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Background: A transition is seen in healthcare from routine face-to-face consultations to increased reliance on video consultations. Practice by healthcare professionals, who serve extensive geographical areas and conduct relatively few physical examinations, may particularly benefit from this modality. While video consultations attract political interest by offering practical advantages—such as reduced travel—healthcare professionals remain responsible for maintaining care quality. Thus, it is essential to examine how healthcare professionals, such as registered dietitians, reason about the use of video consultations to better support informed decisions about the use of video consultations in healthcare practice. 

Methods: Data were collected using digital interviews from nine registered dietitians selected using purposeful, convenience, and snowball sampling. The data were analysed using reflexive thematic analysis, guided by a patient- centred framework for access to healthcare that considers both patient and provider perspectives.

Results: Dietitians reported that video consultations enhanced flexibility and access to healthcare, though not universally for all patients or stages of care. Three themes emerged: Contributing to good and accessible healthcare; Gaining control over one’s working situation; and Keeping the care process in mind. Dietitians selected video consultations based on considerations of equity and effectiveness but preferred face-to-face consultations when physical assessments were necessary, or when patients lacked adequate digital skills. This was interpreted as personal preferences and normative responses to organizational structures, and policy frameworks.

Conclusion: When multiple aspects of care delivery are considered simultaneously, perceived benefits may overshadow limitations, and vice versa. Future research should explore how to support healthcare professionals in involving patients and navigating competing policy frameworks, professional responsibilities, and contextual demands when deciding on consultation modalities.

Background: Intermittent closures of rural maternity units in northern Sweden disrupt access to essential sexual and reproductive health services, making intrapartum care unpredictable for local women. While long travel distances have been linked to adverse outcomes, less is known about how women view the closures and prepare for birth when local services are unavailable. Hence, the aim of this study is to analyse how women make sense of and negotiate the meaning of their pregnancy and childbirth in relation to intermittent maternity unit closures in rural contexts.

Methods: Semi-structured interviews were conducted with 20 women who were pregnant or had given birth between May 2024 and August 2025 and lived in the catchment area of a rural maternity unit with repeated closures. Interviews were conducted in Swedish in September–November 2025, transcribed verbatim and analysed using discourse psychology to identify interpretative repertoires and subject positions.

Results:The closures created a discursive gap in which established expectations about where and how birth should take place no longer functioned as stable points of reference. Three interpretative repertoires were identified: equity and legitimacy, where women framed rural living as a chosen life yet treated secure maternity care as non-negotiable; moral responsibility, where risk management shifted from system-level preparedness to women’s own planning, including preparing for both hospital and roadside birth; and bodily vulnerability and dignity, where distance, admission thresholds and travel reshaped bodily labour, dignity and help-seeking, sometimes leading women to delay or avoid contacting healthcare services despite their concerns.

Conclusion: Intermittent closures disrupt access to maternity care and shift the responsibility for managing uncertainty and risk from the healthcare system to women themselves. Access to sexual and reproductive health services is more than a matter of geographical availability; it is shaped by how responsibility and legitimacy are negotiated in practice. Maternity services function as a clinical service and as a condition for whether family life feels possible and sustainable in rural communities.

Introduction: Physical activity is an important part of accomplishing and maintaining weight loss. As far as the improvement in associated disease is concerned, the effects of Metabolic Bariatric Surgery (MBS) are well known, but the effects on physical activity and ability to perform everyday activities are less obvious. This study explores how weight loss after Roux-en-Y gastric bypass (RYGB) improves physical activity and movement, and how this impacts everyday life.

Method: Semi-structured interviews were held with patients 1–3 years after RYGB. Audio recordings were transcribed verbatim, and the texts were condensed in steps and abstracted with an inductive approach using Qualitative Content Analysis.

Results: 15 individuals, 12 women and 3 men, median age 36 years (26−73), and median body mass index (BMI) 28 (range 22–45), were interviewed until information power was reached.

The overall theme “New Life and Freedom” was the result of the analysis process. This was derived from two sub-themes: 1. Discovery of Having Higher Physical Capacity, including the categories Higher Capacity for Physical Activity, No More Limitations, Daily Tasks Are Less Strenuous, and Bodily Change is an Achievement; and 2. Physical Activity is More Rewarding, including the categories Increased Motivation and Initiative, Increased Social Participation, Better Wellbeing, and More Energy.

Conclusion: After MBS, patients describe they have gained a new life and freedom thanks to greater ease of participating in physical activities. Patients should be encouraged to continue increased physical activity during follow-up.

Introduction: Video consultation (VC) became vital for improving healthcare access during COVID-19 pandemic and remains so. Despite evidence of effectiveness, concerns including technology literacy and inconsistencies in experience highlight the need for larger, patient-focused studies. While patients appreciate the convenience of VC, challenges during complex issues and patients’ preferences for in-person care persists. Synthesising qualitative studies offers insights into the fragmented understanding of patient experiences with VC. This review explores adult patients’ experiences of VC.

Methods: A systematic literature search was conducted for studies published between 2011 and 2024 and reported according to the PRISMA statement. Study quality was assessed using the CASP checklist, and data were analysed through thematic synthesis. Confidence in the findings was evaluated using GRADE-CERQual.

Results: In total, 3203 unique studies were retrieved; 13 were included in the final synthesis, resulting in four main themes: (1) suitable for less complex issues when technical problems can be solved; (2) feeling secure, relaxed, and having mutual focus in an equitable partnership; (3) limitations regarding personal needs and practical help; and (4) increased vulnerability and lack of emotional feedback.

Conclusion: VC is experienced as ideal for managing less complex issues but is challenging for emotional topics due to technical concerns. It empowers patients by providing a neutral place for focused conversations but can create vulnerability and distance that can challenge the patient–professional relationship. Success requires technological adaptation, sufficient time during VC, and emotional support. VC should complement – not replace – traditional care, with its use determined in dialogue with patients.

Background: This study, conducted across three distinct geographical regions in Sweden, highlights the diverse conditions and challenges in healthcare provision. The study focuses on the sparsely populated northern regions of Sweden, the capital city of Stockholm, and the southeast rural area of Sweden. Each location presents unique obstacles to continuity of care, influenced by factors such as population density and geographical disparities. By examining the experiences of patients with complex care needs, their family carers, and healthcare personnel, this study aims to describe the conditions for and identify potential solutions associated with the delivery of continuity in care in different geographical regions of Sweden, with differing population densities.

Method: Secondary analysis was conducted using qualitative content analysis on interview data from two studies, consisting of 53 transcripts from individual, pair, and focus group interviews held between August 2018 and November 2019. The potential solutions identified from participants’ experiences were categorized into region-specific and common themes. Three personas—Vera, Bo, and Inga—were developed, each representing a scenario based on the region-specific analyses.

Results: Despite regional differences, universal solutions to common challenges were identified focusing on relational, management, and informational aspects. Common key obstacles to continuity of care included resource shortages, insufficient information transfer, and privacy regulations. Possible solutions for overcoming these challenges include prioritizing relational continuity, streamlining processes, and advocating for a unified communication system. By collaborating, building trust, understanding patient preferences, and ensuring clear communication, healthcare personnel can effectively promote continuity of care.

Conclusions: Building a stable workforce while prioritizing relational continuity, along with patients’ preferences and needs, is essential for ensuring continuity of care from multiple providers. Digital solutions can enhance collaboration across distances, while coordinating responsibilities within smaller geographical areas can strengthen partnerships among healthcare organizations. Direct dialogue, along with ensuring that everyone has access to relevant information through a unified communication system, is vital for management continuity. By integrating these universal and transferable solutions to the obstacles associated with continuity of care, we can create a cohesive care experience for patients, regardless of geographical and demographic conditions.

Introduction: Medication-related problems (MRPs) are common among older adults. The global population is ageing and there are health-related challenges linked to ageing in rural areas. Home-living rural older adults often face barriers to access healthcare, like long distances to healthcare services and poor continuity of care. Telepharmacy is the remote provision of pharmaceutical care, and telepharmacy could be of particular importance for rural older adults to improve their access to clinical pharmacy services and reduce the incidence of MRPs. The objective of this study is to develop and evaluate a novel telepharmacy service in primary care for home-living older adults in Northern Sweden’s rural areas. The primary objective is to evaluate the effect of the telepharmacy service regarding the identification, classification and resolution of MRPs.

Methods and analysis: This study will be conducted as a single-arm interventional study. A total of 100 people ≥65 years will receive the telepharmacy service for 12 weeks. The key principles of the telepharmacy service are to perform medication interviews and follow-up meetings with study participants, to conduct structured medication reviews, to conduct regular electronic medical record reviews and to have interprofessional collaboration with primary care physicians. All meetings will be conducted through video conferencing via a secure virtual care platform. Identified MRPs will be classified, and the acceptance rate of the pharmacists’ recommendations will be evaluated. The results will be presented with descriptive statistics. As secondary objectives, intra-individual changes in participants’ medication adherence, health-related quality of life and beliefs about medicines will be assessed through self-report questionnaires. Statistical analysis will be conducted using two-sided McNemar’s tests. Semi-structured interviews will also be conducted to explore participants’ and healthcare professionals’ experiences and attitudes towards this telepharmacy service.

Ethics and dissemination: This study has been granted ethical approval by the Swedish Ethical Review Authority (registration number 2022-03819-01 and 2024-08441-02). Participant informed consent is required. The results will be published in peer-reviewed journals and presented at scientific conferences.

Introduction: The implementation of telehealth began globally before the onset of COVID-19 but the use of telehealth, particularly video consultations (VCs), is expected to have increased with pandemic restrictions on face-to-face consultations (FTFCs). However, little is known about its actual usage. In Sweden, VCs have the potential to bridge long distances between Registered Dietitians (RDs) and their patients. This study investigates the use and perceptions of VCs among Swedish RDs before and after the onset of COVID-19.

Methods: Swedish RDs were invited to participate in web-based surveys in 2016 (n = 61) and 2021 (n = 112). Data are analysed and later discussed through the lens of Levesque et al.'s framework for patient-centred access to healthcare.

Results: More RDs reported having VC-experience in 2021 compared to the 2016 survey, 67% and 16% respectively. A majority of the RDs (85%-88%) believed that access to dietetic care would increase with the use of VCs compared to FTFCs. In 2021, about half of RDs (55% and 46%) perceived treatment quality and relational quality to be unaffected by VCs, while approximately one-third (31% and 43%) saw it as being reduced. With their additional experience, there was the caution by 69% of RDs in 2021 that consultations requiring language interpretation services were less suitable for VCs.

Conclusions: The findings suggest broader VC usage among Swedish RDs participating in the study. Implications for clinical practice include maintained access to healthcare and further practice development to meet quality needs and increased equity.

A school's culture has been shown to influence medical students in their choice of future discipline. Therefore, we aimed to explore the culture towards the general practice discipline, as reflected in comments to medical students from their teachers and clinical tutors. Students in their 6th and 11th terms at the Universities of Umeå and Uppsala participated in a questionnaire study. A qualitative analysis of free-text answers of comments was conducted with thematic analysis. The students reported receiving both appreciative and deprecatory comments about general practice and GPs, which altogether ended up in two head themes: work-related factors and opinions about GPs. Appreciative comments included "important", "varying", "responsible work", "broad skills", and "good working hours". Deprecatory comments included "stressful jobs", "unstimulating routine work", "incompetent doctors", and "low status". Considering the present shortfall of GPs, such deprecatory comments are worrying and could hamper the future recruitment of GPs.

Background: Delivering emergency care in rural areas can be challenging, but video consultation (VC) offers opportunities to make healthcare more accessible. The communication and relationship between professionals and patients have a significant impact on the patient’s experience of safety and inclusion. Understanding the patient perspective is crucial to developing good quality healthcare, but little is known about patient experiences of emergency care via VC in a rural context. The aim of this study was to explore patient experiences of emergency care via VC in northern rural Sweden.

Methods: Using a qualitative approach, semi- structured interviews (n = 12) were conducted with individuals aged 18—89 who had received emergency care with a registered nurse (RN) on site and VC with a general practitioner (GP). The interviews were conducted between October 2021 and March 2023 at community hospitals (n = 7) in Västerbotten County, Sweden. Interviews were analysed with content analysis.

Results: The analysis resulted in main categories (n = 2), categories (n = 5) and subcategories (n = 20). In the main category, “We were a team of three”, patients described a sense of inclusion and ability to contribute. The patients perceived the interaction between the GP and RN to function well despite being geographically dispersed. Patients highly valued the opportunity to speak directly to the GP. In the main category, “VC was a two-sided coin”, some experienced the emergency care through VC to be effective and smooth, while some felt that they received a lower quality of care and preferred face-to-face consultation with the GP. The quality of the VC was highly dependent on the RN’s ability to function as the hub in the emergency room.

Conclusion: Patients in rural areas perceived being included in 'the team' during VC, however they experienced disadvantages with the system on individual basis. The nursing profession plays an important role, and a proper educational background is crucial to support RNs in their role as the hub of the visit. The GP’s presence via VC was seen as important, but to fully enable them to fulfil their commitments as medical professionals, VC needs to be further improved with education and support from technical devices.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma.

Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed.

Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems.

Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.