendered patterns. Most of the men in our study considered that their bodies were suddenly "struck" by external circumstances beyond their control. The stories of study women were more diverse, reflecting all four illness narratives. However, the dominant pattern was that women thought that their depression emanated from internal factors, from their own personality or ways of handling life. The women were more preoccupied with shame and guilt, and conveyed a greater sense of personal responsibility and concern with relationships.

    Conclusion: Recognizing gendered narratives of illness in clinical consultation may have a salutary potential, making more visible depression among men while relieving self-blame among women, and thereby encouraging the development of healthier practices of how to be a man or a woman.

  • 12.
    Danielsson, Ulla EB
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Samuelsson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    "My greatest dream is to be normal": the impact of gender on depression narratives of young Swedish women and men2011In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 21, no 5, p. 612-624Article in journal (Refereed)
    Abstract [en]

    Depression is common among young people. Gender differences in diagnosing depression appear during adolescence. The study aim was to explore the impact of gender on depression in young Swedish men and women. Grounded theory was used to analyze interviews with 23 young people aged 17 to 25 years who had been diagnosed with depression. Their narratives were marked by a striving to be normal and disclosed strong gender stereotypes, constructed in interaction with parents, friends, and the media. Gender norms were upheld by feelings of shame, and restricted the acting space of our informants. However, we also found transgressions of these gender norms. Primary health care workers could encourage young men to open up emotionally and communicate their personal distress, and young women to be daring and assertive of their own strengths, so that both genders might gain access to the positive coping strategies practiced respectively by each.

  • 13.
    Danielsson, Ulla EB
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Beyond weeping and crying: a gender analysis of expressions of depression2005In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 23, no 3, p. 171-177Article in journal (Refereed)
  • 14.
    Danielsson, Ulla
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Kap 25. Depressionens genusuttryck - stämmor mellan skratt och gråt.2004In: Kropp och genus i medicinen., Lund: Studentlitteratur , 2004Chapter in book (Other academic)
  • 15.
    Diderichsen, Saima
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Andersson, Jenny
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Verdonk, Petra
    VU University Medical Center, Department of Medical Humanities, EMGO Institute for Health and Care Research, Amsterdam, the Netherlands.
    Lagro-Janssen, Toine
    Department of Primary and Community Care, Centre for Family Medicine, Geriatric and Public Helth, Unit Women's Studies, Radboud University Nijmegen Medical Health Centre, The Netherlands .
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Swedish medical students' expectations of their future life2011In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 2, p. 140-146Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate future life expectations among male and female medical students in their first and final year.

    Methods: The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories.

    Results: Students' written answers were coded, categorized and clustered into four themes: "Work", "Family", "Leisure" and "Quality of personal life". Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students.

    Conclusions: Today's medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.

  • 16.
    Diderichsen, Saima
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Verdonk, Petra
    Lagro-Janssen, Toine
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Few gender differences in specialty preferences and motivational factors: a cross-sectional Swedish study on last-year medical students2013In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 13, article id 39Article in journal (Refereed)
    Abstract [en]

    Background: Today, women constitute about half of medical students in several Western societies, yet women physicians are still underrepresented in surgical specialties and clustered in other branches of medicine. Gender segregation in specialty preference has been found already in medical school. It is important to study the career preferences of our future physicians, as they will influence the maintenance of an adequate supply of physicians in all specialties and the future provision of health care. American and British studies dominate the area of gender and medical careers whereas Swedish studies on medical students' reasons for specialty preference are scarce. The aim of this study is to investigate and compare Swedish male and female medical students' specialty preferences and the motives behind them. Methods: Between 2006 and 2009, all last-year medical students at Umea University, Sweden (N = 421), were invited to answer a questionnaire about their future career and family plans. They were asked about their specialty preference and how they rated the impact that the motivational factors had for their choice. The response rate was 89% (N = 372); 58% were women (N = 215) and 42% were men (N = 157). Logistic regression was used to evaluate the independent impact of each motivational factor for specialty preference. Results: On the whole, male and female last-year students opted for similar specialties. Men and women had an almost identical ranking order of the motivational factors. When analyzed separately, male and female students showed both similarities and differences in the motivational factors that were associated with their specialty preference. A majority of the women and a good third of the men intended to work part-time. The motivational factor combining work with family correlated with number of working hours for women, but not for men. Conclusions: The gender similarities in the medical students' specialty preferences are striking and contrast with research from other Western countries where male and female students show more differences in career aspirations. These similarities should be seized by the health care system in order to counteract the horizontal gender segregation in the physician workforce of today.

  • 17. Eriksson, Bodil
    et al.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    [Old gender patterns still used when physicians are pictured in medical journals. Male physicians are portrayed as active leaders, women physicians as listening, compassionate]2005In: Lakartidningen, ISSN 0023-7205, Vol. 102, no 40, p. 2840-2, 2844Article in journal (Refereed)
  • 18.
    Fhärm, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    ‘Aiming for the stars’—GPs’ dilemmas in the prevention of cardiovascular disease in type 2 diabetes patients: focus group interviews2009In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, no 26, p. 109-114Article in journal (Refereed)
    Abstract [en]

    Background

    Studies have revealed low adherence to guidelines for treatment of diabetes and cardiovascular risk factors.

    Objective

    To explore general practitioners’ experiences regarding treatment practice in type 2 diabetes with specific focus on the prevention of cardiovascular disease.

    Methods

    Fourteen experienced general practitioners from nine health care centres with group practices were interviewed in focus groups. The interviews were digitally recorded, transcribed verbatim and analysed by qualitative content analysis.

    Results

    The overall theme was “dilemmas” in GPs´ treatment practice for type 2 diabetes patients. Five main dilemma categories were identified. First, the GPs were hesitant about labelling someone who feels healthy as ill. Secondly, regarding communicating a diabetes diagnosis and its consequences; should the patient be frightened or comforted? Thirdly, the GPs experienced uncertainty in their role; were they to take responsibility for the care or not? Fourthly, the GPs expressed a conflict between lifestyle changes and drug treatment. Fifthly, the GPs described difficulties in integrating science into reality.

    Conclusions

    The five dilemmas in the general practitioners’ approach to diabetes patients and the treatment of their cardiovascular risk were related to the GPs´ professional role and communication with the patient. To consider these dilemmas in educational efforts is probably essential to achieve improved diabetes care and guideline adherence. 

  • 19.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Hovelius, Birgitta
    Johansson, Eva
    Risberg, Gunilla
    Feministiska perspektiv inom medicin och vård.1998In: Socialmedicinsk tidskrift, Vol. 1-2, p. 2-3Article, review/survey (Other (popular science, discussion, etc.))
  • 20.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Hovelius, Birgitta
    Johansson, Eva
    Ökad utbildning och större inflytande ger kvinnor kontroll över kropp och liv.1995In: Läkartidningen, Vol. 92, p. 656-657Article in journal (Other (popular science, discussion, etc.))
  • 21.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Family, work, health and rehabilitation for women in pain.2002In: Chronic myofascial pain.: A patient centered approach., Radcliffe Medical Press, Oxon , 2002, p. 72-85Chapter in book (Other (popular science, discussion, etc.))
  • 22.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Fråga och lyssna - teori, metod och analys i allmänmedicinsk kvinnoforskning1993In: Allmänmedicin, Vol. 14, p. 238-242Article in journal (Other (popular science, discussion, etc.))
  • 23.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Läkare, kvinna och forskare - reflexioner kring tolkning av intervjuer1998In: Socialmedicinsk Tidskrift, no 1-2, p. 17-20Article, review/survey (Other (popular science, discussion, etc.))
  • 24.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Medical students' attitudes to gender issues in the role and career of physicians: a qualitative study conducted in Sweden2006In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 28, no 7, p. 635-641Article in journal (Refereed)
    Abstract [en]

    There is an increasing awareness of the importance to address gender issues during medical studies. This qualitative study is aimed at exploring students’ attitudes to gender issues in the career of physicians, and identifying questions important to consider in medical education about gender. At Umeå University in Sweden, third-term medical students write an essay about ‘being a doctor’ and they also reflect on gender issues their future career. In 2002, the essays of 41 men and 63 women (75%) were analysed using open coding and repeated comparisons to elaborate categories. Four main attitudes towards gender were identified. Important and interesting (men 22%, women 63%), meaning gender was regarded as a crucial consideration in a physician's working life. Interested women expressed personal worries about their future, while interested men's reflections were more intellectually focused. Relevant with doubts (54%, 27%) represented a positive stand while simultaneously reducing the significance of gender. In Irrelevant and irritating (20%, 8%), gender was seen as over-talked and politics. Irritated students challenged the teachers and questioned gender as a field of scientific knowledge. Neglecting denoted avoidance of gender (5%, 3%). To avoid reinforcing stereotypical ideas about men and women, teachers and physicians need more knowledge about gender.

  • 25.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Practitioner, Researcher and Gender Conflict in a Qualitative Study.1999In: Qualitative Health Research, Vol. 9, no 4, p. 455-467Article in journal (Refereed)
  • 26.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Candib, L
    Chapter 4. Understanding the whole person.2002In: Chronic myofascial pain - a patient-centered approach., Oxford: Radcliffe Medical Press Ltd , 2002Chapter in book (Other academic)
  • 27.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Lindgren, Gerd
    "I was always on guard"--an exploration of woman abuse in a group of women with musculoskeletal pain.1999In: Fam Pract, ISSN 0263-2136, Vol. 16, no 3, p. 238-44Article in journal (Refereed)
  • 28.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lindgren, Gerd
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Scientific rigor in qualitative research: examples from a study of women´s health1994In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 11, p. 176-181Article in journal (Refereed)
    Abstract [en]

    The increase in qualitative research in family medicine raises a demand for critical discussions about design, methods and conclusions. This article shows how scientific claims for truthful findings and neutrality can be assessed. Established concepts such as validity, reliability, objectivity and generalization cannot be used in qualitative research. Alternative criteria for scientific rigour, initially introduced by Lincoln and Guba, are presented: credibility, dependability, confirmability and transferability. These criteria have been applied to a research project, a qualitative study with in-depth interviews with female patients suffering from chronic pain in the locomotor system. The interview data were analysed on the basis of grounded theory. The proposed indicators for scientific rigour were shown to be useful when applied to the research project. Several examples are given. Difficulties in the use of the alternative criteria are also discussed.

  • 29.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lindgren, Gerd
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    The impact of marital relationship on the rehabilitation process in a group of women with long-term musculoskeletal disorders.1997In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 25, no 1, p. 17-25Article in journal (Refereed)
    Abstract [en]

    This qualitative study investigated problems in the rehabilitation of women with long-term, musculoskeletal pain disorders. Data were collected by repeated semi-structured interviews and doctor-patient encounters during two years, and analysed in a gender perspective. The “marriage contract”, i.e. the pattern of division of duties and power structure within the marital relationship, was of obvious importance to the implementation of rehabilitation measures. We explored situations where the rehabilitation measures disagreed with the terms and patterns in the “marriage contract”. The participants' ways of coping with the contract in these delicate situations could be described as three type strategies; accepting the terms, negotiating for new terms, and breaking the contract. The crucial impact of the “marriage contract” and the type strategies on the rehabilitation process are exemplified.

  • 30.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Malterud, Kirsti
    Chapter 5. The patient-clinician relationship.2002In: Chronic myofascial pain - a patient-centered approach., Oxford: Radcliffe Medical Press Ltd. , 2002Chapter in book (Other academic)
  • 31.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Mattsson, B
    [The picture of the psychiatrist should be more nuanced. General practitioners react to articles on depression in primary health care]1998In: Lakartidningen, ISSN 0023-7205, Vol. 95, no 12, p. 1291-2, 1295; discussion 1295Article in journal (Other academic)
  • 32.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Risberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Male and female physicians show different patterns of gender bias: a paper-case study of management of irritable bowel syndrome.2004In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 32, no 2, p. 144-152Article in journal (Refereed)
    Abstract [en]

    AIMS: Research has raised concerns about gender bias in medicine, i.e. that men and women might be treated differently due to gender-stereotyped attitudes among physicians. The authors investigated gender differences in medical management of a common health problem, irritable bowel syndrome (IBS). METHOD: In a national examination for Swedish house officers, the examinees were allocated to suggest management of IBS in either a male or female paper-patient. The case description was identical in both genders with the exception of prior prostate and gynaecological symptoms. The open answers were coded for analysis. A total of 289 physicians (45% women) participated. Chi-squared tests were used to measure differences in proportions. RESULTS: In variables focusing on medication, weight, gynaecological problems, tobacco, alcohol, thyroid function, proposed diagnoses, X-ray of the colon, and advice about lifestyle, significant or close to significant gender differences were seen. Both male and female physicians made gender differences but they did not show the same pattern of differences. CONCLUSIONS: The results suggest that gender bias is involved in medical management of IBS but men and women physicians may show disparate patterns of gender bias. There is a need for larger studies on gender differences in medical management with designs making it possible to consider the gender of both the patient and the physician. Furthermore, the results call attention to 'knowledge-mediated gender bias', a phenomenon implying that once knowledge about gender differences in a condition has been established, this might in fact cause gender-biased assessments of individual patients in clinical practice.

  • 33.
    Hamberg, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Risberg, Gunilla
    Johansson, Eva
    Westman, Göran
    Gender bias in physicians' management of neck pain: a study of the answers in a Swedish national examination.2002In: J Womens Health Gend Based Med, ISSN 1524-6094, Vol. 11, no 7, p. 653-66Article in journal (Refereed)
  • 34.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Genusvetenskapens utveckling inom medicinen.2002In: Genusvägar - antologi om genusforskning, Stockholm: Liber förlag , 2002Chapter in book (Other academic)
  • 35. Hovelius, Birgitta
    et al.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Inledningskapitel2004In: Kropp och genus i medicinen., Lund: Studentlitteratur , 2004Chapter in book (Other (popular science, discussion, etc.))
  • 36.
    Ibrahimi, Pranvera
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Jashari, Fisnik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Ahlqvist, Jan
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Arnerlöv, Conny
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Garoff, Maria
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Carotid ultrasound accurately detects arterial calcification quantified by cone beam computed tomography2014In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, no Supplement 1, Meeting abstract P3519, p. 636-636Article in journal (Other academic)
  • 37.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Huvudförfattare till kapitel l1, 3, 10 och 122006In: : SBU:s rapport: Metoder för behandling av långvarig smärta., Stockholm, 2006Chapter in book (Other (popular science, discussion, etc.))
  • 38.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Jämställd vård: viktigare rapport att diskutera2005In: Allmänmedicin, Vol. 26, p. 35-37Article in journal (Other academic)
  • 39.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Kap 20. Saga och sanning om smärta och genus.2004In: Kropp och genus i medicinen., Lund: Studentlitteratur , 2004Chapter in book (Other academic)
  • 40.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Kap 3. Utfallsmått vid behandlings- och rehabiliteringsstudier av kronisk smärta.2006In: Rehabiliteringsmedicin, Studentlitteratur, Nirvana Press , 2006Chapter in book (Other (popular science, discussion, etc.))
  • 41.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Kap 7. "Att som spindeln söka fäste mellan himmel och jord"1999In: Kvalitativ metod som praktik: erfarenheter av att forska kvalitativt vid medicinsk fakultet, Lund: Studentlitteratur , 1999Chapter in book (Other academic)
  • 42.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Past and present2007In: Challenges in Gender Research, Print & Media, Umeå , 2007Chapter in book (Other (popular science, discussion, etc.))
  • 43.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Prinsessan på ärten - myt eller verklighet2005In: SMÄRTA, Vol. 10, p. 8-11Article in journal (Other academic)
  • 44.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Saga och utsaga om smärta. "Prinsessan på ärten" - myt om kvinnlighet slår igenom i vetenskapen?2004In: Läkartidningen, Vol. 101, p. 3774-3779Article in journal (Other academic)
  • 45.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Tonåren2007In: Allmänmedicin, Studentlitteratur, Lund , 2007Chapter in book (Other (popular science, discussion, etc.))
  • 46.
    Johansson, Eva
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Är kvalitativ forskning vetenskaplig eller bara relevant?: Nya Rön.2004In: Läkartidningen, Vol. 101, p. 467-Article in journal (Other academic)
  • 47.
    Johansson, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gendered discourses of youth sexualities - an exploration of PubMed articles on prevention of sexually transmissible infections2014In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, no 3, p. 81-89Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore how gender is addressed in medical articles on the prevention of sexually transmissible infections (STI) among adolescents.

    METHODS: Sixtyone articles were retrieved from a PubMed search and scrutinized by qualitative content analysis.

    RESULTS: Most articles were affiliated with North American research institutions, but there were also reports from Europe, Africa, South America, and Asia. Gender turned up in the following four recurrent discourses: Gendered Receptiveness for Information, Stereotyped Heterosexual Expectations, Power Imbalance in Sexual Relations, and Gendered Prevention Approaches. Young women were described as knowledgeable, communicative, and responsible, but at risk because of feminine ideals and a lack of negotiating power. Men were described as less informed, more reluctant to discuss, and more risk taking due to masculine ideals and power dominance. Prevention approaches concerned how to postpone sex and/or tailor gender-sensitive programs for specific groups of young women and men.

    CONCLUSION: Researchers' own gender expectations might have a substantial impact on how sex and sexual health is considered in prevention research. To avoid reconstruction of current inequalities and stereotypes regarding sexual practices of young women and men, the impact of gender, the power structures in intimate relations, and the cultural context should be considered. Medical research on STI prevention could benefit from including a wider array of gender perspectives.

  • 48.
    Johansson, Eva E
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Danielsson, Ulla EB
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gaps between patients, media and academic medicine in discourses on gender and depression: a metasynthesis2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 5, p. 633-644Article in journal (Refereed)
  • 49. Johansson, Eva E.
    et al.
    Hamberg, Katarina
    Lindgren, Gerd
    Westman, Göran
    "I've been crying my way": qualitative analysis of a group of female patients' consultation experiences1996In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 13, no 6, p. 498-503Article in journal (Refereed)
    Abstract [en]

    Background and objectives What do women patients, sick-listed for biomedically undefined musculoskeletal disorders, expect and experience when they consult a doctor? With the purpose to learn more about this, a qualitative interview study was conducted.

    Methods Twenty women participated. They were patients at an urban health care centre in northern Sweden. Data were gained through repeated, semi-structured interviews, and analysed according to grounded theory.

    Results The participants described an atmosphere of distrust in the consultation. They had felt ignored, disregarded and rejected by doctors, and had worked out strategies to keep up medical attention in their search for a creditable diagnosis. They were somatizing, claiming under cover, and pleading, to catch the doctor's interest. In addition, they upheld their self-respect by mystifying and martyrizing themselves and their symptoms, and by condemning physicians as ignorant.

    Discussion The patient's consultation experiences are discussed from different aspects; the biomedical framework, the power asymmetry, and the gendered positions of patient and doctor. The findings indicate the importance of making doctors aware of the context behind frustrations in doctor-patient interaction.

  • 50.
    Johansson, Eva E
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lindström, Ulf
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Examen - något mer än bara kunskapskontroll1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, p. 735-736Article in journal (Refereed)
12 1 - 50 of 81
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